Association of body composition and muscle function with hip geometry and BMD in premenopausal women

Physical fitness components are bone mineral density predictors in adulthood: cross-sectional study

BACKGROUND

Health-related physical fitness (HRPF) attributes are considered important markers beneficial to various health outcomes. However, the literature is divergent regarding HRPF and bone health in adulthood, especially due to the end of the second and beginning of the third decades of life when the peak bone mass period occurs.

OBJECTIVE

To analyze which HRPF variables are areal bone mineral density (aBMD) predictors in adult males and females.

METHODS

This study evaluated 137 healthy young adults aged 18-25 years (50% males). Dual-energy X-ray absorptiometry (DXA) was used to estimate fat mass and lean mass and aBMD, hand grip strength test, sit-ups test, flexibility test, lower limb muscle strength and 20-meter run were used to evaluate physical fitness. Multiple linear regression using the backward method was used to analyze bone mineral density predictors by sex.

RESULTS

HRPF indicators showed correlations from R = 0.28 in the right femoral neck aBMD to R = 0.61 in the upper limbs aBMD in males; in females, correlations from R = 0.27 in total body aBMD to R = 0.68 in the lower limbs aBMD were found. In males, body mass and HRPF indicators were aBMD predictors with HRPF indicators explaining variance from R²=0.214 in the lumbar spine to R²=0.497 in the upper limbs, and in females, with the exception of the lumbar spine, variance from R²=0.237 in the right femoral neck aBMD to R²=0.442 in the lower limbs aBMD was found.

CONCLUSION

Health-related physical fitness components were able to predict aBMD in different anatomical regions in young adults, especially muscle strength and cardiorespiratory fitness indicators for males, while only lean mass and fat mass for females.

Psoas muscle index predicts osteoporosis and fracture risk in individuals with degenerative spinal disease

OBJECTIVES

Skeletal muscle loss and osteoporosis are major medical and socioeconomic concerns as the global population ages. Studies have reported that skeletal muscle mass correlates to bone mineral density (BMD). The psoas muscle index (PMI), measured as the L3 cross-sectional areas of the right and left psoas divided by the square of height, has a positive correlation with the total volume of skeletal muscle in the body. This study aimed to evaluate relationships between PMI and BMD and fracture risk estimated by the Fracture Risk Assessment Tool (FRAX).

METHODS

Preoperatively acquired, plain computed tomography images at the L3 level were used to measure PMI in 87 people with degenerative spinal diseases. We evaluated the correlation between PMI and BMD and fracture risk estimated by FRAX.

RESULTS

PMI was significantly correlated with BMD in the entire lumbar spine and femoral neck (r = 0.413 and 0.525, both P < 0.001). People with osteoporosis showed significantly lower PMI than those without (P < 0.05). PMI was also significantly correlated with FRAX score (r = -0.545, P < 0.001). Furthermore, based on the recommendation of osteoporosis treatment, participants were divided into two groups: FRAX ≥15% (R group) and FRAX <15% (C group). The R group showed significantly lower PMI than the C group (P < 0.001). Receiver operating characteristic curve analysis revealed that PMI has moderate accuracy in diagnosing osteoporosis and FRAX ≥15%.

CONCLUSIONS

PMI was significantly associated with BMD and fracture risk. PMI measurement is straightforward and may increase the diagnosis rate of osteoporosis and fracture risk.

NEUROMUSCULAR FITNESS IN EARLY LIFE AND ITS IMPACT ON BONE HEALTH IN ADULTHOOD: A SYSTEMATIC REVIEW

Objective:

To systematically review the literature to verify the relationship between neuromuscular fitness indicators in childhood/adolescence and bone strength variables in adulthood.

Data sources:

A systematic review was conducted in PUBMED, SCOPUS, SPORTDiscus, Web of Science, PsycINFO, LILACS, and SciELO, covering the entire period until March 2019.

Data synthesis:

The search identified 1149 studies. After duplicity analysis and eligibility criteria, four studies were reported. In one study, baseline was childhood and, in the others, adolescence. In childhood, when adjusting the model for age and body mass index, a statistically significant relation was found for girls: standing long jump with quantitative ultrasound index (β=0.11; p<0.05) and with speed of sound (β=0.14; p<0.01). However, when controlling muscular performance in adulthood, the relationship was no longer significant. In adolescence, coefficients ranged from 0.16 for neuromotor battery and bone mineral density (BMD) in the lumbar region to 0.38 for hanging leg lift test and BMD of arms. The explained variance varied between 2% (bent arm hang for BMD total) and 12% (hanging leg-lift for BMD arms), therefore, a higher performance in neuromuscular fitness in adolescence was associated with better bone strength in adulthood.

Conclusions:

In adults, bone strength variables showed significant correlation from low to moderate magnitude with neuromuscular fitness indicators in adolescence, but not in childhood, after controlling for adult performance in neuromuscular fitness. However, there is limited evidence to support the neuromuscular fitness in early life as a determinant of bone strength in adulthood.

Bilateral multidirectional jumps with reactive jump-landings achieve osteogenic thresholds with and without instruction in premenopausal women

BACKGROUND

Currently jump-landing ground reaction forces have only been quantified in the vertical direction as a stimulus for bone development. This study quantified the full-spectrum of jump-landing force magnitudes (body weight's) and rates of strain (body weights per second) of bilateral multidirectional jumps (star jump and stride jump) with reactive jump-landings (i.e. jumping immediately after initial jump-landing) among premenopausal women. It was also of interest to quantify the influence of instruction on the magnitude and rate of the jump-landing ground reaction forces.

METHODS

Twenty-one women [Mean (SD): 43.3(5.9)yr; 69.4(9.6)kg; 167(5.5)cm; 27.5(8.7)% body fat] performed a jump testing session 'with instruction' followed by a jump testing session performed one week later with 'instruction withdrawn'.

FINDINGS

The resultant magnitudes (3.90 to 5.38, body weights) and rates of strain (192 to 329, body weights per second) for the jump-landings, performed on a force plate, exceeded previously determined osteogenic thresholds (>3body weight's and >43body weights per second, respectively). An instruction effect was observed for resultant (↑8% and ↑12%; P ≤ .01) and vertical (↑8% and ↑7%; P ≤ .01) ground reaction force's (Newtons and body weight, respectively) indicating learning/practice effects for these exercises. A jump-landing effect was observed, with larger peak rates of strain (↑29%; P < .0001, body weight per second) and peak forces (↑12% to ↑48%; P ≤ .01, body weights) for the second jump-landing (post-reactive jump).

INTERPRETATION

These multidirectional bilateral jumps represent a unique training stimulus for premenopausal women and achieve osteogenic thresholds thought pre-requisite for bone growth and could be utilized in the development of osteogenic exercise programs.

Body mass estimation from dimensions of the fourth lumbar vertebra in middle-aged Finns

Although body mass is not a stable trait over the lifespan, information regarding body size assists the forensic identification of unknown individuals. In this study, we aimed to study the potential of using the fourth lumbar vertebra (L4) for body mass estimation among contemporary Finns. Our sample comprised 1158 individuals from the Northern Finland Birth Cohort 1966 who had undergone measurements of body mass at age 31 and 46 and lumbar magnetic resonance imaging (MRI) at age 46. MRI scans were used to measure the maximum and minimum widths, depths, and heights of the L4 body. Their means and sum were calculated together with vertebral cross-sectional area (CSA) and volume. Ordinary least squares (OLS) and reduced major axis (RMA) regression was used to produce equations for body mass among the full sample (n = 1158) and among normal-weight individuals (n = 420). In our data, body mass was associated with all the L4 size parameters (R = 0.093-0.582, p ≤ 0.019 among the full sample; R = 0.243-0.696, p ≤ 0.002 among the normal-weight sample). RMA regression models seemed to fit the data better than OLS, with vertebral CSA having the highest predictive value in body mass estimation. In the full sample, the lowest standard errors were 6.1% (95% prediction interval ±9.6 kg) and 7.1% (±9.1 kg) among men and women, respectively. In the normal-weight sample, the lowest errors were 4.9% (±6.9 kg) and 4.7% (±5.7 kg) among men and women, respectively. Our results indicate that L4 dimensions are potentially useful in body mass estimation, especially in cases with only the axial skeleton available.

Estimating body mass and composition from proximal femur dimensions using dual energy x-ray absorptiometry

Body mass prediction from the skeleton most commonly employs femoral head diameter (FHD). However, theoretical predictions and empirical data suggest the relationship between mass and FHD is strongest in young adults, that bone dimensions reflect lean mass better than body or fat mass and that other femoral measurements may be superior. Here, we generate prediction equations for body mass and its components using femoral head, neck and proximal shaft diameters and body composition data derived from dual-energy x-ray absorptiometry (DXA) scans of young adults (n = 155, 77 females and 78 males, mean age 22.7 ± 1.3 years) from the Andhra Pradesh Children and Parents Study, Hyderabad, India. Sex-specific regression of log-transformed data on femoral measurements predicted lean mass with smaller standard errors of estimate (SEEs) than body mass (12-14% and 16-17% respectively), while none of the femoral measurements were significant predictors of fat mass. Subtrochanteric mediolateral shaft diameter gave lower SEEs for lean mass in both sexes and for body mass in males than FHD, while FHD was a better predictor of body mass in women. Our results provide further evidence that lean mass is more closely related to proximal femur dimensions than body or fat mass and that proximal shaft diameter is a better predictor than FHD of lean but not always body mass. The mechanisms underlying these relationships have implications for selecting the most appropriate measurement and reference sample for estimating body or lean mass, which also depend on the question under investigation.

Relationship between body mass, lean mass, fat mass, and limb bone cross-sectional geometry: Implications for estimating body mass and physique from the skeleton

OBJECTIVES

Estimating body mass from skeletal dimensions is widely practiced, but methods for estimating its components (lean and fat mass) are poorly developed. The ability to estimate these characteristics would offer new insights into the evolution of body composition and its variation relative to past and present health. This study investigates the potential of long bone cross-sectional properties as predictors of body, lean, and fat mass.

MATERIALS AND METHODS

Humerus, femur and tibia midshaft cross-sectional properties were measured by peripheral quantitative computed tomography in sample of young adult women (n = 105) characterized by a range of activity levels. Body composition was estimated from bioimpedance analysis.

RESULTS

Lean mass correlated most strongly with both upper and lower limb bone properties (r values up to 0.74), while fat mass showed weak correlations (r ≤ 0.29). Estimation equations generated from tibial midshaft properties indicated that lean mass could be estimated relatively reliably, with some improvement using logged data and including bone length in the models (minimum standard error of estimate = 8.9%). Body mass prediction was less reliable and fat mass only poorly predicted (standard errors of estimate ≥11.9% and >33%, respectively).

DISCUSSION

Lean mass can be predicted more reliably than body mass from limb bone cross-sectional properties. The results highlight the potential for studying evolutionary trends in lean mass from skeletal remains, and have implications for understanding the relationship between bone morphology and body mass or composition.

Association of Jumping Mechanography-Derived Indices of Muscle Function with Tibial Cortical Bone Geometry

Jumping mechanography has been developed to estimate maximum voluntary muscle forces. This study assessed associations of jumping mechanography-derived force and power measurements with tibial cortical bone geometry, compared to other estimates of muscle mass, size, and function. Healthy men (n = 181; 25-45 years) were recruited in a cross-sectional, population-based sibling-pair study. Muscle parameters include isokinetic peak torque of the quadriceps, DXA-derived leg lean mass, mechanography-derived peak jump force and power, and pQCT-derived mid-tibial (66 %) muscle cross-sectional area (CSA). Mid-tibial cortical bone parameters were assessed by pQCT. In age, height, and weight-adjusted analyses, jump force and power correlated positively with cortical bone area, cortical thickness, and polar strength-strain index (SSIp) (β = 0.23-0.34, p ≤ 0.001 for force; β = 0.25-0.30, p ≤ 0.007 for power) and inversely with endosteal circumference adjusted for periosteal circumference (ECPC) (β = -0.16, p < 0.001 for force; β = -0.13, p = 0.007 for power). Force but not power correlated with cortical over total bone area ratio (β = 0.25, p = 0.002). Whereas leg lean mass correlated with all cortical parameters except cortical over total bone area ratio (β = 0.25-0.62, p ≤ 0.004), muscle CSA only correlated with cortical bone area, periosteal circumference, and SSIp (β = 0.21-0.26, p ≤ 0.001), and quadriceps torque showed no significant correlations with the bone parameters. Multivariate models indicated that leg lean mass was independently associated with overall bone size and strength reflected by periosteal and endosteal circumference and SSIp (β = 0.32-0.55, p ≤ 0.004), whereas jump force was independently associated with cortical bone size reflected by ECPC, cortical thickness, and cortical over total bone area ratio (β = 0.13-0.28; p ≤ 0.002). These data indicate that jumping mechanography provides relevant information about the relationship of muscle with bone geometry.

Jump power and force have distinct associations with cortical bone parameters: findings from a population enriched by individuals with high bone mass

CONTEXT

Little is known of the relationships between muscle function and bone, based on the recently developed technique of jumping mechanography.

OBJECTIVE

Our objective was to determine associations between peak ground reaction force and peak power during a 1-legged hopping test and a single 2-legged jump, respectively, and cortical bone parameters.

DESIGN AND SETTING

This was a cross-sectional observational study in participants from the high bone mass cohort.

PARTICIPANTS

Participants included 70 males (mean age 58 years) and 119 females (mean age 56 years); high bone mass cases and controls were pooled.

MAIN OUTCOME MEASURES

Total hip bone mineral density (BMD) (measured by dual-energy x-ray absorptiometry scanning) and mid-tibial peripheral quantitative computed tomography (Stratec XCT2000L).

RESULTS

Jump power was positively related to hip BMD (standardized β [95% confidence interval]=0.29 [0.07, 0.51], P=.01), but hopping force was not (0.03 [-0.16, 0.22], P=.74) (linear regression analysis adjusted for age, gender, height, and weight). In 113 participants with force and peripheral quantitative computed tomography data, both jump power and hopping force were positively associated with tibial strength strain index (0.26 [0.09, 0.44], P<.01; and 0.24 [0.07, 0.42], P=.01 respectively). Although hopping force was positively associated with bone size (total bone area 0.22 [0.03, 0.42], P=.02), jump power was not (0.10 [-0.10, 0.30], P=.33). In contrast, jump power was inversely associated with endocortical circumference adjusted for periosteal circumference (-0.24 [-0.40, -0.08], P<.01) whereas no association was seen for hopping force (-0.10 [-0.26, 0.07], P=.24).

CONCLUSIONS

Although power and force are both positively associated with cortical bone strength, distinct mechanisms appear to be involved because power was primarily associated with reduced endocortical expansion (reflected by endocortical circumference adjusted for periosteal circumference, and hip BMD), whereas force was associated with increased periosteal expansion (reflected by total bone area).

Lean mass predicts hip geometry and bone mineral density in chinese men and women and age comparisons of body composition

Previous studies have suggested that changes in hip geometry increase the risk of hip fracture. The aim of this study was to identify whether body composition were associated with hip geometry or bone mineral density (BMD) in a large sample of Chinese people. A total of 2072 subjects aged 20-79 yr (including 700 males and 1372 females) were selected. The following measurements were taken: lumbar spine (L1-4); proximal femur BMD; lean mass (LM); fat mass (FM); and hip geometric parameters, including hip axis length (HAL), cross-sectional moment of inertia (CSMI), cross-sectional area (CSA), neck-shaft angle, and femur strength index (SI) by dual-energy X-ray absorptiometry. FM and LM were positively correlated with HAL, CSMI, and CSA, and negatively correlated with SI in both men and women. Multiple regression analysis showed that leg LM contributions to HAL, CSMI, and CSA variance were 12.6-37.6%. Compared with FM, LM was generally more strongly related to hip geometry and BMD in young and old men and women. Body composition was a good predictor for hip geometry parameter variation and BMD variation.