Sirola J, Rikkonen T, Tuppurainen M, Jurvelin J S, Kröger H
Bone and Cartilage Research Unit, University of Kuopio, Kuopio, Finland.
Calcif Tissue Int. 2006 Apr;78(4):218-26. doi: 10.1007/s00223-005-0298-y. Epub 2006 Apr 13.
The aim of the present study was to investigate the association between grip strength change and bone health according to menopausal status. A random sample of 971 pre- to postmenopausal women from the Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) study cohort was measured with dual X-ray absorptiometry in the lumbar spine (LS) and femoral neck (FN) and grip strength with pneumatic squeeze dynamometer at baseline (1989-1991), 5 years (1994-1997), and 10 years (1999-2001). Fractures were recorded based on self-reports and validated from medical records. Women were divided into two groups according to change in grip strength quartile from baseline to 5-year follow-up: not improved (n = 735) and improved (n = 236). In the total population, the greatest bone loss was observed in perimenopausal (beginning of menopause during follow-up, n = 311) women [P < 0.001 vs. premenopausal women (n = 139)], and it declined in postmenopausal (n = 521) women [P < 0.001 by analysis of covariance (ANCOVA)]. The perimenopausal bone loss rate was significantly lower in women in the improved group in comparison to the not improved group (P < 0.01) in contrast to the pre- and postmenopausal groups (P > 0.05). Accordingly, there was a greater decline in perimenopausal LS and FN T-scores in the improved group vs. the not improved group over the first 5-year follow-up interval (P < 0.05 by ANCOVA) and remained unchanged over the 10-year follow-up. In perimenopausal women, there was a trend toward higher fracture-free survival rate in the improved group (82%) vs. the not improved group (88%) after 10 years. Adjustments did not change the results. In conclusion, maintenance of grip strength is associated with menopausal bone loss and future fractures.
本研究的目的是根据绝经状态调查握力变化与骨骼健康之间的关联。从库奥皮奥骨质疏松症危险因素与预防（OSTPRE）研究队列中随机抽取971名绝经前至绝经后的女性，在基线期（1989 - 1991年）、5年（1994 - 1997年）和10年（1999 - 2001年）时，使用双能X线吸收法测量腰椎（LS）和股骨颈（FN）的骨密度，并使用气动握力计测量握力。骨折情况根据自我报告记录，并从医疗记录中进行验证。根据从基线到5年随访期间握力四分位数的变化，将女性分为两组：未改善组（n = 735）和改善组（n = 236）。在总体人群中，围绝经期（随访期间开始绝经，n = 311）女性的骨量流失最大[与绝经前女性（n = 139）相比，P < 0.001]，而绝经后（n = 521）女性的骨量流失有所下降[通过协方差分析（ANCOVA），P < 0.001]。与未改善组相比，改善组围绝经期女性的骨量流失率显著更低（P < 0.01），而绝经前和绝经后组则无显著差异（P > 0.05）。因此，在最初的5年随访期间，改善组围绝经期女性腰椎和股骨颈的T值下降幅度大于未改善组（通过ANCOVA，P < 0.05），且在10年随访期间保持不变。在围绝经期女性中，10年后改善组（82%）的无骨折生存率高于未改善组（88%），但差异无统计学意义。调整后结果不变。总之，维持握力与绝经后骨量流失及未来骨折相关。
