PMID- 36530188 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240306 IS - 2473-4039 (Electronic) IS - 2473-4039 (Linking) VI - 6 IP - 12 DP - 2022 Dec TI - Greater pQCT Calf Muscle Density Is Associated with Lower Fracture Risk, Independent of FRAX, Falls and BMD: A Meta-Analysis in the Osteoporotic Fractures in Men (MrOS) Study. PG - e10696 LID - 10.1002/jbm4.10696 [doi] LID - e10696 AB - We investigated the predictive performance of peripheral quantitative computed tomography (pQCT) measures of both calf muscle density (an established surrogate for muscle adiposity, with higher values indicating lower muscle adiposity and higher muscle quality) and size (cross-sectional area [CSA]) for incident fracture. pQCT (Stratec XCT2000/3000) measurements at the tibia were undertaken in Osteoporotic Fractures in Men (MrOS) United States (US), Hong Kong (HK), and Swedish (SW) cohorts. Analyses were by cohort and synthesized by meta-analysis. The predictive value for incident fracture outcomes, illustrated here for hip fracture (HF), using an extension of Poisson regression adjusted for age and follow-up time, was expressed as hazard ratio (HR) per standard deviation (SD) increase in exposure (HR/SD). Further analyses adjusted for femoral neck (fn) bone mineral density (BMD) T-score, Fracture Risk Assessment Tool (FRAX) 10-year fracture probability (major osteoporotic fracture) and prior falls. We studied 991 (US), 1662 (HK), and 1521 (SW) men, mean +/- SD age 77.0 +/- 5.1, 73.9 +/- 4.9, 80 +/- 3.4 years, followed for a mean +/- SD 7.8 +/- 2.2, 8.1 +/- 2.3, 5.3 +/- 2.0 years, with 31, 47, and 78 incident HFs, respectively. Both greater muscle CSA and greater muscle density were associated with a lower risk of incident HF [HR/SD: 0.84; 95% confidence interval [CI], 0.72-1.0 and 0.78; 95% CI, 0.66-0.91, respectively]. The pattern of associations was not materially changed by adjustment for prior falls or FRAX probability. In contrast, after inclusion of fn BMD T-score, the association for muscle CSA was no longer apparent (1.04; 95% CI, 0.88-1.24), whereas that for muscle density was not materially changed (0.69; 95% CI, 0.59-0.82). Findings were similar for osteoporotic fractures. pQCT measures of greater calf muscle density and CSA were both associated with lower incidence of fractures in older men, but only muscle density remained an independent risk factor for fracture after accounting for fn BMD. These findings demonstrate a complex interplay between measures of bone, muscle size, and quality, in determining fracture risk. (c) 2022 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research. CI - (c) 2022 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research. FAU - Harvey, Nicholas C AU - Harvey NC AUID- ORCID: 0000-0002-8194-2512 AD - MRC Lifecourse Epidemiology Centre University of Southampton Southampton UK. AD - NIHR Southampton Biomedical Research Centre University of Southampton and University Hospital Southampton NHS Foundation Trust Southampton UK. FAU - Orwoll, Eric AU - Orwoll E AUID- ORCID: 0000-0002-8520-7355 AD - Division of Endocrinology, Diabetes and Clinical Nutrition, School of Medicine Oregon Health & Science University Portland OR USA. FAU - Cauley, Jane A AU - Cauley JA AUID- ORCID: 0000-0003-0752-4408 AD - Department of Epidemiology, Graduate School of Public Health University of Pittsburgh Pittsburgh PA USA. FAU - Kwok, Timothy AU - Kwok T AD - Department of Medicine & Therapeutics and School of Public Health The Chinese University of Hong Kong Shatin China. FAU - Karlsson, Magnus K AU - Karlsson MK AUID- ORCID: 0000-0002-0616-5928 AD - Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences Malmo Lund University and Department of Orthopedics, Skane University Hospital Malmo Sweden. FAU - Rosengren, Bjorn E AU - Rosengren BE AD - Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences Malmo Lund University and Department of Orthopedics, Skane University Hospital Malmo Sweden. FAU - Ribom, Eva AU - Ribom E AD - Department of Surgical Sciences University of Uppsala Uppsala Sweden. FAU - Cawthon, Peggy M AU - Cawthon PM AUID- ORCID: 0000-0003-4938-9478 AD - Research Institute California Pacific Medical Center San Francisco CA USA. AD - Department of Epidemiology and Biostatistics University of California San Francisco CA USA. FAU - Ensrud, Kristine AU - Ensrud K AUID- ORCID: 0000-0002-9069-3036 AD - Medicine and Epidemiology & Community Health University of Minnesota Minneapolis MN USA. AD - Center for Care Delivery and Outcomes Research Minneapolis VA Health Care System Minneapolis MN USA. FAU - Liu, Enwu AU - Liu E AD - Mary MacKillop Institute for Health Research Australian Catholic University Melbourne Australia. FAU - Laskou, Faidra AU - Laskou F AD - MRC Lifecourse Epidemiology Centre University of Southampton Southampton UK. FAU - Ward, Kate A AU - Ward KA AUID- ORCID: 0000-0001-7034-6750 AD - MRC Lifecourse Epidemiology Centre University of Southampton Southampton UK. FAU - Dennison, Elaine M AU - Dennison EM AD - MRC Lifecourse Epidemiology Centre University of Southampton Southampton UK. FAU - Cooper, Cyrus AU - Cooper C AUID- ORCID: 0000-0003-3510-0709 AD - MRC Lifecourse Epidemiology Centre University of Southampton Southampton UK. AD - NIHR Southampton Biomedical Research Centre University of Southampton and University Hospital Southampton NHS Foundation Trust Southampton UK. AD - NIHR Oxford Biomedical Research Centre University of Oxford Oxford UK. FAU - Kanis, John A AU - Kanis JA AD - Mary MacKillop Institute for Health Research Australian Catholic University Melbourne Australia. AD - Centre for Metabolic Bone Diseases University of Sheffield Sheffield UK. FAU - Vandenput, Liesbeth AU - Vandenput L AD - Mary MacKillop Institute for Health Research Australian Catholic University Melbourne Australia. AD - Sahlgrenska Osteoporosis Centre, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden. FAU - Lorentzon, Mattias AU - Lorentzon M AUID- ORCID: 0000-0003-0749-1431 AD - Mary MacKillop Institute for Health Research Australian Catholic University Melbourne Australia. AD - Sahlgrenska Osteoporosis Centre, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden. FAU - Ohlsson, Claes AU - Ohlsson C AD - Sahlgrenska Osteoporosis Centre, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden. FAU - Mellstrom, Dan AU - Mellstrom D AD - Sahlgrenska Osteoporosis Centre, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden. FAU - Johansson, Helena AU - Johansson H AD - Mary MacKillop Institute for Health Research Australian Catholic University Melbourne Australia. AD - Sahlgrenska Osteoporosis Centre, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden. FAU - McCloskey, Eugene AU - McCloskey E AUID- ORCID: 0000-0003-0177-8140 AD - Centre for Metabolic Bone Diseases University of Sheffield Sheffield UK. AD - Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Mellanby Centre for Musculoskeletal Research University of Sheffield Sheffield UK. LA - eng GR - MC_UP_A620_1015/MRC_/Medical Research Council/United Kingdom GR - MR/P020941/1/MRC_/Medical Research Council/United Kingdom GR - UL1 TR002369/TR/NCATS NIH HHS/United States GR - MC_PC_21003/MRC_/Medical Research Council/United Kingdom GR - U01 AG042145/AG/NIA NIH HHS/United States GR - U01 AG042168/AG/NIA NIH HHS/United States GR - MRF_MRF-145-0011-DG-HARV-C0913/MRF/MRF/United Kingdom GR - U01 AG042140/AG/NIA NIH HHS/United States GR - U01 AG027810/AG/NIA NIH HHS/United States GR - U01 AG042143/AG/NIA NIH HHS/United States GR - U01 AG042139/AG/NIA NIH HHS/United States GR - U01 AR066160/AR/NIAMS NIH HHS/United States GR - R01 AG066671/AG/NIA NIH HHS/United States GR - U01 AG042124/AG/NIA NIH HHS/United States GR - MC_UU_12011/2/MRC_/Medical Research Council/United Kingdom PT - Journal Article DEP - 20221122 PL - England TA - JBMR Plus JT - JBMR plus JID - 101707013 PMC - PMC9751652 OTO - NOTNLM OT - EPIDEMIOLOGY OT - FRACTURE OT - FRAX OT - OSTEOPOROSIS OT - PERIPHERAL QUANTITATIVE COMPUTED TOMOGRAPHY OT - PQCT OT - SARCOPENIA COIS- All authors have no disclosures in relation to this manuscript. EDAT- 2022/12/20 06:00 MHDA- 2022/12/20 06:01 PMCR- 2022/11/22 CRDT- 2022/12/19 03:24 PHST- 2022/10/15 00:00 [received] PHST- 2022/10/26 00:00 [accepted] PHST- 2022/12/19 03:24 [entrez] PHST- 2022/12/20 06:00 [pubmed] PHST- 2022/12/20 06:01 [medline] PHST- 2022/11/22 00:00 [pmc-release] AID - JBM410696 [pii] AID - 10.1002/jbm4.10696 [doi] PST - epublish SO - JBMR Plus. 2022 Nov 22;6(12):e10696. doi: 10.1002/jbm4.10696. eCollection 2022 Dec.