Article: Low handgrip strength is a predictor of osteoporotic fractures: Cross-sectional and prospective evidence from the Hong Kong Osteoporosis Study

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Publisher Website: 10.1007/s11357-011-9297-2
Scopus: eid_2-s2.0-84867575842
PMID: 21853264

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Title	Low handgrip strength is a predictor of osteoporotic fractures: Cross-sectional and prospective evidence from the Hong Kong Osteoporosis Study
Authors	Cheung, CL Tan, KCB Bow, CH Soong, CSS Loong, CHN Kung, AWC
Keywords	Falls Fracture Handgrip strength Osteoporosis
Issue Date	2012
Publisher	Springer Netherlands. The Journal's web site is located at http://www.springerlink.com/content/0161-9152/
Citation	Age, 2012, v. 34 n. 5, p. 1239-1248 [How to Cite?] DOI: http://dx.doi.org/10.1007/s11357-011-9297-2
Abstract	Handgrip strength (HGS) is a potentially useful objective parameter to predict fracture since it is an indicator of general muscle strength and is associated with fragility and propensity to fall. Our objective was to examine the association of HGS with fracture, to evaluate the accuracy of HGS in predicting incident fracture, and to identify subjects at risk of fracture. We analyzed a cross-sectional cohort with 2,793 subjects (1,217 men and 1,576 women aged 50-101 years) and a subset of 1,702 subjects which were followed for a total of 4,855 person-years. The primary outcome measures were prevalent fractures and incident major fragility fractures. Each standard deviation (SD) reduction in HGS was associated with a 1.24-fold increased odds for major clinical fractures even after adjustment for other clinical factors. A similar result was obtained in the prospective cohort with each SD reduction in HGS being associated with a 1.57-fold increased hazard ratio of fracture even after adjustment for clinical factors. A combination of HGS and femoral neck bone mineral density (FN BMD) T-score values (combined T-score), together with other clinical factors, had a better predictive power of incident fractures than FN BMD or HGS T-score alone with clinical factors. In addition, combined T-score has better sensitivity and specificity in predicting incidence fractures than FN BMD alone. This study is the first study to compare the predictive ability of HGS and BMD. We showed that HGS is an independent risk factor for major clinical fractures. Compared with using FN BMD T-score of -2.5 alone, HGS alone has a comparable predictive power to BMD, and the combined T-score may be useful to identify extra subjects at risk of clinical fractures with improved specificity. © The Author(s) 2011.
ISSN	0161-9152 2011 Impact Factor: 3.948 2011 SCImago Journal Rankings: 0.163
DOI	http://dx.doi.org/10.1007/s11357-011-9297-2
References	References in Scopus

DC Field	Value
dc.contributor.author	Cheung, CL
dc.contributor.author	Tan, KCB
dc.contributor.author	Bow, CH
dc.contributor.author	Soong, CSS
dc.contributor.author	Loong, CHN
dc.contributor.author	Kung, AWC
dc.date.accessioned	2012-02-21T05:43:19Z
dc.date.available	2012-02-21T05:43:19Z
dc.date.issued	2012
dc.description.abstract	Handgrip strength (HGS) is a potentially useful objective parameter to predict fracture since it is an indicator of general muscle strength and is associated with fragility and propensity to fall. Our objective was to examine the association of HGS with fracture, to evaluate the accuracy of HGS in predicting incident fracture, and to identify subjects at risk of fracture. We analyzed a cross-sectional cohort with 2,793 subjects (1,217 men and 1,576 women aged 50-101 years) and a subset of 1,702 subjects which were followed for a total of 4,855 person-years. The primary outcome measures were prevalent fractures and incident major fragility fractures. Each standard deviation (SD) reduction in HGS was associated with a 1.24-fold increased odds for major clinical fractures even after adjustment for other clinical factors. A similar result was obtained in the prospective cohort with each SD reduction in HGS being associated with a 1.57-fold increased hazard ratio of fracture even after adjustment for clinical factors. A combination of HGS and femoral neck bone mineral density (FN BMD) T-score values (combined T-score), together with other clinical factors, had a better predictive power of incident fractures than FN BMD or HGS T-score alone with clinical factors. In addition, combined T-score has better sensitivity and specificity in predicting incidence fractures than FN BMD alone. This study is the first study to compare the predictive ability of HGS and BMD. We showed that HGS is an independent risk factor for major clinical fractures. Compared with using FN BMD T-score of -2.5 alone, HGS alone has a comparable predictive power to BMD, and the combined T-score may be useful to identify extra subjects at risk of clinical fractures with improved specificity. © The Author(s) 2011.
dc.description.nature	published_or_final_version
dc.description.other	Springer Open Choice, 21 Feb 2012
dc.identifier.citation	Age, 2012, v. 34 n. 5, p. 1239-1248 [How to Cite?] DOI: http://dx.doi.org/10.1007/s11357-011-9297-2
dc.identifier.citeulike	9822336
dc.identifier.doi	http://dx.doi.org/10.1007/s11357-011-9297-2
dc.identifier.eissn	1574-4647
dc.identifier.epage	1248
dc.identifier.hkuros	192167
dc.identifier.issn	0161-9152 2011 Impact Factor: 3.948 2011 SCImago Journal Rankings: 0.163
dc.identifier.issue	5
dc.identifier.pmid	21853264
dc.identifier.scopus	eid_2-s2.0-84867575842
dc.identifier.spage	1239
dc.identifier.uri	http://hdl.handle.net/10722/144931
dc.identifier.volume	34
dc.language	eng
dc.publisher	Springer Netherlands. The Journal's web site is located at http://www.springerlink.com/content/0161-9152/
dc.publisher.place	Netherlands
dc.relation.ispartof	Age
dc.relation.references	References in Scopus
dc.rights	Creative Commons: Attribution 3.0 Hong Kong License
dc.subject	Falls
dc.subject	Fracture
dc.subject	Handgrip strength
dc.subject	Osteoporosis
dc.title	Low handgrip strength is a predictor of osteoporotic fractures: Cross-sectional and prospective evidence from the Hong Kong Osteoporosis Study
dc.type	Article

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Author Affiliations

The University of Hong Kong