Muscle mass deficits are associated with bone mineral density in men with idiopathic vertebral fracture
- 109 Downloads
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.
KeywordsBody 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.
- 12.Johansson AG, Eriksen EF, Lindh E et al (1997) Reduced serum levels of the growth hormone-dependent insulin-like growth factor binding protein and a negative bone balance at the level of individual remodeling units in idiopathic osteoporosis in men. J Clin Endocrinol Metab 82:2795–2798PubMedCrossRefGoogle Scholar
- 17.Ongphiphadhanakul B, Rajatanavin R, Chailurkit L et al (1995) Serum testosterone and its relation to bone mineral density and body composition in normal males. Clin Endocrinol 43:727–733Google Scholar
- 27.Gallagher D, Ruts E, Visser M et al (2000) Weight stability masks sarcopenia in elderly men and women. Am J Physiol 279:366–375Google Scholar
- 28.Stevens JP (2002) Applied multivariate statistics for the social sciences, 4th ed. Lawrence Erlbaum Associates, LondonGoogle Scholar
- 31.Bhasin S, Woodhouse L, Casaburi R et al (2001) Testosterone dose-response relationships in healthy young men. Am J Physiol Endocrinol Metab 281:1172–1181Google Scholar
- 38.Lemmey AB, Glassford J, Flick-Smith HC et al (1997) Differential regulation of tissue insulin-like growth factor-binding protein (IGFBP)-3, IGF-I and IGF type 1 receptor mRNA levels, and serum IGF-I and IGFBP concentrations by growth hormone and IGF-I. J Endocrinol 154:319–328PubMedCrossRefGoogle Scholar
- 41.Haung C, Ross PD, Lydick E, Davis JW et al (1996) Contribution of vertebral fractures to stature loss among elderly Japanese-American women in Hawaii. J Bone Miner Res 11:408–411Google Scholar