Upper and lower limb muscle strength, particularly handgrip and vertical jump performance, were positively associated with BMD of the forearm and femur in children and adolescents with low socioeconomic status, with associations observed in boys.
Abstract
Background
Bone mineral density (BMD) is crucial for evaluating bone health, particularly in the pediatric population. Physical parameters such as lower body strength (assessed by jump tests) and handgrip strength (a marker of musculoskeletal health) have been linked to BMD. This study aims to investigate the association between upper and lower limb strength and BMD of the forearm and femur in children and adolescents stratified by sex.
Methods
This cross-sectional study involved 57 participants (aged 9 ± 2 years) from a philanthropic institution in Brazil. Participants were assessed for anthropometric measurements, somatic maturation, and BMD and lean soft tissue using Dual X-ray Absorptiometry (DXA). Handgrip strength was measured using a dynamometer, and horizontal and vertical jump performances were also assessed. Statistical analyses included Quantile Regression to examine the relationships between strength measures and BMD, adjusted for somatic maturation and lean soft tissue.
Results
Significant positive associations were found between handgrip strength and femoral BMD, especially in boys (Femoral neck: β = 12.65; 95%CI = 2.39; 22.92,; Trochanter: β = 17.37; 95%CI = 5.04; 29.70; Total femur: β = 11.13 95%CI = 0.98; 21.27).
Conclusion
Upper and lower limb muscle strength, particularly handgrip and vertical jump performance, were positively associated with BMD of the forearm and femur in children and adolescents with low socioeconomic status, with associations observed in boys.
In this cross-sectional study, we aimed to explore the correlation between body composition and bone mineral density (BMD) in young and middle-aged people with different gender and different BMI groups. We selected 1,295 young and middle-aged people (20 to 50 years old) who underwent physical examination at the Health Management Center of the International Medical Service (Xidan Branch) of Peking Union Medical College Hospital from January 2020 to June 2024 as the study subjects, and demographic characteristics, laboratory examinations, body composition(assessed by bioelectrical impedance analysis, including measurements of skeletal muscle mass, skeletal muscle index, body fat mass, percent body fat, fat-free mass, and visceral Fat Area), and dual-energy X-ray bone absorptiometry (DXA) results were collected. Based on gender and body mass index (BMI), the study participants were categorized into three groups: normal weight (18.5 kg/m² ≤ BMI < 24 kg/m²), overweight (24 kg/m² ≤ BMI < 28 kg/m²), and obese (BMI ≥ 28 kg/m²). One-way ANOVA was employed to assess differences among the three groups. The relationship between BMI and BMD was analyzed using multiple regression models along with natural cubic spline models. Additionally, multiple regression models were used to examine the association between body composition and BMD. There were 774 males (216 in the normal body composition group, 380 in the overweight group, and 178 in the obese group) and 521 females (386 in the normal body composition group, 99 in the overweight group, and 36 in the obese group), and there was a significant difference in the laboratory results, body composition, and BMD among the three groups of males and females (all P < 0.05). Multiple regression analysis, after adjusting for age, smoking and alcohol consumption history, hypertension, and diabetes mellitus, revealed a significant positive correlation between BMI and BMD at all skeletal sites (all P < 0.05). The obese group exhibited a more pronounced increase in BMD compared to the overweight group (lumbar spine BMD: β = 0.04, 95% CI 0.02-0.07; femoral neck BMD: β = 0.09, 95% CI 0.07-0.11; total hip BMD: β = 0.11, 95% CI 0.09-0.13; all P < 0.05). Further analysis of the nonlinear relationship between BMI and BMD demonstrated that in women, BMD at all sites increased with higher BMI. In contrast, men exhibited an inverted U-shaped nonlinear association, with a decline in BMD observed in the high BMI range (BMI ≥ 30 kg/m²). The correlation between body composition and BMD, skeletal muscle mass (SMM), skeletal muscle index (SMI), and fat free mass (FFM) were significantly positively correlated with BMD at all sites in both males and females (P < 0.05), and percent body fat (PBF) was negatively correlated with BMD at all sites in the obese group of males, the overweight groups of males and females (P < 0.05). Among young and middle-aged individuals, men show a decline in BMD when BMI reaches 30 or above, whereas women continue to experience a gradual increase in BMD with rising BMI. Additionally, elevated PBF is negatively correlated with BMD. This suggests that maintaining an appropriate BMI and PBF may be beneficial for bone health in this age group.
Yanmeng Qi, Xiaoyu Zhou, Xiao Wang et al.· BMC Endocrine Disorders· 0 citations
FRAX-derived fracture probability in postmenopausal women is associated not only with bone-related parameters but also with muscle structure, muscle quality, and physical performance, which highlights the potential relevance of muscle-related parameters within the broader musculoskeletal profile reflected by FRAX.
Osteoporosis is increasingly recognized as an immune-mediated condition (“immunoporosis”), yet data on bone health in adults with primary immunodeficiencies (PIDs) remain limited. Chronic immune dysregulation and multisystem complications in PIDs may adversely affect skeletal integrity, but bone microarchitecture and muscle mass have not been comprehensively evaluated in this population. The aim of our study was to assess bone mineral density (BMD), trabecular bone score (TBS), and muscle mass in adults with PIDs. Exploratory analyses examined associations between these measures and clinical features and the main peripheral blood lymphocyte subsets.
In this single-center cross-sectional study, 61 adult patients with PIDs underwent dual-energy X-ray absorptiometry (DXA) of the lumbar spine, total hip, femoral neck, and whole body. TBS was derived from lumbar spine DXA images, and the appendicular lean mass index was calculated to assess muscle mass. Clinical characteristics and immunological parameters, including peripheral blood lymphocyte subsets, were analyzed in relation to skeletal outcomes.
Based on age-appropriate DXA findings and clinical data, osteoporosis was diagnosed in 12 of 61 patients (19.7%). Three additional patients were diagnosed based on fragility fractures, increasing the overall prevalence to 15 of 61 (24.6%). Low BMD was more frequently detected at the hip than at the lumbar spine. Partially degraded or degraded TBS was observed in 15 of 61 patients (24.6%). Low muscle mass was identified in 17 of 61 patients (27.9%) and was associated with significantly lower BMD at all skeletal sites. Participants with bronchiectasis had lower femoral neck and total hip BMD and lower TBS, whereas those with enteropathy had lower BMD across all skeletal sites and lower TBS. Among participants eligible for T-score assessment (n = 15), NK-cell counts correlated positively with femoral neck (ρ = 0.63, p = 0.01) and total hip T-scores (ρ = 0.68, p < 0.01), and with TBS in the entire cohort (n = 61; ρ = 0.28, p = 0.03). CD4+, CD8+, and CD19+ cell counts were not associated with any evaluated densitometric parameters.
In this cohort of adults with PIDs, reduced BMD and impaired TBS represented distinct, partially overlapping findings. Hip DXA appeared particularly informative, while TBS provided complementary information beyond BMD. These exploratory findings should be confirmed in prospective controlled studies.
A. Nowakowska-Płaza, J. Wroński, A. Zegadło et al.· Frontiers in Endocrinology· 0 citations
It is indicated that trabecular microarchitecture deteriorates earlier and more rapidly with aging than bone mass loss captured by BMD, supporting the use of TBS as a complementary tool for evaluating skeletal health and fracture risk.
C. Gomes, R. M. R. Pereira, J. C. Alvarenga et al.· Menopause· 0 citations
INTRODUCTION/PURPOSE
Aging is associated with declines in muscle strength, lean mass, and bone mineral density (BMD), yet sex-specific lower-body trajectories and their interrelationships across the adult lifespan remain incompletely characterized. The purpose of this study was to determine whether lower-body strength and regional lean mass are differentially associated with hip and lumbar spine BMD across adulthood and whether these relationships vary by age and sex.
METHODS
In this cross-sectional study (n = 251; 149 females, 102 males; 18-85 yr), maximal dynamic strength was assessed using a one-repetition maximum (1RM) leg press. Dual-energy x-ray absorptiometry quantified lumbar spine and hip BMD, lower-body lean mass, and visceral adipose tissue volume. Hierarchical regression models evaluated the effects of age, sex, and age × sex interactions on BMD, with additional models used to test associations between strength, lean mass, and BMD while controlling for adiposity.
RESULTS
Hip BMD was lower with increasing age in both sexes, with higher values in males. Leg-press strength and lower-body lean mass were lower with increasing age but were positively associated with hip BMD (β = 0.32-0.45, p < 0.001) independent of age, sex, and adiposity. The strength-hip BMD association was stronger in younger relative to older adults (interaction p = 0.051). Spine BMD demonstrated a significant age × sex interaction, with age-related declines evident in females but not males.
CONCLUSIONS
Maximal lower-body strength is strongly associated with hip BMD across adulthood and may serve as a functional marker of skeletal integrity. These findings highlight the need for caution when interpreting lumbar spine DXA measures in aging males and reinforce the importance of preserving neuromuscular quality for skeletal health across adulthood.
William J. Kraemer, G. Amadon, J. H. Graham et al.· Medicine & Science in Sports...· 0 citations
In postmenopausal women, higher BMI was associated with higher BMD but lower TBS, supporting a divergent relationship between densitometric findings and DXA-derived trabecular texture parameters, and suggesting that TBS may complement BMD in describing skeletal imaging status in overweight and obese women.