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Muscle size, strength and performance impact on bone function


Edwards et al. studied 318 women and 313 men from the Hertfordshire Cohort Study to investigate whether sarcopenia is associated with a greater risk of fracture because of the impact of muscle degeneration on bone, in addition to the increased tendency to fall.

Participants were assessed for general health, muscle strength (using grip strength) and physical performance (using walking speed). Peripheral quantitative CT scanning was used to measure the cross-sectional area of the muscles in the forearm and calf and to determine the trabecular and cortical bone structure.

In men and women, bone size correlated positively with muscle size and grip strength (P<0.001); the associations persisted after adjusting for height, age, limb length and weight (both adjusted for height), smoking, alcohol intake, calcium supplementation, social class, level of physical activity and diabetes mellitus. Bone size and bone strength showed an association with grip strength, but this was reduced after adjustment for the above factors. Gait speed was not associated with bone structure.

Editor’s comment: Bone strength and size in both sexes are associated with muscle size and this association remains significant after rigorous adjustment. Because no such association was seen between walking speed and bone density, it is likely that sarcopenia leads to a reduction in bone size and strength. This condition, which is typified by an age-related reduction in muscle mass, may be an independent risk factor for fractures in the elderly population.

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