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

Research output: Contribution to journalArticle

Original languageEnglish
Pages (from-to)211-220
Number of pages10
JournalOsteoporosis International
Issue number1
Early online date14 Dec 2018
DateAccepted/In press - 29 Nov 2018
DateE-pub ahead of print - 14 Dec 2018
DatePublished (current) - 14 Jan 2019


In a population-based sample of British women aged over 70 years old, lean mass and peak lower limb muscle force were both independently associated with hip strength and fracture risk indices, thereby suggesting a potential benefit of promoting leg muscle strengthening exercise for the prevention of hip fractures in postmenopausal women.

INTRODUCTION: To investigate cross-sectional associations of lean mass and physical performance, including lower limb muscle function, with hip strength, geometry and fracture risk indices (FRIs) in postmenopausal women.

METHODS: Data were from the Cohort of Skeletal Health in Bristol and Avon. Total hip (TH) and femoral neck (FN) bone mineral density (BMD), hip geometry and total body lean mass (TBLM) were assessed by dual x-ray absorptiometry (DXA). Finite element analysis of hip DXA was used to derive FN, intertrochanteric and subtrochanteric FRIs. Grip strength, gait speed and chair rise time were measured objectively. Lower limb peak muscle force and muscle power were assessed by jumping mechanography.

RESULTS: In total, 241 women were included (age = 76.4; SD = 2.6 years). After adjustment for age, height, weight/fat mass and comorbidities, TBLM was positively associated with hip BMD (β TH BMD  = 0.36, P ≤ 0.001; β FN BMD  = 0.26, P = 0.01) and cross-section moment of inertia (0.24, P ≤ 0.001) and inversely associated with FN FRI (- 0.21, P = 0.03) and intertrochanteric FRI (- 0.11, P = 0.05) (estimates represent SD difference in bone measures per SD difference in TBLM). Lower limb peak muscle force was positively associated with hip BMD (β TH BMD  = 0.28, P ≤ 0.001; β FN BMD  = 0.23, P = 0.008) and inversely associated with FN FRI (- 0.17, P = 0.04) and subtrochanteric FRI (- 0.18, P = 0.04). Associations of grip strength, gait speed, chair rise time and peak muscle power with hip parameters were close to the null.

CONCLUSIONS: Lean mass and lower limb peak muscle force were associated with hip BMD and geometrical FRIs in postmenopausal women. Leg muscle strengthening exercises may therefore help prevent hip fractures in older women.

    Research areas

  • Absorptiometry, Photon/methods, Adiposity/physiology, Aged, Aged, 80 and over, Anthropometry/methods, Body Composition/physiology, Bone Density/physiology, Female, Femur Neck/physiology, Hand Strength/physiology, Hip Fractures/etiology, Hip Joint/anatomy & histology, Humans, Independent Living, Leg/physiology, Muscle, Skeletal/physiology, Risk Assessment/methods

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    Rights statement: This is the author accepted manuscript (AAM). The final published version (version of record) is available online via Springer at . Please refer to any applicable terms of use of the publisher.

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    Licence: CC BY


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