Impaired bone microarchitecture at the distal radius in older men with low muscle mass and grip strength: The STRAMBO study

Szulc, Paweł; Blaizot, Stéphanie; Boutroy, Stéphanie; Vilayphiou, Nicolas; Boonen, Steven; Chapurlat, Roland

doi:10.1002/jbmr.1726

Cited by 51 publications

(57 citation statements)

References 51 publications

(92 reference statements)

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“…Further studies are required to determine the mechanisms by which low lean mass influences fracture. (40)(41)(42) This is further supported by a recent study showing independent relationships between ALM/height 2 and bone microarchitecture including cortical area and thickness in older men and women. For instance, low lean mass may act on fracture through falls' risk.…”

Section: Discussionsupporting

confidence: 71%

Low Lean Mass Predicts Incident Fractures Independently From FRAX: a Prospective Cohort Study of Recent Retirees

Hars

Biver

Chevalley

et al. 2016

Journal of Bone and Mineral Research

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Whether low muscle mass predisposes to fracture is still poorly understood. In the diagnosis of sarcopenia, different thresholds for low lean mass have been proposed but comparative data for these criteria against hard outcomes such as fractures are lacking. This study aimed to investigate the prevalence of low lean mass according to different thresholds used in operational definitions of sarcopenia and their association with 3-year fracture incidence in a cohort of healthy 63- to 67-year-old community dwellers. In a longitudinal analysis of 913 participants (mean age 65.0 ± 1.4 years) enrolled in the Geneva Retirees Cohort (GERICO) study, lean mass was assessed by dual-energy X-ray absorptiometry (DXA), and low trauma clinical fracture incidence was recorded over a 3-year period. Prevalence of low lean mass ranged from 3.5% to 20.2% according to the threshold applied. During a follow-up of 3.4 ± 0.9 years, 40 (4.4%) participants sustained at least one low trauma fracture. After multivariate adjustment including Fracture Risk Assessment Tool (FRAX) probability with femoral neck bone mineral density (BMD), low lean mass, as defined by Baumgartner thresholds, was associated with higher fracture risk (odds ratio [OR], 2.32; 95% CI, 1.04 to 5.18; p = 0.040). It also added significant predictive value beyond FRAX (likelihood ratio test for nested models, 4.28; p < 0.039). No significant association was found for other definition thresholds. The coexistence of sarcopenia and a T-score <-2.5 at spine or hip was associated with a 3.39-fold (95% CI, 1.54 to 7.46; p = 0.002) increase in low trauma fracture risk. In conclusion, low lean mass, as defined by the Baumgartner thresholds, is a predictor of incident fractures in a large cohort of healthy 65-year-old community dwellers, independently of FRAX probability. The increased risk is related to the threshold for low lean mass selected. These findings suggest that identification of sarcopenia should be considered in fracture risk assessment beyond usual risk factors. © 2016 American Society for Bone and Mineral Research.

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Section: Discussionsupporting

confidence: 71%

Low Lean Mass Predicts Incident Fractures Independently From FRAX: a Prospective Cohort Study of Recent Retirees

Hars

Biver

Chevalley

et al. 2016

Journal of Bone and Mineral Research

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“…In humans, conditions that result in a marked loss of muscle volume and strength in adults or poor accretion in children, such as spinal cord injury [25] and cerebral palsy [16], are associated with impaired trabecular bone architecture. Moreover, diminished trabecular bone architecture is associated with low muscle volume and low muscle strength [27]. In addition, relationships between appendicular muscle volume predicted by dual-energy X-ray absorptiometry and measures of trabecular bone architecture have been observed in men and women 20–97 years of age [28].…”

Section: Discussionmentioning

confidence: 99%

Muscle volume is related to trabecular and cortical bone architecture in typically developing children

Bajaj

Allerton

Kirby

et al. 2015

Bone

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Introduction Muscle is strongly related to cortical bone architecture in children; however, the relationship between muscle volume and trabecular bone architecture is poorly studied. The aim of this study was to determine if muscle volume is related to trabecular bone architecture in children and if the relationship is different than the relationship between muscle volume and cortical bone architecture. Materials and methods Forty typically developing children (20 boys and 20 girls; 6 to 12 y) were included in the study. Measures of trabecular bone architecture [apparent trabecular bone volume to total volume (appBV/TV), trabecular number (appTb.N), trabecular thickness (appTb.Th), and trabecular separation (appTb.Sp)] in the distal femur, cortical bone architecture [(cortical volume, medullary volume, total volume, polar moment of inertia (J) and section modulus (Z)] in the midfemur, muscle volume in the midthigh and femur length were assessed using magnetic resonance imaging. Total and moderate-to-vigorous physical activity were assessed using an accelerometer-based activity monitor worn around the waist for four days. Calcium intake was assessed using diet records. Relationships among the measures were tested using multiple linear regression analysis. Results Muscle volume was moderately-to-strongly related to measures of trabecular bone architecture [appBV/TV (r = 0.81, appTb.N (r = 0.53), appTb.Th (r = 0.67), appTb.Sp (r = −0.71; all p < 0.001] but more strongly related to measures of cortical bone architecture [cortical volume (r = 0.96), total volume (r = 0.94), Z (r = 0.94) and J (r = 0.92; all p < 0.001)]. Similar relationships were observed between femur length and measures of trabecular (p < 0.01) and cortical (p < 0.001) bone architecture. Sex, physical activity and calcium intake were not related to any measure of bone architecture (p > 0.05). Because muscle volume and femur length were strongly related (r = 0.91, p < 0.001), muscle volume was scaled for femur length (muscle volume/femur length2.77). When muscle volume/femur length2.77 was included in a regression model with femur length, sex, physical activity and calcium intake, muscle volume/femur length2.77 was a significant predictor of appBV/TV, appTb.Th and appTb.Sp (partial r = 0.44 to 049, p < 0.05) and all measures of cortical bone architecture (partial r = 0.47 to 054; p < 0.01). Conclusions The findings suggest that muscle volume in the midthigh is related to trabecular bone architecture in the distal femur of children. The relationship is weaker than the relationship between muscle volume in the midthigh and cortical bone architecture in the midfemur, but the discrepancy is driven, in large part, by the greater dependence of cortical bone architecture measures on femur length.

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“…Another traditional measure, grip strength, has been shown to be a good predictor of morbidity, mortality, and bone health 17, 18. A study in men aged 60 years and over has demonstrated that men in the lowest grip strength quartile had lower total volumetric bone mineral density (vBMD), cortical area (Ct.area), and cortical thickness (measured with pQCT) at the radius vs. men in the highest quartile 19. Jump force assessed by jumping mechanography has been shown to be positively correlated with cortical bone area and cortical thickness in men aged 25–45 years,20 suggesting that the force generated by muscle contractions has a positive effect on cortical bone parameters.…”

Section: Introductionmentioning

confidence: 99%

Associations of muscle force, power, cross‐sectional muscle area and bone geometry in older UK men

Zengin

Pye

Cook

et al. 2017

J cachexia sarcopenia muscle

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BackgroundAgeing is associated with sarcopenia, osteoporosis, and increased fall risk, all of which contribute to increased fracture risk. Mechanically, bone strength adapts in response to forces created by muscle contractions. Adaptations can be through changes in bone size, geometry, and bending strength. Muscle mass is often used as a surrogate for muscle force; however, force can be increased without changes in muscle mass. Increased fall risk with ageing has been associated with a decline in muscle power—which is a measure of mobility. The aims of this study were as follows: (i) to investigate the relationship between muscle parameters in the upper and lower limbs with age in UK men and the influence of ethnicity on these relationships; (ii) to examine the relationships between jump force/grip strength/cross‐sectional muscle area (CSMA) with bone outcomes at the radius and tibia.MethodsWhite European, Black Afro‐Caribbean, and South Asian men aged 40–79 years were recruited from Manchester, UK. Cortical bone mineral content, cross‐sectional area, cortical area, cross‐sectional moment of inertia, and CSMA were measured at the diaphysis of the radius and tibia using peripheral quantitative computed tomography. Lower limb jump force and power were measured from a single two‐legged jump performed on a ground‐reaction force platform. Grip strength was measured using a dynamometer. Associations between muscle and bone outcomes was determined using linear regression with adjustments for age, height, weight, and ethnicity.ResultsThree hundred and one men were recruited. Jump force was negatively associated with age; for every 10 year increase in age, there was a 4% reduction in jump force (P < 0.0001). There was a significant age–ethnicity interaction for jump power (P = 0.039); after adjustments, this was attenuated (P = 0.088). For every 10 year increase in age, grip strength decreased by 11%. Jump force was positively associated with tibial bone outcomes: a 1 standard deviation greater jump force was associated with significantly higher cortical bone mineral content 3.1%, cross‐sectional area 4.2%, cortical area 3.4%, and cross‐sectional moment of inertia 6.8% (all P < 0.001). Cross‐sectional muscle area of the lower leg was not associated with tibial bone outcomes. Both grip strength and CSMA of the arm were positively associated, to a similar extent, with radius diaphyseal bone outcomes.ConclusionsJump force and power are negatively associated with age in UK men. In the lower limb, the measurement of jump force is more strongly related to bone outcomes than CSMA. It is important to consider jump force and power when understanding the aetiology of bone loss and mobility in ageing men.

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Impaired bone microarchitecture at the distal radius in older men with low muscle mass and grip strength: The STRAMBO study

Cited by 51 publications

References 51 publications

Low Lean Mass Predicts Incident Fractures Independently From FRAX: a Prospective Cohort Study of Recent Retirees

Low Lean Mass Predicts Incident Fractures Independently From FRAX: a Prospective Cohort Study of Recent Retirees

Muscle volume is related to trabecular and cortical bone architecture in typically developing children

Associations of muscle force, power, cross‐sectional muscle area and bone geometry in older UK men

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