In this study on postmenopausal healthy women, we demonstrated that lower handgrip strength of the dominant hand is associated with reduced BMD in the spine, femoral neck, and total hip. The association could not be explained by differences in BMI, levels of activity, age, smoking status, or postmenopausal duration.
Conflicting results regarding the relationship between handgrip strength and BMD have been previously reported (2
). Our study of postmenopausal women with a relatively large sample size (n = 337) is consistent with the majority of previous studies and reinforces the association between handgrip strength and BMD in the spine and hip.
Two prospective studies concerning the association between low handgrip strength and fractures (2
) have been published to date. In a study population of 1,380 women, low handgrip strength was shown to be associated with an increased risk of incident vertebral fractures, but not with prevalent fractures (2
). In another study that evaluated 649 healthy postmenopausal women, handgrip strength was found to be a risk factor of incident fragility fractures (7
We showed that low handgrip strength and low BMD are associated with increased risk of previous fragility fractures. Because the numbers of previous vertebral fractures (n = 8, 2.4%) were too small to reach statistical significance, this study failed to show an association between handgrip strength and fragility vertebral fractures.
Handgrip strength measurements are a non-invasive, low-cost, easy method for characterizing overall muscle strength. Handgrip strength is correlated with muscle function of the lower extremities (8
) and lower mobility (9
) in elderly adults. Handgrip strength may show general frailty (10
), nutritional status (1
), physical activity (12
), functional disability (13
), dependency in activities of daily living (ADL) and cognitive decline (14
), and all-cause mortality (15
). Epidemiological studies demonstrated that low handgrip strength in healthy adults is a risk factor for functional limitations and disability in older age as well as for all-cause mortality (13
). Whereas dominant handgrip strength was shown to be associated with BMD in Korean perimenopausal and postmenopausal women (17
), there were no previous studies on handgrip strength and fragility fractures in Korean women. Our multiple regression analysis showed that low handgrip strength and low femur neck BMD are risk factors of previous fragility fractures, suggesting DXA measurement could be coupled with simple handgrip strength measurements to predict fractures in postmenopausal women. This study suggests that strategies for improving muscle strength may provide protection against future risk of low BMD and may prevent fragility fractures in postmenopausal women.
This study has several limitations to be considered when interpreting the results. First, this study is a cross-sectional study with community dwelling volunteer participants, therefore our findings may not apply to the general population of postmenopausal women. Further, we did not verify the standardized radiographs to define fractures, relying instead on the interview history of fragility fractures.
In conclusion, low handgrip strength is positively associated with low BMD of the spine, femur neck, and total hip, as well as with increased risk of previous fragility fractures in postmenopausal Korean women.