Prediction of 10‐Year Fragility Fractures Using Muscle Health Indicators in Postmenopausal Women: The OsteoLaus Cohort
ABSTRACT Background Muscle strength, mass and function have been associated with falls, fractures and mortality, but the results vary between previous studies. We aimed to investigate the predictive ability of muscle strength and mass with 10‐year incident fragility fractures. Methods This study inc...
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Wiley
2025-06-01
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| Series: | Journal of Cachexia, Sarcopenia and Muscle |
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| Online Access: | https://doi.org/10.1002/jcsm.13837 |
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| author | Colin Vendrami Elena Gonzalez Rodriguez Guillaume Gatineau Peter Vollenweider Pedro Marques‐Vidal Olivier Lamy Didier Hans Enisa Shevroja |
| author_facet | Colin Vendrami Elena Gonzalez Rodriguez Guillaume Gatineau Peter Vollenweider Pedro Marques‐Vidal Olivier Lamy Didier Hans Enisa Shevroja |
| author_sort | Colin Vendrami |
| collection | DOAJ |
| description | ABSTRACT Background Muscle strength, mass and function have been associated with falls, fractures and mortality, but the results vary between previous studies. We aimed to investigate the predictive ability of muscle strength and mass with 10‐year incident fragility fractures. Methods This study included 1475 postmenopausal women aged 50–80 years (OsteoLaus cohort, Lausanne, Switzerland). Handgrip strength (HGS) was assessed. With a Jamar dynamometer and lean mass (LM) with dual x‐ray absorptiometers (DXA) every 2.5 years for 10 years. LM, appendicular lean mass (ALM) and their indexes were assessed following the International Society for Clinical Densitometry (ISCD) guidelines. Main outcomes included hip, humerus and forearm low‐trauma fractures from in‐person interviews and vertebral fracture (VF) from lateral DXA screening. Secondary outcomes included falls and death. Baseline values were compared using two‐sided t‐test or Wilcoxon test (p < 0.0029 based on Bonferroni). Multivariate analysis included time to fracture with accelerated failure time (AFT) model and odds ratio (OR) with logistic regression, 95% confidence interval (CI) and C‐Index or AUC. Results After 10.2 ± 0.4 years of follow‐up, 944 women remained enrolled (age 73.0 ± 6.9 years, BMI 25.7 ± 4.8 kg/m2, ALM 16.8 ± 2.5 kg, HGS 21.2 ± 5.5 kg), of whom 260 fractured (174 VF, 107 non‐VF), 863 fell and 74 died. Participants with an incident fragility fracture had a 1.5‐kg lower HGS at baseline but no significant difference in their ALM, ALM/height2 and ALM/BMI compared to nonfractured participants. In the multivariable models, one SD increase in ALM (+2.58 kg) was associated with a 0.72 (CI:0.61–0.85) and 0.67 (CI:0.55–0.82) shorter time to major osteoporotic fractures (MOF) and VF. While ALM/BMI was associated with a 1.26 (CI:1.01–1.59) and 1.98 (CI:1.21–3.25) longer time to MOF and non‐VF. One SD increase in HGS was associated with a 1.37 (CI:1.03–1.81) longer time to non‐VF only. A careful consideration of body weight and fat mass is needed in the association of lean mass with fractures. Baseline muscle parameters were not different for participant with or without incident fall or death. Conclusions Lean mass and grip strength appear as independent risk factors for incident MOF, but with limited additional prediction performance. The prediction of fragility fractures differs between the fracture sites. Further studies with larger sample size, other muscle assessment modalities considering weight or fat mass as covariate, and broader ethnicities are needed. |
| format | Article |
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| institution | Kabale University |
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| spelling | doaj-art-5b9d6c7688954cf3b7716645178994e22025-08-20T03:32:26ZengWileyJournal of Cachexia, Sarcopenia and Muscle2190-59912190-60092025-06-01163n/an/a10.1002/jcsm.13837Prediction of 10‐Year Fragility Fractures Using Muscle Health Indicators in Postmenopausal Women: The OsteoLaus CohortColin Vendrami0Elena Gonzalez Rodriguez1Guillaume Gatineau2Peter Vollenweider3Pedro Marques‐Vidal4Olivier Lamy5Didier Hans6Enisa Shevroja7Interdisciplinary Center of Bone Diseases, Rheumatology Unit, Bone and Joint Department Lausanne University Hospital and University of Lausanne Lausanne SwitzerlandInterdisciplinary Center of Bone Diseases, Rheumatology Unit, Bone and Joint Department Lausanne University Hospital and University of Lausanne Lausanne SwitzerlandInterdisciplinary Center of Bone Diseases, Rheumatology Unit, Bone and Joint Department Lausanne University Hospital and University of Lausanne Lausanne SwitzerlandDepartment of Medicine, Internal Medicine Lausanne University Hospital and University of Lausanne Lausanne SwitzerlandDepartment of Medicine, Internal Medicine Lausanne University Hospital and University of Lausanne Lausanne SwitzerlandInterdisciplinary Center of Bone Diseases, Rheumatology Unit, Bone and Joint Department Lausanne University Hospital and University of Lausanne Lausanne SwitzerlandInterdisciplinary Center of Bone Diseases, Rheumatology Unit, Bone and Joint Department Lausanne University Hospital and University of Lausanne Lausanne SwitzerlandInterdisciplinary Center of Bone Diseases, Rheumatology Unit, Bone and Joint Department Lausanne University Hospital and University of Lausanne Lausanne SwitzerlandABSTRACT Background Muscle strength, mass and function have been associated with falls, fractures and mortality, but the results vary between previous studies. We aimed to investigate the predictive ability of muscle strength and mass with 10‐year incident fragility fractures. Methods This study included 1475 postmenopausal women aged 50–80 years (OsteoLaus cohort, Lausanne, Switzerland). Handgrip strength (HGS) was assessed. With a Jamar dynamometer and lean mass (LM) with dual x‐ray absorptiometers (DXA) every 2.5 years for 10 years. LM, appendicular lean mass (ALM) and their indexes were assessed following the International Society for Clinical Densitometry (ISCD) guidelines. Main outcomes included hip, humerus and forearm low‐trauma fractures from in‐person interviews and vertebral fracture (VF) from lateral DXA screening. Secondary outcomes included falls and death. Baseline values were compared using two‐sided t‐test or Wilcoxon test (p < 0.0029 based on Bonferroni). Multivariate analysis included time to fracture with accelerated failure time (AFT) model and odds ratio (OR) with logistic regression, 95% confidence interval (CI) and C‐Index or AUC. Results After 10.2 ± 0.4 years of follow‐up, 944 women remained enrolled (age 73.0 ± 6.9 years, BMI 25.7 ± 4.8 kg/m2, ALM 16.8 ± 2.5 kg, HGS 21.2 ± 5.5 kg), of whom 260 fractured (174 VF, 107 non‐VF), 863 fell and 74 died. Participants with an incident fragility fracture had a 1.5‐kg lower HGS at baseline but no significant difference in their ALM, ALM/height2 and ALM/BMI compared to nonfractured participants. In the multivariable models, one SD increase in ALM (+2.58 kg) was associated with a 0.72 (CI:0.61–0.85) and 0.67 (CI:0.55–0.82) shorter time to major osteoporotic fractures (MOF) and VF. While ALM/BMI was associated with a 1.26 (CI:1.01–1.59) and 1.98 (CI:1.21–3.25) longer time to MOF and non‐VF. One SD increase in HGS was associated with a 1.37 (CI:1.03–1.81) longer time to non‐VF only. A careful consideration of body weight and fat mass is needed in the association of lean mass with fractures. Baseline muscle parameters were not different for participant with or without incident fall or death. Conclusions Lean mass and grip strength appear as independent risk factors for incident MOF, but with limited additional prediction performance. The prediction of fragility fractures differs between the fracture sites. Further studies with larger sample size, other muscle assessment modalities considering weight or fat mass as covariate, and broader ethnicities are needed.https://doi.org/10.1002/jcsm.13837dual‐x‐ray absorptiometryepidemiologyfragility fracturemuscleosteoporosispopulation studies |
| spellingShingle | Colin Vendrami Elena Gonzalez Rodriguez Guillaume Gatineau Peter Vollenweider Pedro Marques‐Vidal Olivier Lamy Didier Hans Enisa Shevroja Prediction of 10‐Year Fragility Fractures Using Muscle Health Indicators in Postmenopausal Women: The OsteoLaus Cohort Journal of Cachexia, Sarcopenia and Muscle dual‐x‐ray absorptiometry epidemiology fragility fracture muscle osteoporosis population studies |
| title | Prediction of 10‐Year Fragility Fractures Using Muscle Health Indicators in Postmenopausal Women: The OsteoLaus Cohort |
| title_full | Prediction of 10‐Year Fragility Fractures Using Muscle Health Indicators in Postmenopausal Women: The OsteoLaus Cohort |
| title_fullStr | Prediction of 10‐Year Fragility Fractures Using Muscle Health Indicators in Postmenopausal Women: The OsteoLaus Cohort |
| title_full_unstemmed | Prediction of 10‐Year Fragility Fractures Using Muscle Health Indicators in Postmenopausal Women: The OsteoLaus Cohort |
| title_short | Prediction of 10‐Year Fragility Fractures Using Muscle Health Indicators in Postmenopausal Women: The OsteoLaus Cohort |
| title_sort | prediction of 10 year fragility fractures using muscle health indicators in postmenopausal women the osteolaus cohort |
| topic | dual‐x‐ray absorptiometry epidemiology fragility fracture muscle osteoporosis population studies |
| url | https://doi.org/10.1002/jcsm.13837 |
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