SIB# 427- Lean Mass and Fracture Risk

The Study: Lean mass and lower limb muscle function in relation to hip strength, geometry and fracture risk indices in community-dwelling older women             

The Facts:

a. This study was conducted in a group of British women who were over 70 years of age. 

b. The authors wished to determine if lean body mass and physical performance were associated with the risk of fracture. 

c. There were 241 women in the study. 

d. Bone mineral density in hip and femoral neck as well as total lean body mass was determined by the use of “dual x-ray absorptiometry (DXA).” 

e. They evaluated the lower limb muscle power by using a “Leonardo Mechanography Ground Reaction Force platform”.  

f. “Peak power was assessed by two-legged jump and peak force by a one-legged hopping.” 

g. “DXA-based finite element analysis was used to derive fracture risk indices for the femoral neck, intertrochanteric and subtrochanteric hip regions.” 

h. “…lean mass and lower limb peak muscle force were both independently associated

with hip BMD [bone mineral density] and fracture risk…”

i. The authors felt that more research was needed and that this research should aim to improve peak muscle force. 

j. They indicated this could be accomplished using a combination of isometric and balance exercises.

 Take Home:

Subjects that lose muscle mass and have decreased lower limb strength are more inclined to have lower bone mineral density and increased risk of fracture.

Reviewer's Comments:

I think this type of outcome was probably what most of us would have expected. I remember years ago seeing mention that leg strength was important in the elderly. We do have to be careful about how we go about trying to increase strength and muscle mass in the elderly and as always more research is needed. You may also wish to refer back to   previous Science in Brief articles (SIB# 410 and 412) that examined how many older subjects were capable of improving muscle mass.

 Reviewer:  Roger Coleman DC

Editor: Mark R. Payne DC

Reference: A Elhakeeml A Hartley, Y Luo et.al. Lean mass and lower limb muscle function in relation to hip strength, geometry and fracture risk indices in community-dwelling older women. Osteoporosis Int 2019 Jan;30(1):211-220.  doi: 10.1007/s00198-018-4795-z. Epub 2018 Dec 14.   

Link to Abstract: https://pubmed.ncbi.nlm.nih.gov/30552442/  

Link to Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6331743/pdf/198_2018_Article_4795.pdf