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Additional file 1: Supplementary table 1. Demographics of the total study population by high bone mass status.

Summary 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 (βTH BMD = 0.36, P ≤ 0.001; βFN 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 (βTH BMD = 0.28, P ≤ 0.001; βFN 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. Electronic supplementary material The online version of this article (10.1007/s00198-018-4795-z) contains supplementary material, which is available to authorized users.

We previously reported an association between high bone mass (HBM) and a bone-forming phenotype of radiographic hip osteoarthritis (OA). As knee and hip OA have distinct risk factors, in this study we aimed to determine (i) whether HBM is also associated with knee OA, and (ii) whether the HBM knee OA phenotype demonstrates a similar pattern of radiographic features to that observed at the hip.HBM cases (defined by DXA BMD Z-scores) from the UK-based HBM study were compared with unaffected family controls and general population controls from the Chingford and Hertfordshire cohort studies. A single blinded observer graded AP weight-bearing knee radiographs for features of OA (Kellgren-Lawrence score, osteophytes, joint space narrowing (JSN), sclerosis) using an atlas. Analyses used logistic regression, adjusting a priori for age and gender, and additionally for BMI as a potential mediator of the HBM-OA association, using Stata v12.609 HBM knees in 311 cases (mean age 60.8. years, 74% female) and 1937 control knees in 991 controls (63.4. years, 81% female) were analysed. The prevalence of radiographic knee OA, defined as Kellgren-Lawrence grade. ≥. 2, was increased in cases (31.5% vs. 20.9%), with age and gender adjusted OR [95% CI] 2.38 [1.81, 3.14], p.

Objectives: To use objective measures of physical fitness and muscle function to assess the interplay between exercise, muscle and fractures during childhood. Methods: A cross-sectional analysis was performed using The Young Hearts Project, a population-based cohort recruited from Northern Ireland. Grip strength was assessed with a hand-held dynamometer. Aerobic fitness was assessed using the 20-metre endurance shuttle run. The outcome of interest was reported fractures. Data were also collected on other potential confounders. Results: There were 787 boys (49.5%) and 803 girls aged 13.9±1.5 years. 414 (26.0%) children reported a fracture at anytime since birth. There was a positive association between higher aerobic fitness and reported fracture (OR1.23, 95%CI 1.05 to 1.45, P=0.012) greatest in those with lowest grip strength (OR 2.10, 95%CI 1.23 to 3.31, P=0.005). Conversely, in those with highest grip strength, no association was seen between aerobic fitness and reported fractures. Conclusion: In children, higher levels of aerobic fitness are associated with an increased risk of fractures, with the greatest risk seen in those with low muscle strength. Our results suggest that there is the potential for exercise protocols that aim to strengthen forearm musculature to reduce upper limb fractures in adolescents.