医学
定量计算机断层扫描
骨矿物
前瞻性队列研究
内科学
骨密度
瘦体质量
队列
人口
骨小梁评分
骨质疏松症
物理疗法
体重
环境卫生
作者
Philippe Paul Wagner,Danielle E. Whittier,Dominique Foesser,Steven K. Boyd,Roland Chapurlat,Pawel Szulc
标识
DOI:10.1210/clinem/dgab506
摘要
High fracture risk in individuals with low muscle strength is attributed to high risk of falls.This work aims to study the association of muscle mass and physical performance with bone microarchitecture decline and risk of fall and nonvertebral fracture in men.A prospective, 8-year follow-up of a cohort was conducted among the general population. A total of 821 volunteer men aged 60 and older participated. Hip areal bone mineral density (aBMD) and appendicular lean mass (ALM) were assessed at baseline by dual x-ray absorptiometry. Lower-limb relative ALM (RALM-LL) is ALM-LL/(leg length)2. The physical performance score reflects the ability to perform chair stands and static and dynamic balance. Bone microarchitecture was assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT) at baseline and after 4 and 8 years. Statistical analyses were adjusted for shared risk factors. Outcome measurements included the rate of change in the HR-pQCT indices, incident falls, and fractures.Cortical bone loss and estimated bone strength decline were faster in men with low vs normal RALM-LL (failure load: -0.74 ± 0.09 vs -0.43 ± 0.10%/year; P < .005). Differences were similar between men with poor and those with normal physical performance (failure load: -1.12 ± 0.09 vs -0.40 ± 0.05%/year; P < .001). Differences were similar between men having poor performance and low RALM-LL and men having normal RALM-LL and performance (failure load: -1.40 ± 0.17 vs -0.47 ± 0.03%/year; P < .001). Men with poor physical performance had a higher risk of fall (hazard ratio [HR] = 3.52; 95% CI, 1.57-7.90, P < .05) and fracture (HR = 2.68; 95% CI, 1.08-6.66, P < .05).Rapid decline of bone microarchitecture and estimated strength in men with poor physical performance and low RALM-LL may contribute to higher fracture risk.
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