Among older men and women, there is a positive association between hand grip strength and distal radius bone strength and size, according to study results published in JBMR Plus.

Researchers sought to establish the association between grip strength and high-resolution peripheral quantitative computed tomography (HR-pQCT) measures of distal radius bone density, size, microarchitecture, morphology, and overall bone strength, as estimated by micro-finite element analysis (µFEA), in women and men aged 50 years or higher.

The current study was conducted in a Framingham Study Offspring cohort of participants in the Framingham Study Original cohort (between 1971 and 1975 in adult children and their spouses).

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A total of 1159 participants were enrolled in the Framingham Offspring Study, based on the following criteria: 50 years or older; available data on grip strength, which was established at a primary Framingham visit (2011-2014); and HR-pQCT scans of sufficient quality (part of a call-back visit for the Framingham Osteoporosis Study [2012-2015]). All HR-pQCT scans were collected at an average of 1.8 years (range, 0-4.3 years) after grip strengths were determined.

The current study included a total of 1159 patients (508 men and 651 women; mean participant age, 70 years). Grip strength was measured between 2011 and 2014, whereas HR-pQCT scanning was performed between 2012 and 2015.

Participants who were men vs women had higher mean grip strength (37 vs 21 kg, respectively). Bone strength, evaluated with µFEA-calculated failure load, was significantly higher with greater grip strength among both men and women

(P <.01 and P =.04, respectively). In addition, greater grip strength was associated with a significantly larger cross-sectional area in both men and women (P <.01). Differences in area of 6% and 11% from the lowest to the highest grip strength quartiles were reported among men and women, respectively.

Cortical thickness was significantly associated with grip strength in men only (P =.03). Further, among men, grip strength was not associated with volumetric bone mineral density (vBMD). In contrast, a trend for significantly lower total vBMD with higher grip strength was observed among women (P =.02), but pairwise comparisons did not demonstrate any statistically significant differences in total vBMD across grip strength quartiles. No associations were observed between bone microarchitecture (ie, trabecular thickness, trabecular number, and cortical porosity) and grip strength in both women and men.

A major limitation of the current study included the fact that although the researchers focused their analysis on the direct influence of local muscle strength on bone, additional systemic endocrine and genetic effects on the bone-muscle relationship are likely, which were not taken into consideration. Moreover, the study did not account for muscle mass.

Researchers concluded that although the study findings offer further evidence of the important role of muscle strength in preventing fractures in both women and men, it is still unclear whether maintenance and gains in strength among older adults have a meaningful effect on prevention of age-related declines in bone strength.

Disclosure: One study author declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of the author’s disclosures.


McLean RR, Samelson EJ, Lobergs AL, et al. Higher hand grip strength is associated with greater radius bone size and strength in older men and women: the Framingham Osteoporosis Study. JBMR Plus. Published online March 9, 2021. doi:10.1002/jbm4.10485