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Grip Strength May Facilitate Fracture Prediction in Perimenopausal Women with Normal BMD: A 15-Year Population-Based Study

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Abstract

The aim of the present study was to investigate the ability of grip strength measurements to predict fracture risk in perimenopausal women according to bone mineral density (BMD). A random sample of 971 perimenopausal women from the Kuopio Osteoporosis Risk Factor and Prevention study cohort was measured with dual-energy X-ray absorptiometry (DXA) at the femoral neck and grip strength with a pneumatic squeeze dynamometer in 5-year intervals from baseline (1989–1991). Fractures during the 15-year follow-up were recorded based on self-reports and validated from medical records. In the total sample and in osteopenic or osteoporotic women (T score < −1, n = 284) grip strength was not significantly associated with fracture-free survival rate (P = nonsignificant in Cox regression). In women with normal baseline BMD (N-BMD, T score > −1, n = 687) the lowest grip strength quartile had a significantly lower fracture-free survival rate in the Cox proportional hazard model (P = 0.005, hazard ratio [HR] = 2.0). In the multivariate Cox regression model, T score and grip strength were the only significant predictors of 15-year fracture-free survival in the N-BMD group and a risk index (RI) was formed according to HRs of these two variables. High RI (0–5 points) was associated with significantly lower 15-year fracture-free survival rate (P = 0.001, HR = 0.137) in the N-BMD group. In contrast, 5-year T score was no better a predictor of fractures in the baseline N-BMD group (P = 0.04, HR = 0.36). In conclusion, grip strength predicts 15-year fracture-free survival in perimenopausal women with N-BMD, while 5-year DXA does not seem to be any better a predictor of fracture risk. DXA measurements could be coupled with simple and cost-effective grip strength measurements. Controlling BMD in women with N-BMD could be abandoned.

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Acknowledgment

The study was financially supported by the Academy of Finland.

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Authors and Affiliations

  1. Bone and Cartilage Research Unit, University of Kuopio, Mediteknia Building, P.O. Box 1627, 70211, Kuopio, Finland

    Joonas Sirola, Toni Rikkonen, Marjo Tuppurainen & Heikki Kröger

  2. Department of Orthopedics and Traumatology, Kuopio University Hospital, Kuopio, Finland

    Joonas Sirola & Heikki Kröger

  3. Department of Obstetrics and Gynecology, Kuopio University Hospital, Kuopio, Finland

    Marjo Tuppurainen

  4. Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland

    Jukka S. Jurvelin

  5. Department of Surgery, Kuopio University Hospital, Kuopio, Finland

    Esko Alhava

Authors
  1. Joonas Sirola
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  2. Toni Rikkonen
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  3. Marjo Tuppurainen
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  4. Jukka S. Jurvelin
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  5. Esko Alhava
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  6. Heikki Kröger
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Correspondence to Joonas Sirola.

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Sirola, J., Rikkonen, T., Tuppurainen, M. et al. Grip Strength May Facilitate Fracture Prediction in Perimenopausal Women with Normal BMD: A 15-Year Population-Based Study. Calcif Tissue Int 83, 93–100 (2008). https://doi.org/10.1007/s00223-008-9155-0

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  • DOI: https://doi.org/10.1007/s00223-008-9155-0

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