Poor bone microarchitecture in older men with impaired physical performance—the STRAMBO study

• Published in: Osteoporosis international Vol. 23; no. 12; pp. 2785 - 2796
• Main Authors: Blaizot, S., Boutroy, S., Vilayphiou, N., Boonen, S., Chapurlat, R., Szulc, P.
• Format: Journal Article
• Language: English
• Published: London Springer-Verlag 01-12-2012; Springer Nature B.V
• Subjects: Absorptiometry, Photon; Accidental Falls; Aged; Aged, 80 and over; Bone density; Bone Density - physiology; Bone mineral density; Computed tomography; Disability Evaluation; Dual energy X-ray absorptiometry; Endocrinology; Exercise; Femur; Femur Neck - physiopathology; Hip; Hip joint; Hip Joint - physiopathology; Humans; Legs; Limbs; Male; Medicine; Medicine & Public Health; Men; Middle Aged; Older people; Original Article; Orthopedics; Osteoporosis; Osteoporosis - pathology; Osteoporosis - physiopathology; Physical Fitness - physiology; Prospective Studies; Radius; Radius - pathology; Radius - physiopathology; Rheumatology; Spine; Tibia; Tibia - pathology; Tibia - physiopathology; Trochanter; Bone mineral density; Physical performance; Leg disability; Bone microarchitecture; Men
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-012-1906-0

Summary
In 810 men ≥60 years, poor physical performance of lower limbs was associated with lower areal bone mineral density (aBMD) of total hip and poor bone microarchitecture at the distal tibia (assessed by HR-pQCT). Men who reported falls had lower hip aBMD and lower cortical density at the distal tibia.
Introduction
The aim of this study was to assess the association between bone microarchitecture and physical performance in older men.
Methods
Volumetric bone mineral density (vBMD) and bone microarchitecture were assessed in 810 men ≥60 years at the distal radius and tibia by high resolution pQCT. aBMD was measured at the spine, hip, whole body, and distal radius by dual energy X-ray absorptiometry. Clinical tests included chair stands and tests of static and dynamic balance. We calculated a composite score summarizing abilities and time required to perform the tests.
Results
In multivariable models, men who failed in ≥one test had lower total hip aBMD than men who accomplished all the tests. They had lower total vBMD (Tt.vBMD), cortical thickness (Ct.Th), trabecular vBMD (Tb.vBMD), and more heterogenous trabecular distribution (Tb.Sp.SD) at the distal tibia (
p
 < 0.05). Men who failed in ≥two tests had lower aBMD at the total hip, femoral neck, and trochanter as well as lower Tt.vBMD, cortical vBMD (Ct.vBMD), Ct.Th and trabecular number (Tb.N), and higher Tb.Sp.SD at the distal tibia (
p
 < 0.05). Men in the lowest quartile of the composite score had lower aBMD (total hip, distal radius), lower Tb.vBMD and Tb.N at the distal radius, and lower Tt.vBMD, Ct.vBMD, Ct.Th, Tb.vBMD, and Tb.N, and higher Tb.Sp.SD at the distal tibia compared with the highest quartile. In multivariables models, men reporting falls had lower total hip aBMD and lower distal tibia Ct.vBMD (
p
 < 0.01).
Conclusion
In older men, poor physical performance is associated with lower hip aBMD and poor bone microarchitecture (mainly at the distal tibia).