Higher Hand Grip Strength Is Associated With Greater Radius Bone Size and Strength in Older Men and Women: The Framingham Osteoporosis Study

McLean, Robert R.; Samelson, Elizabeth J.; Lorbergs, Amanda L.; Broe, Kerry E; Hannan, Marian T.; Boyd, Steven K.; Bouxsein, Mary L.; Kiel, Douglas P.

doi:10.1002/jbm4.10485

Cited by 9 publications

(11 citation statements)

References 42 publications

(76 reference statements)

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Section: Discussionsupporting

confidence: 89%

“…Muscle strength was primarily associated with cortical thickness and area, which is in line with the previous observation that higher hand grip strength was associated with greater radius bone size and strength in elderly women and men. 28 It is interesting to note that the main effect of muscle strength was on the cortical compartment. This finding is supported by a previous bedrest study in which only the cortical thickness of the distal tibia was restored by physical activity countermeasures in women.…”

Section: Discussionmentioning

confidence: 99%

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Compartment‐specific effects of muscle strength on bone microarchitecture in women at high risk of osteoporosis

Simon

Schäfer

Schmidt

et al. 2022

J cachexia sarcopenia muscle

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Background It is well known that skeletal integrity is influenced by the musculature. Poor muscle strength (i.e. sarcopenia) is considered a major predictor of fragility fractures. While this observation appears particularly relevant for older women with increased risk of osteoporosis, there has been no comprehensive investigation to determine the influence of muscle performance on compartment-specific bone microarchitecture in multiple body regions. Methods We retrospectively analysed data from different muscle performance and bone microarchitecture assessments in 230 women (aged 21 to 87 years) at high risk of osteoporosis. Muscle performance tests included grip strength and chair rising test (CRT) combined with mechanography. Balance was determined by Romberg posturography. Areal bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA) at the hip and lumbar spine. Compartment-specific volumetric BMD, microarchitecture, and geometry were assessed by second-generation highresolution peripheral quantitative computed tomography (HR-pQCT) at multiple skeletal sites (distal radius, tibia, and fibula). Regression models were applied to test for interactions between muscle and bone parameters. Subgroups were defined to compare women with osteoporosis and osteosarcopenia regarding BMD and microarchitecture. Results While osteoporosis was diagnosed in 115/230 (50.0%) women, sarcopenia was detected in 38/230 (16.5%). Positive associations of both grip strength and CRT maximum force with cortical geometric and microarchitectural parameters were detected at all measured sites, with the strongest effect applying to CRT maximum force and tibial parameters (e.g. tibial cortical area R 2 = 0.36, P < 0.0001, and tibial cortical thickness R 2 = 0.26, P < 0.0001). Balance parameters showed much weaker or no associations with HR-pQCT parameters. Major associations between muscle strength and trabecular parameters could not be confirmed. Age and body mass index were confirmed as negative and positive predictors for several microarchitectural parameters, respectively. An independent predictive value of grip strength on radial, tibial, and fibular (all P < 0.01) cortical area and of CRT maximum relative force on cortical thickness (all P < 0.05) was revealed. Women with osteosarcopenia showed significantly reduced cortical HR-pQCT parameters but no differences in DXA values compared with women with osteoporosis but no sarcopenia. Stratification by fracture and treatment status revealed that vertebral fractures and denosumab treatment altered the muscle-bone interaction. Conclusions A systemic interaction between muscle strength and bone microarchitecture was demonstrated, and this interaction appears to be primarily with the cortical bone compartment. The value of muscle assessments in fracture risk evaluation may be partly mediated by their effects on bone microarchitecture.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Compartment‐specific effects of muscle strength on bone microarchitecture in women at high risk of osteoporosis

Simon

Schäfer

Schmidt

et al. 2022

J cachexia sarcopenia muscle

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“…A similar protective effect of hand grip strength on nonadjacent bones was also found in a Chile study including 1427 adolescent students ( 14) and a small Chinese study including 120 postmenopausal women (33). In terms of adjacent bone, Mclean et al analyzed the Framingham osteoporosis cohort including 1159 participants and found that higher hand grip strength was associated with higher radius bone size and strength but not volumetric BMD (34). The authors speculate that the unaffected BMD may be because larger bone has similar bone mineral content.…”

Section: Discussionsupporting

confidence: 52%

“…In terms of adjacent bone, Mclean et al. analyzed the Framingham osteoporosis cohort including 1159 participants and found that higher hand grip strength was associated with higher radius bone size and strength but not volumetric BMD ( 34 ). The authors speculate that the unaffected BMD may be because larger bone has similar bone mineral content.…”

Section: Discussionmentioning

confidence: 99%

Causal associations of hand grip strength with bone mineral density and fracture risk: A mendelian randomization study

et al. 2022

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BackgroundMuscle strength has been shown to exert positive effects on bone health. The causal relationship between hand grip strength and osteoporosis is an important public health issue but is not fully revealed. The goal of this study was to investigate whether and to what extent hand grip strength affects bone mineral density (BMD) and fracture risk.MethodsWe conducted a state-of-the-art two-sample Mendelian randomization analysis. Genomewide significant (P<5×10-8) single nucleotide polymorphisms associated with hand grip strength were obtained. Summary level data of BMD and fractures at different body sites (lumbar spine, heel, forearm and femoral neck) was obtained from a large-scale osteoporosis database. The inverse variance weighted method was the primary method used for analysis, and the weighted-median, MR-Egger were utilized for sensitivity analyses.ResultsThe results provided strong evidence that hand grip strength trait was causally and positively associated with lumbar spine BMD (β: 0.288, 95% CI: 0.079 to 0.497; P=0.007), while no causal relationship was found between hand grip strength and BMD at heel (β: -0.081, 95% CI: -0.232 to 0.070; P=0.295), forearm (β: 0.-0.101, 95% CI: -0.451 to 0.248; P=0.571) or femoral neck (β: 0.054, 95% CI: -0.171 to 0.278; P=0.639). In addition, no statistically significant effects were observed for hand grip strength on fracture risks (β: -0.004, 95% CI: -0.019 to 0.012; P=0.662).ConclusionsThis study showed a positive causal relationship between hand grip strength and lumbar BMD, which is the most common site of osteoporotic fracture, but did not find a causal relationship between hand grip strength and BMD of heel, forearm, or femoral neck. No statistically significant effect of hand grip strength on fracture risk was observed. This study indicates variations in the abilities of hand grip strength trait to causally influence BMD at different skeleton sites. These results should be considered in further studies and public health measures on osteoporosis prevention strategies.

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“…These associations are consistent with previous studies. 22,[43][44][45] This suggests that lower muscle function test performance may be "indirect" indicators of low bone strength (ie, impaired bone geometry and low aBMD). Furthermore, 5-STS and dynamometry are simple, quick, low cost, easy to apply, have good reproducibility, and can be used in a variety of clinical settings, making them ideal for outpatient clinics.…”

Section: Discussionmentioning

confidence: 99%

Relationship of sarcopenia with bone geometry and mass among postmenopausal women

et al. 2022

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Objective: The aim of this study was to verify whether sarcopenia and its components are associated with hip areal bone mineral density (aBMD) and geometry in postmenopausal women (PW).Methods: In this cross-sectional study, appendicular bone-free lean mass (aLM) and hip bone mass and geometry were measured using dual-energy x-ray emission absorptiometry (DXA). Muscle power and strength were measured by five times Sit-to-Stand Test (5-STS) and dynamometry, respectively, in 175 PW. Sarcopenia was identified as low aLM plus low muscle strength or low muscle power. Multiple linear regression (covaried by age, smoking, hormonal therapy, and diseases) was used to determine the relationship between sarcopenia and bone geometry and mass. The results are presented as mean differences between groups.Results: Dynamometry, five times Sit-to-Stand Test, and aLM indicated positive associations ( P < 0.05) with most indicators of bone mass and geometry. Sarcopenia, applying low muscle strength or low muscle power, was negatively associated with femoral neck width (−0.2 mm, P = 0.001), cortical thickness of femoral calcar (−0.6 mm, P = 0.043), subtrochanteric cortical thickness (−1.2 mm, P = 0.002), femoral neck cross-sectional area (−19.5 mm 2 , P < 0.001), cross-section moment of inertia (−2,244 mm 4 , P < 0.001), section modulus (−115 mm 3 , P < 0.001), femoral neck aBMD (−0.1 g/cm 2 , P = 0.002), upper femoral neck aBMD (−0.1 g/cm 2 , P = 0.003), lower femoral neck aBMD (−0.1 g/cm 2 , P = 0.016), and trochanteric aBMD (−0.1 g/cm 2 , P = 0.035).Conclusions: Thus, muscle mass, strength and power, alone or in combination (ie, sarcopenia), are associated with low aBMD, impaired bone geometry, and, therefore, bone strength in PW. These measures may help identify PW at risk of hip fractures.

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Higher Hand Grip Strength Is Associated With Greater Radius Bone Size and Strength in Older Men and Women: The Framingham Osteoporosis Study

Abstract: This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process which may lead to differences between this version and the Version of Record. Please cite this article as

Cited by 9 publications

References 42 publications

Compartment‐specific effects of muscle strength on bone microarchitecture in women at high risk of osteoporosis

Compartment‐specific effects of muscle strength on bone microarchitecture in women at high risk of osteoporosis

Causal associations of hand grip strength with bone mineral density and fracture risk: A mendelian randomization study

Relationship of sarcopenia with bone geometry and mass among postmenopausal women

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