Original Article

Osteoporosis International

, Volume 18, Issue 10, pp 1371-1378

Muscle mass deficits are associated with bone mineral density in men with idiopathic vertebral fracture

  • J. H. MacdonaldAffiliated withSchool of Sport, Health and Exercise Sciences, University of Wales Email author 
  • , S. F. EvansAffiliated withCharles Salt Centre, Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Trust
  • , M. W. J. DavieAffiliated withCharles Salt Centre, Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Trust
  • , C. A. SharpAffiliated withCharles Salt Centre, Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Trust

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Abstract

Introduction and hypothesis

The causes of idiopathic vertebral fractures (IVF) in men are poorly understood. We hypothesised that in IVF, areal bone mineral density (aBMD) deficits would be associated with reduced muscle mass.

Methods

In this case-control study, 48 men (61.5 ± 12.1 years old) presenting with symptomatic IVF were compared with 48 healthy controls matched for age (±5 years) and stature (±5 cm). The aBMD and soft-tissue body composition were determined by dual energy X-ray absorptiometry (DXA). Muscle mass was defined as the ratio of appendicular lean mass to the square of height (ALMI). Sex hormones, IGF-I and its binding protein IGFBP-3 were measured by immunoassay.

Results

ALMI was significantly lower in IVF patients (8.27 ± 0.90 vs 8.65 ± 0.88 kg/m2, t = 2.193, df = 47, P = 0.033 by paired sample t-test). Hierarchical regression analysis revealed that for IVF patients, ALMI explained the greatest proportion of variance in BMD at the lumbar spine, femoral neck and total hip (R 2 change = 16.4–22.7%, P = 0.012–0.002) and only IGFBP-3 explained variance in ALMI (R 2 change = 19.9%, P = 0.006).

Conclusions

In men with IVF, ALMI was reduced and associated with IGFBP-3. ALMI was identified as a novel factor that explained a greater proportion of variance in BMD than either fat mass or serum biochemistry.

Keywords

Body composition Bone density Idiopathic vertebral fracture IGFBP-3 Men Muscle mass