Muscle force has greater effects on tibial bone strength in Gambian women compared to men — ASN Events
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Muscle force has greater effects on tibial bone strength in Gambian women compared to men (#227)

Ayse Zengin 1 2 , Ann Prentice 2 3 , Landing M Jarjou 3 , Mustapha Ceesay 3 , Michael Mendy 3 , Peter R Ebeling 1 , Kate A Ward 2 4
  1. Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
  2. Nutrition and Bone Health, Medical Research Council Elsie Widdowson Laboratory, Cambridge, UK
  3. Calcium, Vitamin D and Bone Health, Medical Research Council Unit The Gambia, Keneba, The Gambia
  4. Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK

Musculoskeletal disease is a major contributor to the global non-communicable disease burden, with 119-million disability-adjusted life years lost worldwide. The global increase in ageing is expected to double the osteoporotic fracture incidence in developing countries by 2040. Strategies to maintain bone strength, prevent damage and fracture are imperative. The aim of this study was to examine the effects of muscle-strength on tibial bone outcomes in a population where fracture incidence is expected to rise.

Women (W) and men (M) aged ≥40years from rural Gambia (West-Africa) were recruited. Tibial bone outcomes- 14%: cortical (Ct) vBMC, cross-sectional area (CSA), Ct area (Ct.Area), cross-sectional moment of inertia (CSMI); 66%: cross-sectional muscle area (CSMA). Muscle-strength was assessed by jumping-mechanography: single 2-leg counter-jump to calculate muscle-force (kN) and power (kW). Linear regressions explored the relationship between force and bone outcomes, adjusting for age, weight, height; including a sex-force interaction. Similar analyses were used to identify the effects of muscle-force/power and age; including an age-sex interaction. Results are expressed as β-coefficients [95% CI] of percentage unit change in force/age.

For every 10yr increase in age, there was a decline in: muscle-force (M:-10.2%[-11.9,-8.4], W:-7.5%[-9.5,-5.4], p<0.05; muscle power (M:-27.4%[-31.2,-23.6], W:-20.2%[-24.6,-15.7], p=0.01). CSMA decline with age was markedly less, with no sex differences (p=0.885). Muscle-force was a significant predictor of bone. For every 1kN increase in force, there was an increase in: Ct.vBMC (M:11.4%[-2.8,25.6], W:44.3%[26.2,62.7], p<0.0001); CSA (M:10.6%[-1.2,22.4], W:33.6%[18.6,48.5], p=0.001); Ct.Area (M:9.9%[-1.9,21.8], W:33.5%[18.4,48.6], p=0.001); CSMI (M:12.7%[1.2,24.2], W:22.5%[7.9,37.2], p=0.152). Similar effects were seen at the 38% tibia.

Muscle-force and power decreased with age in this population. Less change in muscle-strength was observed in women, possibly due to continued farming/gardening. Greater force was associated with greater estimates of bone strength, more so in women compared to men. Intervention strategies should focus on maintaining muscle and bone strength in ageing Gambians.