Bone strength and muscle properties in postmenopausal women with and without a recent distal radius fracture
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Distal radius (wrist) fracture (DRF) in women over age 50 years is an early sign of bone fragility. Women with a recent DRF compared to women without DRF demonstrated lower bone strength, muscle density, and strength, but no difference in dual-energy x-ray absorptiometry (DXA) measures, suggesting DXA alone may not be a sufficient predictor for DRF risk.
The objective of this study was to investigate differences in bone and muscle properties between women with and without a recent DRF.
One hundred sixty-six postmenopausal women (50–78 years) were recruited. Participants were excluded if they had taken bone-altering medications in the past 6 months or had medical conditions that severely affected daily living or the upper extremity. Seventy-seven age-matched women with a fracture in the past 6–24 months (Fx, n = 32) and without fracture (NFx, n = 45) were measured for bone and muscle properties using the nondominant (NFx) or non-fractured limb (Fx). Peripheral quantitative computed tomography (pQCT) was used to estimate bone strength in compression (BSIc) at the distal radius and tibia, bone strength in torsion (SSIp) at the shaft sites, muscle density, and area at the forearm and lower leg. Areal bone mineral density at the ultradistal forearm, spine, and femoral neck was measured by DXA. Grip strength and the 30-s chair stand test were used as estimates of upper and lower extremity muscle strength. Limb-specific between-group differences were compared using multivariate analysis of variance (MANOVA).
There was a significant group difference (p < 0.05) for the forearm and lower leg, with the Fx group demonstrating 16 and 19 % lower BSIc, 3 and 6 % lower muscle density, and 20 and 21 % lower muscle strength at the upper and lower extremities, respectively. There were no differences between groups for DXA measures.
Women with recent DRF had lower pQCT-derived estimated bone strength at the distal radius and tibia and lower muscle density and strength at both extremities.
KeywordsDistal radius fracture Dual-energy x-ray absorptiometry (DXA) Musculoskeletal properties Peripheral quantitative computed tomography (pQCT)
We would like to acknowledge the funding from the Saskatchewan Health Research Foundation (SHRF) for the support of the Bone and Joint Imaging Group and their research at the University of Saskatchewan and to thank all the volunteers for their participation in the study. We would also like to thank Blanc Star, Valerie Wellans, Lauren Lattimer, Heidi Hunt, and Emma Burke for their assistance with data collection.
Conflicts of interest
Katie Crockett, Catherine M. Arnold, Jonathan P. Farthing, Philip D. Chilibeck, James D. Johnston, Brenna Bath, Adam D.G. Baxter-Jones, and Saija A. Kontulainen declare that they have no conflict of interest.
- 2.Osteoporosis Canada (2013) Make the first break the last with fracture liason services. http://www.osteoporosis.ca/wp-content/uploads/FLS-TOOLKIT.pdf. Accessed 5 April 2015
- 3.International Osteoporosis Foundation (2012) Capture the fracture: a global campaign to break the fragility fracture cycle. http://share.iofbonehealth.org/WOD/2012/report/WOD12-Report.pdf. Accessed 5 April 2015
- 12.Sheu Y, Zmuda JM, Boudreau RM, Petit MA, Ensrud KE, Bauer DC, Gordon CL, Orwoll ES, Cauley JA (2011) Bone strength measured by peripheral quantitative computed tomography and the risk of nonvertebral fractures: the osteoporotic fractures in men (MrOS) study. J Bone Miner Res 26:63–71PubMedCentralCrossRefPubMedGoogle Scholar
- 22.Lafayette Instrument Company (2004) Jamar hydrolic hand dynamometer user instructions. https://www.chponline.com/store/pdfs/j-20.pdf. Accessed 5 April 2015
- 25.McLean RR, Shardell MD, Alley DE et al (2014) Criteria for clinically relevant weakness and low lean mass and their longitudinal association with incident mobility impairment and mortality: the Foundation for the National Institutes of Health (FNIH) sarcopenia project. J Gerontol A Biol Sci Med Sci 69:576–583PubMedCentralCrossRefPubMedGoogle Scholar
- 27.Rikli RE, Jones CJ (2001) Senior fitness test manual. Human Kinetics, ChampaignGoogle Scholar
- 32.International Society for the Advancement of Kinanthropometry (2001) International standards for anthropometric assessment. http://www.ceap.br/material/MAT17032011184632.pdf. Accessed 5 April 2015
- 35.Chilibeck PD, Vatanparast H, Pierson R, Case A, Olatunbosun O, Whiting SJ, Beck TJ, Pahwa P, Biem HJ (2013) Effect of exercise training combined with isoflavone supplementation on bone and lipids in postmenopausal women: a randomized clinical trial. J Bone Miner Res 28:780–793CrossRefPubMedGoogle Scholar
- 43.Rozental TD, Deschamps LN, Taylor A, Earp B, Zurakowski D, Day CS, Bouxsein ML (2013) Premenopausal women with a distal radial fracture have deteriorated trabecular bone density and morphology compared with controls without a fracture. J Bone Joint Surg Am 95:633–642PubMedCentralCrossRefPubMedGoogle Scholar
- 47.Kontulainen S, Sievanen H, Kannus P, Pasanen M, Vuori I (2002) Effect of long-term impact-loading on mass, size, and estimated strength of humerus and radius of female racquet-sports players: a peripheral quantitative computed tomography study between young and old starters and controls. J Bone Miner Res 17:2281–2289CrossRefPubMedGoogle Scholar