Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha, Toledo, Spain.
Health and Social Research Center (CESS), Universidad de Castilla-La Mancha, Ed/ Melchor Cano, C/Santa Teresa Jornet s/n, 16071, Cuenca, Spain.
Sports Med. 2020 Jun;50(6):1163-1190. doi: 10.1007/s40279-020-01267-y.
Osteoporosis is a major worldwide health concern. The acquisition of bone mass during growth decreases the risk of osteoporosis later in life. Muscular strength is an important and modifiable factor to improve bone development in this period.
The aim of this review was to summarize the relationship between muscular strength and bone health.
Cross-sectional data from studies addressing this association from childhood to young adulthood were systematically searched. The DerSimonian and Laird method was used to compute pooled estimates of effect size and respective 95% CI. The meta-analyses were conducted separately for upper limbs or lower limbs muscular strength and for bone regions. Additionally, a regression model was used to estimate the influence of determinants such as age, lean mass, fat mass, height, weight and cardiorespiratory fitness in this association.
Thirty-nine published studies were included in the systematic review. The pooled effect size for the association of upper limbs muscular strength with upper limbs, spine and total body BMD ranged from 0.70 to 1.07 and with upper limbs, spine and total body BMC ranged from 1.84 to 1.30. The pooled effect size for the association of lower limbs muscular strength with lower limbs, spine and total body BMD ranged from 0.54 to 0.88 and with lower limbs, spine and total body BMC ranged between 0.81 and 0.71. All reported pooled effect size estimates were statistically significant.
This systematic review and meta-analysis supports that muscular strength should be considered as a useful skeletal health marker during development and a target outcome for interventions aimed at improving bone health.
骨质疏松症是一个全球性的健康问题。在生长过程中获得的骨量可以降低日后患骨质疏松症的风险。肌肉力量是一个重要且可改变的因素，可以促进这一时期的骨骼发育。
本综述的目的是总结肌肉力量与骨骼健康之间的关系。
系统检索了从儿童期到青年期研究该相关性的横断面数据。采用 DerSimonian 和 Laird 法计算效应量的合并估计值及其 95%CI。分别对上肢或下肢肌肉力量与骨区进行meta 分析。此外，还使用回归模型来估计年龄、瘦体重、脂肪量、身高、体重和心肺适能等决定因素对该相关性的影响。
系统综述共纳入 39 项已发表的研究。上肢肌肉力量与上肢、脊柱和全身骨密度的关联的合并效应量范围为 0.70 至 1.07，与上肢、脊柱和全身骨矿物质含量的关联的合并效应量范围为 1.84 至 1.30。下肢肌肉力量与下肢、脊柱和全身骨密度的关联的合并效应量范围为 0.54 至 0.88，与下肢、脊柱和全身骨矿物质含量的关联的合并效应量范围为 0.81 至 0.71。所有报告的合并效应量估计值均具有统计学意义。
本系统综述和荟萃分析支持肌肉力量应被视为发育过程中骨骼健康的有用标志物，也是旨在改善骨骼健康的干预措施的目标结果。
