title: Greater association of peak neuromuscular performance with cortical bone geometry, bone mass and bone strength than bone density: A study in 417 older women.
abstract: BACKGROUND
  We evaluated which aspects of neuromuscular performance are associated with bone mass, density, strength and geometry.
  
  
  METHODS
  417 women aged 60-94years were examined. Countermovement jump, sit-to-stand test, grip strength, forearm and calf muscle cross-sectional area, areal bone mineral content and density (aBMC and aBMD) at the hip and lumbar spine via dual X-ray absorptiometry, and measures of volumetric vBMC and vBMD, bone geometry and section modulus at 4% and 66% of radius length and 4%, 38% and 66% of tibia length via peripheral quantitative computed tomography were performed. The first principal component of the neuromuscular variables was calculated to generate a summary neuromuscular variable. Percentage of total variance in bone parameters explained by the neuromuscular parameters was calculated. Step-wise regression was also performed.
  
  
  RESULTS
  At all pQCT bone sites (radius, ulna, tibia, fibula), a greater percentage of total variance in measures of bone mass, cortical geometry and/or bone strength was explained by peak neuromuscular performance than for vBMD. Sit-to-stand performance did not relate strongly to bone parameters. No obvious differential in the explanatory power of neuromuscular performance was seen for DXA aBMC versus aBMD. In step-wise regression, bone mass, cortical morphology, and/or strength remained significant in relation to the first principal component of the neuromuscular variables. In no case was vBMD positively related to neuromuscular performance in the final step-wise regression models.
  
  
  CONCLUSIONS
  Peak neuromuscular performance has a stronger relationship with leg and forearm bone mass and cortical geometry as well as proximal forearm section modulus than with vBMD.
authors.affiliation: Centre for Muscle and Bone Research, Charité Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Germany; Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia. Electronic address: belavy@gmail.com.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Belavý
authors.affiliation: Centre for Muscle and Bone Research, Charité Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Germany. Electronic address: gabi.armbrecht@charite.de.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Armbrecht
authors.affiliation: Centre for Muscle and Bone Research, Charité Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Germany. Electronic address: tilo.blenk@googlemail.com.
authors.forename: Tilo
authors.initials: T
authors.lastname: Blenk
authors.affiliation: Centre for Muscle and Bone Research, Charité Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Germany. Electronic address: ob@promedio.eu.
authors.forename: Oliver
authors.initials: O
authors.lastname: Bock
authors.affiliation: Centre for Muscle and Bone Research, Charité Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Germany. Electronic address: Hendrikje.Boerst@charite.de.
authors.forename: Hendrikje
authors.initials: H
authors.lastname: Börst
authors.affiliation: Centre for Muscle and Bone Research, Charité Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Germany. Electronic address: info@dr-kocakaya.de.
authors.forename: Emine
authors.initials: E
authors.lastname: Kocakaya
authors.affiliation: Centre for Muscle and Bone Research, Charité Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Germany. Electronic address: franziska.luhn@gmx.de.
authors.forename: Franziska
authors.initials: F
authors.lastname: Luhn
authors.affiliation: Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia. Electronic address: t.rantalainen@deakin.edu.au.
authors.forename: Timo
authors.initials: T
authors.lastname: Rantalainen
authors.affiliation: Stratec Medizintechnik GmbH, Durlacher Str. 35, 75172 Pforzheim, Germany. Electronic address: r.rawer@novotecmedical.de.
authors.forename: Rainer
authors.initials: R
authors.lastname: Rawer
authors.affiliation: Centre for Muscle and Bone Research, Charité Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Germany. Electronic address: fe_thomasius@web.de.
authors.forename: Frederike
authors.initials: F
authors.lastname: Tomasius
authors.affiliation: Stratec Medizintechnik GmbH, Durlacher Str. 35, 75172 Pforzheim, Germany. Electronic address: j.willnecker@stratec-med.com.
authors.forename: Johannes
authors.initials: J
authors.lastname: Willnecker
authors.affiliation: Centre for Muscle and Bone Research, Charité Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Germany. Electronic address: dieter.felsenberg@charite.de.
authors.forename: Dieter
authors.initials: D
authors.lastname: Felsenberg
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D001827:Body Height; D001835:Body Weight; D015519:Bone Density / Q000502:physiology*; D001842:Bone and Bones / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000502:physiology; D005260:Female; D018737:Hand Strength; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D009132:Muscles / Q000502:physiology*; D009929:Organ Size; D025341:Principal Component Analysis; D014057:Tomography, X-Ray Computed
keywords: Exercise; Function; Osteoporosis; Sarcopenia