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Decreased lower-extremity muscle performance is associated with decreased hip bone mineral density and increased estimated fracture risk in community-dwelling postmenopausal women

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Abstract

Summary

The present study demonstrated that the lower-extremity muscle performance in Chinese community-dwelling postmenopausal women with lower bone mineral density (BMD) was positively associated with hip BMD and negatively associated with estimated fracture risk.

Purpose

Postmenopausal women are at high risk for osteoporotic fractures. It has been shown that decreased lower-extremity muscle performance is associated with osteoporotic fractures. However, the relationship between muscle performance and bone mineral density in postmenopausal women is inconsistent in the literature. The present study was to investigate the relationship between lower-extremity muscle performance and BMD or estimated fracture risk in community-dwelling postmenopausal women.

Methods

Two hundred forty-seven postmenopausal women aged 50–85 years were recruited in the study. The short physical performance battery (SPPB) tool including the chair stand test (CST), gait speed test (GST), and balance test (BT) was used to determine lower-extremity functioning and the CST, GST, BT, and SPPB total scores were recorded. The BMD of lumbar spine (LSBMD), femoral neck (FNBMD), and total hip (THBMD) were measured by dual-energy X-ray absorptiometry (DXA), and the vertebral fracture was confirmed by lateral spine X-rays radiographs. In addition, patients’ 10-year estimated major osteoporotic fracture risk (MOFR) and hip fracture risk (HFR) were assessed by the Fracture Risk Assessment Tool (FRAX). Linear regression analysis was used to analyze the association between muscle performance and BMD.

Results

The CST, GST, and SPPB total scores were positively associated with LSBMD, THBMD, and FNBMD before adjustment for age, height, and weight. The SPPB total score was positively associated with FNBMD and THBMD, but not with LSBMD after adjustment for age, height, and weight. The BT score was positively associated with FNBMD and THBMD, but not with LSBMD before and after adjustment for age, height, and weight. Moreover, the CST, GST, BT, and SPPB scores were negatively associated with the FRAX score.

Conclusion

The lower-extremity muscle performance in community-dwelling postmenopausal women is positively associated with FNBMD and THBMD and negatively associated with the FRAX score.

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Data availability

All data generated or analyzed during this study are included in this published article.

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Acknowledgments

We thank the following participating for their contribution in subject recruitment: Qiongfei Zhou, Danlei Yu, Lihong Peng, Rui Fang, Shuying Liu, Lusha Li, Rong Chen, Ting Zhu, and Zhe Zhou.

Funding

This work was supported by funding from The National Natural Science Foundation of China [grant number 81072219, 81272973, 81471055, and 81672646].

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Authors and Affiliations

  1. National Clinical Research Center for Metabolic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, and Department of Endocrinology and Metabolism, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China

    Dexing Dai, Feng Xu, Ruoman Sun, Lingqing Yuan, Zhifeng Sheng & Zhongjian Xie

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  1. Dexing Dai
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  2. Feng Xu
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  3. Ruoman Sun
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Contributions

Dexing Dai, Lingqing Yuan, Zhifeng Sheng, and Zhongjian Xie contributed to conception and design. Dexing Dai, Feng Xu, and Ruoman Sun acquired the data. Dexing Dai and Feng Xu contributed to the analysis and interpretation of data. All authors contributed toward data drafting and critically revising the paper, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

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Correspondence to Zhongjian Xie.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Ethics Committee of the Second Xiangya Hospital.

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Informed consent was obtained from all individual participants included in the study.

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Dai, D., Xu, F., Sun, R. et al. Decreased lower-extremity muscle performance is associated with decreased hip bone mineral density and increased estimated fracture risk in community-dwelling postmenopausal women. Arch Osteoporos 15, 173 (2020). https://doi.org/10.1007/s11657-020-00835-z

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