Skip to main content

Advertisement

SpringerLink
Log in

Hand grip strength in predicting the risk of osteoporosis in Asian adults

  • Original Article
  • Published:
Journal of Bone and Mineral Metabolism Aims and scope Submit manuscript

Abstract

Introduction

There is a need for a cost-effective method to identify individuals with a high risk of osteoporosis. This study aimed to investigate the suitability of hand grip strength in predicting the risk of osteoporosis in Asian adults.

Materials and methods

In this cross-sectional, hospital-based study of 1007 participants, the bone mineral density of the spine and hips was evaluated using dual-energy X-ray absorptiometry according to the 2019 International Society for Clinical Densitometry official positions. Bone microarchitecture was evaluated using the trabecular bone score, and hand grip strength was measured in the dominant hand using a hand digital dynamometer.

Results

Hand grip strength was significantly related to bone density and bone microarchitecture. Moreover, hand grip strength was a significant predictor of osteoporosis in both women and men. For osteoporosis prediction in women, a threshold of 21.9 kg of hand grip strength had a sensitivity of 59%, specificity of 59%, and area under the curve (AUC) of 0.61. In men, a threshold of 28.7 kg had a sensitivity of 66%, specificity of 78%, and AUC of 0.75. The optimal cutoff strengths for osteoporosis depended on age and sex.

Conclusion

The measurement of hand grip strength is a simple, cost-effective and an easy assessment method for identifying individuals at a high risk of osteoporosis. The cutoff strength for evaluating osteoporosis in adults is age and sex specific.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Availability of data and material

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Tarantino U, Piccirilli E, Fantini M, Baldi J, Gasbarra E, Bei R (2015) Sarcopenia and fragility fractures: molecular and clinical evidence of the bone-muscle interaction. J Bone Joint Surg Am 97:429–437

    Article  Google Scholar 

  2. Janssen I, Shepard DS, Katzmarzyk PT, Roubenoff R (2004) The healthcare costs of sarcopenia in the United States. J Am Geriatr Soc 52:80–85

    Article  Google Scholar 

  3. Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 22:465–475

    Article  Google Scholar 

  4. Masoni A, Morosano M, Pezzotto SM, Tomat F, Bentancur F, Bocanera R, Tozzini R, Puche RC (2005) Construction of two instruments for the presumptive detection of post-menopausal women with low spinal bone mass by means of clinical risk factors. Maturitas 51:314–324

    Article  Google Scholar 

  5. Lydick E, Cook K, Turpin J, Melton M, Stine R, Byrnes C (1998) Development and validation of a simple questionnaire to facilitate identification of women likely to have low bone density. Am J Manag Care 4:37–48

    CAS  PubMed  Google Scholar 

  6. Koh LK, Sedrine WB, Torralba TP, Kung A, Fujiwara S, Chan SP, Huang QR, Rajatanavin R, Tsai KS, Park HM, Reginster JY (2001) A simple tool to identify asian women at increased risk of osteoporosis. Osteoporos Int 12:699–705

    Article  CAS  Google Scholar 

  7. Cadarette SM, Jaglal SB, Kreiger N, McIsaac WJ, Darlington GA, Tu JV (2000) Development and validation of the Osteoporosis Risk Assessment Instrument to facilitate selection of women for bone densitometry. CMAJ 162:1289–1294

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Hansen M, Florescu A, Stoltenberg M, Podenphant J, Pedersen-Zbinden B, Horslev-Petersen K, Hyldstrup L, Lorenzen I (1996) Bone loss in rheumatoid arthritis. Influence of disease activity, duration of the disease, functional capacity, and corticosteroid treatment. Scand J Rheumatol 25:367–376

    Article  CAS  Google Scholar 

  9. Kärkkäinen M, Rikkonen T, Kroger H, Sirola J, Tuppurainen M, Salovaara K, Arokoski J, Jurvelin J, Honkanen R, Alhava E (2009) Physical tests for patient selection for bone mineral density measurements in postmenopausal women. Bone 44:660–665

    Article  Google Scholar 

  10. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyere O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, Schneider SM (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48:16–31

    Article  Google Scholar 

  11. Rikkonen T, Sirola J, Salovaara K, Tuppurainen M, Jurvelin JS, Honkanen R, Kroger H (2012) Muscle strength and body composition are clinical indicators of osteoporosis. Calcif Tissue Int 91:131–138

    Article  CAS  Google Scholar 

  12. Li YZ, Zhuang HF, Cai SQ, Lin CK, Wang PW, Yan LS, Lin JK, Yu HM (2018) Low grip strength is a strong risk factor of osteoporosis in postmenopausal women. Orthop Surg 10:17–22

    Article  Google Scholar 

  13. Ma Y, Fu L, Jia L, Han P, Kang L, Yu H, Chen X, Yu X, Hou L, Wang L, Zhang W (2018) Muscle strength rather than muscle mass is associated with osteoporosis in older Chinese adults. J Formos Med Assoc 117:101–108

    Article  Google Scholar 

  14. Qi H, Sheng Y, Chen S, Wang S, Zhang A, Cai J, Lai B, Ding G (2019) Bone mineral density and trabecular bone score in Chinese subjects with sarcopenia. Aging Clin Exp Res 17:019–01266

    Google Scholar 

  15. The International Society for Clinical Densitometry (2019) ISCD Official Positions—Adult. https://www.iscd.org/official-positions/2019

  16. Silva BC, Leslie WD, Resch H, Lamy O, Lesnyak O, Binkley N, McCloskey EV, Kanis JA, Bilezikian JP (2014) Trabecular bone score: a noninvasive analytical method based upon the DXA image. J Bone Miner Res 29:518–530

    Article  Google Scholar 

  17. Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K, Jang HC, Kang L, Kim M, Kim S, Kojima T (2020) Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc 21:300–307.e302

    Article  Google Scholar 

  18. Arazi H, Eghbali E, Saeedi T, Moghadam R (2016) The relationship of physical activity and anthropometric and physiological characteristics to bone mineral density in postmenopausal women. J Clin Densitom 19:382–388

    Article  Google Scholar 

  19. Aydin G, Atalar E, Keles I, Tosun A, Zog G, Keles H, Orkun S (2006) Predictive value of grip strength for bone mineral density in males: site specific or systemic? Rheumatol Int 27:125–129

    Article  Google Scholar 

  20. Pereira FB, Leite AF, de Paula AP (2015) Relationship between pre-sarcopenia, sarcopenia and bone mineral density in elderly men. Arch Endocrinol Metab 59:59–65

    Article  Google Scholar 

  21. Klibanski A, Adams-Campbell L, Bassford TL, Blair SN, Boden SD, Dickersin K, Gifford DR, Glasse L, Goldring SR, Hruska K, Johnson SR (2001) Osteoporosis prevention, diagnosis, and therapy. JAMA 285:785–795

    Article  Google Scholar 

Download references

Acknowledgements

This work was supported by Grants (CHGH108-24) and (CHGH109-(FA)03) from the Cheng Hsin General Hospital, Taipei, Taiwan.

Funding

The authors declare that they have no funding.

Author information

Authors and Affiliations

  1. Department of Medical Imaging, Cheng Hsin General Hospital, 45 Cheng Hsin Street, Taipei, 112, Taiwan

    Yen-Huai Lin & Michael Mu Huo Teng

  2. Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan

    Yen-Huai Lin, Nai-Wei Hsu & Pesus Chou

  3. Department of Psychiatry and Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan

    Hsi-Chung Chen

  4. Division of Cardiology, Department of Internal Medicine, National Yang-Ming University Hospital, Yilan, Taiwan

    Nai-Wei Hsu

  5. Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Nai-Wei Hsu & Michael Mu Huo Teng

  6. Public Health Bureau, Yilan County, Taiwan

    Nai-Wei Hsu

Authors
  1. Yen-Huai Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hsi-Chung Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nai-Wei Hsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Pesus Chou
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michael Mu Huo Teng
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

YHL and MMHT initiated the study and all authors contributed to its design. YHL, and MMHT managed the data collection, performed the data analysis, and wrote the first draft of the manuscript. YHL, NWH, HCC, PC, and MMHT are collectively responsible for interpreting the results and critically reviewed subsequent drafts of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Michael Mu Huo Teng.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the institutional review board of Cheng Hsin General Hospital (IRB no. (660)107A-32).

Consent to participate

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

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 13 kb)

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lin, YH., Chen, HC., Hsu, NW. et al. Hand grip strength in predicting the risk of osteoporosis in Asian adults. J Bone Miner Metab 39, 289–294 (2021). https://doi.org/10.1007/s00774-020-01150-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00774-020-01150-w

Keywords

Search

Navigation