Low skeletal muscle mass is associated with poor structural parameters of bone and impaired balance in elderly men–the MINOS study

Szulc, Pawel; Beck, Tom J; Marchand, François; Delmas, Pierre D

doi:10.1359/jbmr.041230

Cited by 284Nutrition and Health in AgingBone health and osteoporosis researchBody Composition Measurement Techniques

Low skeletal muscle mass is associated with poor structural parameters of bone and impaired balance in elderly men–the MINOS study

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Szulc, Pawel, Beck, Tom J, Marchand, François, Delmas, Pierre D·2005·Journal of Bone and Mineral Research

DOI 10.1359/jbmr.041230

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Abstract

In 796 men, 50-85 years of age, decreased relative skeletal muscle mass index was associated with narrower bones, thinner cortices, and a consequent decreased bending strength (lower section modulus), as well as with impaired balance and an increased risk of falls. Introduction: In men, appendicular skeletal muscle mass (ASM) is correlated positively with BMC and areal BMD (aBMD). In elderly men, low muscle mass and strength (sarcopenia) is associated with difficulties in daily living activities. The aim of this study was to evaluate if ASM is correlated with bone size, mechanical properties of bones, balance, and risk of falls in elderly men. Materials and Methods: This study used 796 men, 50-85 years of age, belonging to the MINOS cohort. Lifestyle factors were evaluated by standardized questionnaires. Estimates of mechanical bone properties were derived from aBMD measured by DXA. ASM was estimated by DXA. The relative skeletal muscle mass index (RASM) was calculated as ASM/(body height)2.3. Results: After adjustment for age, body size, tobacco smoking, professional physical activity, and 17β-estradiol concentration, RASM was correlated positively with BMC, aBMD, external diameter, and cortical thickness (r = 0.17-0.34, p < 0.0001) but not with volumetric BMD. Consequently, RASM was correlated with section modulus (r = 0.29-0.39, p < 0.0001). Men in the lowest quartile of RASM had section modulus of femoral neck and distal radius lower by 12-18% in comparison with men in the highest quartile of RASM. In contrast, bone width was not correlated with fat mass, reflecting the load of body weight (except for L3), which suggests that the muscular strain may exert a direct stimulatory effect on periosteal apposition. After adjustment for confounding variables, a decrease in RASM was associated with increased risk of falls and of inability to accomplish clinical tests of muscle strength, static balance, and dynamic balance (odds ratio per 1 SD decrease in RASM, 1.31-2.23; p < 0.05-0.001). Conclusions: In elderly men, decreased RASM is associated with narrower bones and thinner cortices, which results in a lower bending strength. Low RASM is associated with impaired balance and with an increased risk of falls in elderly men. It remains to be studied whether low RASM is associated with decreased periosteal apposition and with increased fracture risk in elderly men, and whether the difference in skeletal muscle mass between men and women contributes to the between-sex difference in fracture incidence.

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Low muscle mass and strength are associated with an increased fall risk in community-dwelling older adults.
“Low muscle mass and strength are associated with an increased fall risk in community-dwelling older adults.”
From Health Consequences of Sarcopenic Obesity: A Narrative Review (2020) · cites this paper as [109]
In elderly men, low muscle mass is associated with impaired balance and an increased risk of falls.
“In elderly men, low muscle mass was associated with impaired balance and an increased risk of falls (109).”
From Health Consequences of Sarcopenic Obesity: A Narrative Review (2020) · cites this paper as [109]

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Self-citation

Authors: Szulc, P., Beck, T. J., Marchand, F., & Delmas, P. D.
Affiliations: INSERM Unit 403, Lyon, France
Johns Hopkins University (US)
Société de Secours Minière de Bourgogne, Montceau les Mines, France
Inserm (FR)
Venue: Journal of Bone and Mineral Research
Publisher: Oxford University Press (OUP)
Published: 2005-05-01
Volume: 20
Issue: 5
Pages: 721-729
ISSN: 0884-0431 (ISSN-L)
1523-4681
DOI: 10.1359/jbmr.041230
OpenAlex: W2096856754
Cited by: 284
References: 69
Citations by year: 2026: 4 · 2025: 8 · 2024: 5 · 2023: 11 · 2022: 13 · 2021: 15 · 2020: 19 · 2019: 26 · 2018: 18 · 2017: 14 · 2016: 8 · 2015: 17 · 2014: 14 · 2013: 11 · 2012: 15
FWCI: 7.94
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations: Journal of Bone and Mineral Research (publishedVersion)
PubMed (publishedVersion)
Funders: Institut National de la Santé et de la Recherche Médicale
Merck Sharp and Dohme
Topics: Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
Keywords: skeletal muscle mass, sarcopenia, older men, bone mechanical properties, section modulus, cortical thickness, bone width, balance, fall risk, bone mineral density, bone mass, muscle strength, periosteal apposition, muscle strain, physical activity, estradiol
MeSH terms: Aged, Aged, 80 and over, Analysis of Variance, Body Weight, Bone and Bones, Estradiol, Humans, Male, Middle Aged, Muscular Atrophy, Muscular Diseases, Musculoskeletal System, Osteoporosis, Prospective Studies, Testosterone, Cohort Studies, Bone Density, Odds Ratio, Muscle, Skeletal

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Low skeletal muscle mass is associated with poor structural parameters of bone and impaired balance in elderly men–the MINOS study

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