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. 2021 Dec;7(4):127-133.
doi: 10.1016/j.afos.2021.10.001. Epub 2021 Oct 21.

Daily activity relates to not only femoral bone mineral density, but also hip structural analysis parameters: A cross-sectional observational study

Norifumi Fujii  1   2 , Nobukazu Okimoto  3   4 , Manabu Tsukamoto  5 , Norimitsu Fujii  6 , Kei Asano  4 , Yoshiaki Ikejiri  4 , Toru Yoshioka  4 , Takafumi Tajima  5 , Yoshiaki Yamanaka  5 , Yukichi Zenke  5 , Makoto Kawasaki  5 , Junya Ozawa  7 , Takuya Umehara  7 , Shogo Takano  1 , Hideaki Murata  4 , Nobuhiro Kito  7
Affiliations

Daily activity relates to not only femoral bone mineral density, but also hip structural analysis parameters: A cross-sectional observational study

Norifumi Fujii et al. Osteoporos Sarcopenia. 2021 Dec.

Abstract

Objectives: Physical activity to maintain bone mass and strength is important for hip fracture prevention. We aim to investigate the relationship between physical performance/activity status and bone mineral density (BMD)/hip structural analysis (HSA) parameters among postmenopausal women in Japan.

Methods: Sixty-two postmenopausal women diagnosed with osteoporosis (mean age: 72.61 ± 7.43 years) were enrolled in this cross-sectional observational study. They were evaluated for BMD and HSA in the proximal femur by dual-energy X-ray absorptiometry and underwent several physical performance tests, the Geriatric Locomotive Function Scale of 25 questions (GLFS-25). Principal component analysis (PCA) was used to summarize data on the BMD/HSA parameters. Partial correlation analysis, multiple regression analysis, and structural equation modeling (SEM) were performed to investigate the relationship between physical performance/activity status and BMD/HSA parameters of the proximal femur.

Results: In a partial correlation analysis adjusted for age and body mass index (BMI), GLFS-25 scores were correlated with HSA parameter (|r| = 0.260-0.396, P < 0.05). Principal component 1 (PC1) calculated by PCA was interpreted as more reflective of bone strength based on the value of BMD/HSA parameters. The SEM results showed that the model created by the 3 questions (Q13, brisk walking; Q15, keep walking without rest; Q20, load-bearing tasks and housework) of the GLFS-25 had the best fit and was associated with the PC1 score (β = -0.444, P = 0.001).

Conclusions: The GLFS-25 score was associated with the BMD/HSA parameter, which may reflect the bone strength of the proximal femur as calculated by PCA.

Keywords: Bone mineral density; Geriatric locomotive function scale of 25 questions; Hip structural analysis; Locomotive syndrome; Osteoporosis.

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Conflict of interest statement

Nobukazu Okimoto has received consulting fees from Teijin Pharma Ltd and Asahi-Kasei Pharmaceutical Co., Ltd. Nobukazu Okimoto has received payments for lectures, such as speakers’ bureau fees, from Astellas Pharma Inc.; Asahi-Kasei Pharmaceutical Co., Ltd.; Eli Lilly Japan K·K.; Chugai Pharmaceutical Co.; Amgen Astellas BioPharma K·K.; Daiichi-Sankyo Co. Ltd.; Eisai Co., Ltd.; Teijin Pharma Ltd.; Pfizer Japan Inc.; Ono Pharmaceutical Co.; and Mitsubishi-Tanabe Pharma Corp. There are no conflicts of interest for all other authors.

Figures

Fig. 1
Fig. 1
Calculated region of the hip structural analysis parameters used in this study. Parameters calculated in the narrow neck region (NN) and intertrochanter region (IT) were used in the analysis. (a); Narrow neck region, (b); Intertrochanter region.
Fig. 2
Fig. 2
Final model created by structural equation modeling The numbers on the arrows represent the standardized regression coefficients. The ellipse indicates a latent variable. χ2 = 0.714, CFI = 1.000, GFI = 0.994, AGFI = 0.971, RMSEA = 0.000, AIC = 16.714. ∗∗P < 0.01 CFI, comparative fit index; GFI, goodness-of-fit index; AGFI, adjusted goodness-of-fit index; RMSEA, root mean square error of approximation; AIC, Akaike's information criterion.
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