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Association between handgrip strength and subsequent vertebral-fracture risk following percutaneous vertebral augmentation

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Abstract

Introduction

The aim of this study was to investigate the association between handgrip strength (HGS) and the risk of subsequent vertebral fracture (SVF) after percutaneous vertebral augmentation (PVA).

Materials and methods

A total of 340 patients aged over 50 years with osteoporotic vertebral fracture were enrolled in this 3-year follow-up investigation. HGS was measured with a hand-held dynamometer before PVA. Female patients and male patients were grouped using the HGS threshold recommended by the Asian Working Group for Sarcopenia (AWGS). Kaplan–Meier analysis was used to evaluate SVF-free survival. The hazard ratios (HRs) of HGS for SVF events were estimated with the Cox proportional hazards model.

Results

During the follow-up period, a total of 93 patients (27.4%) experienced SVF. Kaplan–Meier analysis showed that the HGS of female patients < 18.0 kg and male patients < 28 kg was significantly associated with lower SVF-free survival (female patients: p < 0.001, male patients: p = 0.038; log-rank test). Among women, each 1-kg increase in HGS was associated with a 9% lower risk of SVF (HR 0.91, p = 0.035) after adjustment for potential risk factors. Among men, although the associations between low HGS and increased risk of SVF were significant in the crude model (HR 0.79, p < 0.001), this significance disappeared after adjustment for bone mineral density of the femoral neck.

Conclusions

Low HGS was significantly associated with lower SVF-free survival among elderly patients who underwent single-level PVA for osteoporotic vertebral fracture.

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Acknowledgements

Primary Funding Source: This work was funded by the National Natural Science Foundation of China (81572181). This work was also funded by a Municipal Human Resources Development Program for Outstanding Young Talents in Medical and Health Sciences in Shanghai (2017YQ070) and Key Discipline Construction Project of Pudong Health Bureau of Shanghai (PWZxk2017-08).

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Author notes

  1. Shu-Bao Zhang and Hao Chen are co-first authors.

  2. Shan-Jin Wang and Hao-Wei Xu are co-corresponding authors.

Authors and Affiliations

  1. Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150# Jimo RD, Pudong New Area, Shanghai, 200120, China

    Shu-Bao Zhang, Hao Chen, Hao-Wei Xu, Yu-Yang Yi, Shan-Jin Wang & De-Sheng Wu

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Contributions

All authors contributed to the study conception and design. S-JW and H-WX initiated the idea, did the data analysis, the first draft of the manuscript was written by S-BZ and HC. Y-YY supervised and reviewed the manuscript. D-SW gathered the data and helped with the data analysis and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Hao-Wei Xu or Shan-Jin Wang.

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Zhang, SB., Chen, H., Xu, HW. et al. Association between handgrip strength and subsequent vertebral-fracture risk following percutaneous vertebral augmentation. J Bone Miner Metab 39, 186–192 (2021). https://doi.org/10.1007/s00774-020-01131-z

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  • DOI: https://doi.org/10.1007/s00774-020-01131-z

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