title: Relationship of calf circumference with bone mineral density and hip geometry: a hospital-based cross-sectional study.
abstract: Calf circumference has significant predictive value for bone mineral density (BMD) at hip and spine and for fracture at spine in both genders and hence may be used as a clinical risk factor for fracture when BMD is not available.
  
  
  BACKGROUND
  Lean muscle mass and higher regular physical ability has been shown to correlate with BMD and hip geometry. Calf circumference is an indicator of muscle mass. We examined the association of calf circumference (CC), thigh circumference (TC), and physical performances with BMD and hip geometry.
  
  
  METHODS
  Females above 45 years (at least 5 years postmenopausal) and males above 55 years were enrolled. Bilateral CC and TC were measured, and BMD was assessed at neck of femur (NF), trochanter (TR), inter-trochanter (IT), spine, and forearm. Dual energy X-ray absorptiometry scan-based hip geometry parameters were analyzed.
  
  
  RESULTS
  One hundred sixteen subjects (29 males and 87 females) were enrolled. CC correlated significantly with BMD at NF, IT, TR, and spine in male and female, respectively, and at forearm in female. Multivariate regression analysis showed CC as a significant predictor of BMD (at TR, IT, NF, and spine in both genders) and fracture (at spine in both genders). CC had significant positive correlation with hip parameters-cross-sectional area; cortical thickness; and section modulus at NF, IT, and TR in both genders and negative correlation with buckling ratio at NF and IT in females.
  
  
  CONCLUSIONS
  CC is a significant predictor of BMD at hip and spine and fracture at spine in both genders.
authors.affiliation: Department of Endocrinology, Nizam's Institute of Medical Sciences, Hyderabad, India, 500082, rekha.endo@gmail.com.
authors.forename: Rekha
authors.initials: R
authors.lastname: Singh
authors.forename: Sushil
authors.initials: S
authors.lastname: Gupta
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D001837:Body Weights and Measures; D015519:Bone Density; D003430:Cross-Sectional Studies; D005260:Female; D006615:Hip / Q000033:anatomy & histology*; D006761:Hospitals; D006801:Humans; D007866:Leg / Q000033:anatomy & histology*; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000473:pathology