Osteoporosis International

, Volume 18, Issue 10, pp 1371–1378 | Cite as

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

  • J. H. Macdonald
  • S. F. Evans
  • M. W. J. Davie
  • C. A. Sharp
Original Article


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.


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.


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 (R2change = 16.4–22.7%, P = 0.012–0.002) and only IGFBP-3 explained variance in ALMI (R2change = 19.9%, P = 0.006).


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.


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



We thank Mrs Helen Davies SSR, DCR(Diagnostic) for help with all aspects of DXA scanning. We also thank Mike Haddaway for helpful comments during preparation of the manuscript. We are grateful to the National Osteoporosis Society, Remedi and the Bone Disease Foundation for supporting our studies of osteoporosis in men. This work was undertaken at the Robert Jones & Agnes Hunt Orthopaedic & District Hospital NHS Trust, which received a proportion of its funding from the NHS Executive.

Supplementary material


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2007

Authors and Affiliations

  • J. H. Macdonald
    • 1
  • S. F. Evans
    • 2
  • M. W. J. Davie
    • 2
  • C. A. Sharp
    • 2
  1. 1.School of Sport, Health and Exercise SciencesUniversity of WalesBangor, GwyneddUK
  2. 2.Charles Salt CentreRobert Jones & Agnes Hunt Orthopaedic Hospital NHS TrustGobowenUK

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