Foley K T, Owings T M, Pavol M J, Grabiner M D
Section of Geriatric Medicine, The Cleveland Foundation, Cleveland, Ohio 44195, USA.
Calcif Tissue Int. 1999 Apr;64(4):291-4. doi: 10.1007/s002239900621.
In the past decade there have been numerous publications reporting a significant and direct relationship between handgrip strength and bone mineral density (BMD) of the proximal femur in older adults. The present report challenges the appropriateness of the methods, and thus the conclusions used in these studies. Specifically, these studies failed to control for the concomitant influence of body weight on both BMD and muscle strength. In the present study, maximum handgrip strength was measured using a conventional hand-held hydraulic dynamometer. Bone mineral density of the proximal femur was measured using dual-energy X-ray absorptiometry (DXA). Using allometric scaling, the influence of body weight on the value of maximum handgrip strength was removed for the data of the women. A small, but significant relationship between BMD of the proximal femur and maximum handgrip strength was found that accounted for about 6% of the total variation. The relationship between BMD of the proximal femur and unscaled maximum handgrip strength was not significant for the men. The findings diminish the confidence in a protective effect of skeletal muscle on some nonadjacent skeletal structures and suggest that these relationships may benefit from being revisited. The results highlight the utility of allometric scaling in analyses in which the relationship between a physiological variable and a body dimension variable can be nonlinearly and simultaneously influenced by other body dimension variables that are not considered in the analysis and therefore are statistically uncontrolled.
在过去十年中,有大量出版物报道了老年人握力与股骨近端骨密度(BMD)之间存在显著的直接关系。本报告对这些研究中所使用方法的恰当性提出质疑,进而也对这些研究所得出的结论提出质疑。具体而言,这些研究未能控制体重对骨密度和肌肉力量的同时影响。在本研究中,使用传统的手持式液压测力计测量最大握力。使用双能X线吸收法(DXA)测量股骨近端的骨密度。通过异速生长标度法,去除了体重对女性数据中最大握力值的影响。研究发现,股骨近端骨密度与最大握力之间存在微弱但显著的关系,约占总变异的6%。对于男性而言,股骨近端骨密度与未标度的最大握力之间的关系并不显著。这些发现削弱了人们对骨骼肌对某些非相邻骨骼结构具有保护作用的信心,并表明这些关系可能需要重新审视。结果突出了异速生长标度法在分析中的作用,即在分析中,生理变量与身体尺寸变量之间的关系可能会受到分析中未考虑且因此未进行统计控制的其他身体尺寸变量的非线性和同时影响。