Impaired bone microarchitecture at the distal radius in older men with low muscle mass and grip strength: The STRAMBO study

The aim was to study the association between bone microarchitecture and muscle mass and strength in older men. Volumetric bone mineral density (vBMD) and bone microarchitecture were assessed in 810 men aged ≥60 years at the distal radius by high‐resolution peripheral computed tomography (HR‐pQCT). Areal bone mineral density (aBMD) and appendicular muscle mass (ASM) were assessed by dual‐energy X‐ray absorptiometry (DXA). Relative ASM of the upper limbs (RASM‐u.l.) was calculated as ASM of the upper limbs/(height)². Grip strength was measured by dynanometry. In multivariable models, men in the lowest RASM‐u.l. quartile had lower cross‐sectional area (CSA), cortical area (Ct.Ar), cortical thickness (Ct.Th), and trabecular area (Tb.Ar) at distal radius compared with men in the highest quartile. The trends remained significant after adjustment for grip strength. Men in the lowest quartile of the normalized grip strength (grip strength/[height]²) had lower aBMD, total vBMD, Ct.Ar, Ct.Th, Tb.vBMD, and Tb.N, and higher Tb.Sp and Tb.Sp.SD. The associations for Ct.Ar, total vBMD, Ct.Th, Tb.vBMD, and Tb.Sp remained significant after adjustment for RASM‐u.l. In the models including RASM‐u.l. and normalized grip strength, CSA and Tb.Ar were associated with RASM‐u.l. but not with the strength. Lower Ct.Th, Tb.vBMD, and Tb.N were associated with lower grip strength but not with RASM‐u.l. Lower Ct.Ar was associated with lower grip strength and with lower RASM‐u.l. In conclusion, in older men, low RASM‐u.l. and low grip strength are associated with poor cortical and trabecular microarchitecture partly independently of each other, after adjustment for confounders. © 2013 American Society for Bone and Mineral Research