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Associations between lean mass, muscle strength and power, and skeletal size, density and strength in older men

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Chalhoub D1, Boudreau R2, Greenspan S2, Newman AB2, Zmuda J2, Frank-Wilson AW1, Nagaraj N2, Hoffman AR3, Lane NE4, Stefanick ML3, Barrett-Connor E5, Dam T5,6, Cawthon P7, Orwoll E8, Cauley JA2; Osteoporotic Fractures in Men (MrOS) Study Research Group.. J Bone Miner Res. 2018 Apr 27. doi: 10.1002/jbmr.3458. [Epub ahead of print]


Author information

1 Intramural Research Program, Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, MD.

2 Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.

3 Stanford University School of Medicine, CA.

4 Center for Musculoskeletal Health, University of California, Davis School of Medicine.

5 Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA.

6 Division of Geriatrics and Aging, Columbia University, New York, NY.

7 California Pacific Medical Center, San Francisco, CA.

8 Oregon Health and Sciences University, Portland.


Studies examining the relationship between muscle parameters and bone strength have not included multiple muscle measurements and/or both central and peripheral skeletal parameters. The purpose of this study was to explore the relationship between lean mass, muscle strength and power, and skeletal size, bone density and bone strength. We studied the association between appendicular lean mass (ALM), grip strength and leg power, and central quantitative computed tomography (QCT) parameters in 2,857 men aged 65 or older; peripheral QCT was available on a subset (Nā€‰=ā€‰786). ALM, grip strength, and leg power were measured by dual-energy X-ray absorptiometry (DXA), Jamar dynamometer, and the Nottingham Power Rig, respectively. Multivariable models adjusting for potential confounders including age, race, study site, BMI, and muscle measurements were developed and least squares means were generated from linear regression models. For the multivariable model, percent differences of bone parameters between lowest (Q1) and highest quartiles (Q4) of ALM, grip strength, and leg power were reported. ALM was significantly associated with central and peripheral QCT parameters: percent higher values (Q4 vs Q1) ranging from 3.3% (cortical volumetric bone mineral density (vBMD) of the femoral neck) to 31% (vertebral strength index of the spine). Grip strength was only significantly associated with radial parameters: percent higher values (Q4 vs Q1) ranging from 2.5% (periosteal circumference) to 7.5% (33% axial strength index -SSIx). Leg power was associated with vertebral strength and lower cross-sectional area with percent lower values (Q4 vs Q1) of -11.9% and -2.7% respectively. In older men, stronger associations were observed for ALM compared to muscle strength and power. Longitudinal studies are needed to examine the relationship between independent changes in muscle measurements and skeletal size, density and strength.