Lean mass and lower limb muscle function in relation to hip strength, geometry and fracture risk indices in community-dwelling older women

Ahmed Elhakeem*, April Hartley, Yunhua Luo, Andrew Goertzen, Kimberly Hannam, Emma Clark, William Leslie, Jonathan Tobias

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

10 Citations (Scopus)
277 Downloads (Pure)

Abstract

In a population-based sample of British women aged over 70 years old, lean mass and peak lower limb muscle force were both independently associated with hip strength and fracture risk indices, thereby suggesting a potential benefit of promoting leg muscle strengthening exercise for the prevention of hip fractures in postmenopausal women.

INTRODUCTION: To investigate cross-sectional associations of lean mass and physical performance, including lower limb muscle function, with hip strength, geometry and fracture risk indices (FRIs) in postmenopausal women.

METHODS: Data were from the Cohort of Skeletal Health in Bristol and Avon. Total hip (TH) and femoral neck (FN) bone mineral density (BMD), hip geometry and total body lean mass (TBLM) were assessed by dual x-ray absorptiometry (DXA). Finite element analysis of hip DXA was used to derive FN, intertrochanteric and subtrochanteric FRIs. Grip strength, gait speed and chair rise time were measured objectively. Lower limb peak muscle force and muscle power were assessed by jumping mechanography.

RESULTS: In total, 241 women were included (age = 76.4; SD = 2.6 years). After adjustment for age, height, weight/fat mass and comorbidities, TBLM was positively associated with hip BMD (β TH BMD  = 0.36, P ≤ 0.001; β FN BMD  = 0.26, P = 0.01) and cross-section moment of inertia (0.24, P ≤ 0.001) and inversely associated with FN FRI (- 0.21, P = 0.03) and intertrochanteric FRI (- 0.11, P = 0.05) (estimates represent SD difference in bone measures per SD difference in TBLM). Lower limb peak muscle force was positively associated with hip BMD (β TH BMD  = 0.28, P ≤ 0.001; β FN BMD  = 0.23, P = 0.008) and inversely associated with FN FRI (- 0.17, P = 0.04) and subtrochanteric FRI (- 0.18, P = 0.04). Associations of grip strength, gait speed, chair rise time and peak muscle power with hip parameters were close to the null.

CONCLUSIONS: Lean mass and lower limb peak muscle force were associated with hip BMD and geometrical FRIs in postmenopausal women. Leg muscle strengthening exercises may therefore help prevent hip fractures in older women.

Original languageEnglish
Pages (from-to)211-220
Number of pages10
JournalOsteoporosis International
Volume30
Issue number1
Early online date14 Dec 2018
DOIs
Publication statusPublished - 14 Jan 2019

Keywords

  • Absorptiometry, Photon/methods
  • Adiposity/physiology
  • Aged
  • Aged, 80 and over
  • Anthropometry/methods
  • Body Composition/physiology
  • Bone Density/physiology
  • Female
  • Femur Neck/physiology
  • Hand Strength/physiology
  • Hip Fractures/etiology
  • Hip Joint/anatomy & histology
  • Humans
  • Independent Living
  • Leg/physiology
  • Muscle, Skeletal/physiology
  • Risk Assessment/methods

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