Aortic Calcification is Associated with Five-Year Decline in Handgrip Strength in Older Women

• Published in: Calcified tissue international Vol. 103; no. 6; pp. 589 - 598
• Main Authors: Rodríguez, Alexander J., Lewis, Joshua R., Scott, David S., Kiel, Douglas P., Schousboe, John T., Ebeling, Peter R., Prince, Richard L.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.12.2018; Springer Nature B.V
• Subjects: Aorta; Biochemistry; Biomedical and Life Sciences; Bone density; Calcification; Calcification (ectopic); Calcium; Cell Biology; Diabetes mellitus; Dual energy X-ray absorptiometry; Endocrinology; Life Sciences; Mobility; Muscle contraction; Muscle strength; Original Research; Orthopedics; Physical activity; Renal function; Smoking; Spine; Supplements; Vascular diseases; Mobility; Older women; Aortic calcification; Grip strength; Physical function
• ISSN: 0171-967X; 1432-0827
• DOI: 10.1007/s00223-018-0458-5

The objective of the study was to determine the association between AAC and neuromuscular function over 5 years. Participants in this study were ambulant women over 70 years old residing in Perth, Western Australia who participated in the Calcium Intake Fracture Outcomes Study, a randomised controlled trial of calcium supplementation. 1046 women (mean age = 74.9 ± 2.6 years; BMI = 27.1 ± 4.4 kg/m 2 ) were included. Lateral spine images captured during bone density testing were scored for AAC (AAC24; 0–24) at baseline. Severe AAC (AAC sev ) was defined using established cut points (AAC24 ≥ 6). At baseline and follow-up, isometric grip strength was assessed using a dynamometer. Mobility was assessed by the Timed-Up-and-Go (TUG) test. Using pre-defined criteria, muscle weakness was considered as grip strength < 22 kg and poor mobility defined as TUG > 10.2 s. A subset of women had appendicular lean mass (ALM) determined by dual-energy X-ray absorptiometry at baseline and follow-up ( n  = 261). AAC sev was evident in 193 (18.5%) women. Average decline in grip strength after 5 years was greater in those with AAC sev than those without (3.6 ± 3.7 vs. 2.9 ± 4.2 kg; p  = 0.034). This remained significant after adjustment for age, treatment allocation, diabetes, smoking history, renal function, medical record-derived prevalent vascular disease, BMI and physical activity ( β  = − 0.184; 95% confidence interval: − 0.361, − 0.008; p  = 0.040). AAC sev was not associated with 5-year changes in TUG or ALM in univariable or multivariable analyses (all p  > 0.05). In older women, severe aortic calcification was associated with greater 5-year decline in muscle strength, but not TUG or ALM. These findings support the concept that vascular disease may have an effect on the loss of muscular strength.