Low grip strength is associated with bone mineral density and vertebral fracture in women
Low grip strength is associated with bone mineral density and vertebral fracture in women
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DOI：
10.1093/rheumatology/keh569
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发表时间：
2005-05-01
期刊：
影响因子：
5.5
通讯作者：
O'Neill, TW
中科院分区：
文献类型：
--
作者：
Dixon, WG;Lunt, M;O'Neill, TW
目标。据报道，握力与前臂局部的骨量以及包括脊柱和髋部在内的远处骨骼部位的骨量有关。关于低握力和脊椎骨折风险之间的联系，人们知之甚少。本研究的目的是研究低握力、髋部和脊柱骨密度与中老年欧洲男性和女性椎体骨折之间的关系。年龄在50岁及以上的男性和女性被招募参加欧洲各地的椎体骨质疏松症筛查调查。同意参与的受试者接受了面试者管理的问卷调查，并进行了脊柱侧位X光检查。受试者还使用握力测力计(范围0-300毫米汞柱)评估握力。这些被招募的人中的一部分进行了脊柱和股骨颈的骨密度测量。受试者在基线调查后进行了重复的脊柱侧位X线片，平均时间为3.8年。使用线性回归分析来确定低握力与髋部和脊柱的骨密度之间的关系。用Logistic回归分析握力与常见和偶发的椎体骨折之间的关系。1,265名男性和1,380名女性的握力和骨密度数据被纳入分析。在女性中，经过年龄调整后，与握力正常的女性相比，握力受损(231-299毫米汞)和握力低(231毫米汞)的女性脊柱和股骨颈的骨量显著降低。在男性中，握力低的人脊柱和臀部的骨密度低于正常组。然而，由于握力低于最大值的人数很少，所有估计的可信区间都为零。对身体大小和体力活动水平的调整对结果几乎没有影响。此外，在女性中，在调整了年龄、身体质量指数和体力活动水平后，与握力正常的人相比，握力低的人发生脊椎骨折的风险更高(优势比=2.67；95%可信区间1.13，6.30)。进一步调整脊柱骨密度对关联几乎没有影响(优势比=2.60)。在女性中，低握力与脊柱和髋部的低骨密度相关，并增加了发生脊椎骨折的风险。这些联系不能用体型或生活方式的差异来解释。
Objectives. Grip strength has been reported to be associated with bone mass locally at the forearm and also at distant skeletal sites, including the spine and hip. Less is known about the association between low grip strength and risk of vertebral fracture. The aim of this study was to examine the association between low grip strength, bone mineral density at the hip and spine, and vertebral fracture in middle-aged and elderly European men and women.Methods. Men and women aged 50 yr and over were recruited for participation in a screening survey of vertebral osteoporosis across Europe. Subjects who agreed to take part had an interviewer-administered questionnaire and lateral spinal radiographs performed. Subjects were assessed also for grip strength using a handgrip dynamometer (range 0-300 mmHg). A subsample of those recruited had bone mineral density measurements performed at the spine and femoral neck. Subjects had repeat lateral spine radiographs performed a mean of 3.8 yr following the baseline survey. Linear regression analysis was used to determine the association between low grip strength and bone mineral density at the hip and spine. Logistic regression was used to determine the association between grip strength and both prevalent and incident vertebral fracture.Results. One thousand two hundred and sixty-five men and 1380 women with data concerning grip strength and bone mineral density were included in the analysis. In women, after age adjustment, compared with those with 'normal' grip, those with 'impaired' (231-299 mmHg) and low grip (< 231 mmHg) had significantly lower bone mass at the spine and femoral neck. In men, those with low grip strength had a lower BMD at the spine and hip than those in the normal group. However, because of the small numbers with submaximal grip strength, the confidence intervals around all estimates included zero. Adjustment for body size and levels of physical activity had little effect on the results. In addition, among women, after adjustment for age, body mass index and physical activity levels, compared with those with normal grip, those with low grip strength had an increased risk of developing incident vertebral fracture (odds ratio = 2.67; 95% confidence interval 1.13, 6.30). Further adjustment for spine bone density had little influence on the association (odds ratio = 2.60).Conclusions. In women, low grip strength is associated with low bone mineral density at both the spine and hip and an increased risk of incident vertebral fracture. These associations cannot be explained by differences in body size or lifestyle.