Smoking and Alcohol Intake but Not Muscle Strength in Young Men Increase Fracture Risk at Middle Age: A Cohort Study Linked to the Swedish National Patient Registry

Prieto-Alhambra, Daniel; Turkiewicz, Aleksandra; Reyes, Carlen; Timpka, Simon; Rosengren, Björn; Englund, Martin

doi:10.1002/jbmr.3917

Cited by 18 publications

(18 citation statements)

References 38 publications

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“…We identified 18 population-based prospective cohort studies reporting on the associations between handgrip strength and fracture risk (Electronic Supplementary Material 7 and Table 3 ). [ 2 , 3 , 15 , 20 , 27 , 28 , 31 , 36 , 38 , 54 , 60 , 62 – 65 , 70 , 74 ] Including the current study, the pooled analysis comprised 19 studies involving 220,757 participants and 9199 incident fractures (comprising 1302 hip fractures). Average age of participants ranged from 18 to 81 years with a weighted mean (SD) of 48 (16) years.…”

Section: Resultsmentioning

confidence: 99%

Handgrip strength—a risk indicator for future fractures in the general population: findings from a prospective study and meta-analysis of 19 prospective cohort studies

et al. 2020

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Evolving debate suggests that handgrip strength, a measure of muscular strength, might be associated with the risk of fractures; however, the evidence is conflicting. We aimed to assess the association of handgrip strength with the risk of fracture in the general population. Handgrip strength, measured using a dynamometer, was assessed at baseline in a population-based sample of 853 men and women aged 61–73 years in the Kuopio Ischemic Heart Disease prospective cohort. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated for incident fractures. Incident fractures (hip, humeral, or wrist) (n = 159) occurred during a median follow-up of 16.7 years. Comparing extreme tertiles of handgrip strength, the age- and sex-adjusted hazard ratio (95% CI) for fractures was 0.80 (0.55–1.18). The association remained similar on further adjustment for other potential confounders: HR (95% CI) of 0.82 (0.55–1.21). In a meta-analysis of 19 population-based prospective cohort studies (including the current study) comprising 220,757 participants and 9199 fractures (including 1302 hip fractures), the fully adjusted relative risk (RR) (95% confidence interval, CI) for incident fractures was 0.70 (0.61–0.80) comparing the top versus bottom thirds of handgrip strength. The association remained significant after trim-and-fill correction for publication bias. The corresponding RR (95% CI) for hip fractures (9 studies) was 0.61 (0.54–0.70). Handgrip was only modestly associated with fracture risk in the primary analysis, which may be driven by the low event rate. Pooled prospective cohort evidence suggests that elevated handgrip strength is associated with reduced future fracture risk.

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Section: Resultsmentioning

confidence: 99%

Handgrip strength—a risk indicator for future fractures in the general population: findings from a prospective study and meta-analysis of 19 prospective cohort studies

et al. 2020

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“…Therefore, a multidisciplinary team, including physiotherapists and exercise physiologists, may aid in reducing fracture risk in patients with schizophrenia [ 48 ]. Furthermore, smoking and alcohol use are common in patients with schizophrenia, both of which are established risk factors for osteoporosis and osteoporotic fracture [ 49 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

Hip, vertebral, and wrist fracture risks and schizophrenia: a nationwide longitudinal study

et al. 2022

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Background Fractures are a great health issue associated with morbidity, quality of life, life span, and health care expenditure. Fractures are correlated with cardiovascular disease, type 2 diabetes mellitus, cerebrovascular disease, and some psychiatric disorders. However, representative national data are few, and longitudinal cohort studies on the association between schizophrenia and the subsequent fracture risk are scant. We designed a nationwide population-based cohort study to investigate the association of schizophrenia with hip, vertebral, and wrist fractures over a 10-year follow-up. Methods Data of patients with schizophrenia (International Classification of Diseases, Ninth Revision, Clinical Modification code 295) and matched over January 2000–December 2009) were extracted from Taiwan National Health Insurance Research Database. A Cox proportional-hazards regression model was constructed to calculate hazard ratios (HRs) for fractures between the schizophrenia and control cohorts. Results Of 2028 people with schizophrenia (mean age: 36.3 years, 49.4% female), 89 (4.4%) reported newly diagnosed fractures—significantly higher than the proportion in the control population (257, 3.2%; P = 0.007). The incidences of hip (1.2%, P = 0.009) and vertebral (2.6%, P = 0.011) fractures were significantly higher in the schizophrenia cohort than in the control cohort. In Cox regression analysis, hip (adjusted HR: 1.78, 95% confidence interval [CI]: 1.08–2.93) and vertebral (adjusted HR: 1.40, 95% CI: 1.01–1.95) fracture risks were significantly higher in patients with schizophrenia. Furthermore, a sex-based subgroup analysis revealed that the risk of hip fracture remained significantly higher in female patients with schizophrenia (HR: 2.68, 95% CI: 1.32–5.44) than in female controls. On the other hand, there was no significant interaction between effects of sex and schizophrenia on the risk of fractures. Conclusions Over a 10-year follow-up, hip and vertebral fracture risks were higher in the people with schizophrenia than in the controls. The risk of fractures in patients with schizophrenia does not differ between female and male.

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“…And Hoge et al (34) showed that higher income was associated with better physical functioning in several areas relative to PIR. Relevant human (35,36) and animal (37,38) studies have demonstrated significant negative effects of smoking and alcohol consumption on muscle composition and strength. Scientific physical activity has been shown to improve human health and muscle strength levels (36,39,40), but sedentary time has a range of adverse physiological effects on muscle strength independent of physical activity (41-43).…”

Section: Nhanesmentioning

confidence: 99%

“…Relevant human (35,36) and animal (37,38) studies have demonstrated significant negative effects of smoking and alcohol consumption on muscle composition and strength. Scientific physical activity has been shown to improve human health and muscle strength levels (36,39,40), but sedentary time has a range of adverse physiological effects on muscle strength independent of physical activity (41-43). Previous studies have confirmed that hypertension (44,45), hyperlipidemia (46)(47)(48) Smoking conditions are divided into three categories: never (smoked less than 100 cigarettes in life), former (smoked more than 100 cigarettes in life and smoke not at all now), now (smoked moth than 100 cigarettes in life and smoke some days or every day).…”

Section: Nhanesmentioning

confidence: 99%

Association between composite dietary antioxidant index and handgrip strength in American adults: Data from National Health and Nutrition Examination Survey (NHANES, 2011-2014)

Wang

et al. 2023

Front. Nutr.

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BackgroundThe Composite Dietary Antioxidant Index (CDAI), a composite score of multiple dietary antioxidants (including vitamin A, C, and E, selenium, zinc, and carotenoids), represents an individual’s comprehensive dietary antioxidant intake profile. CDAI was developed based on its combined effect on pro-inflammatory markers Tumor Necrosis Factor-α (TNF-α) and anti-inflammatory effects of Interleukin-1β (IL-1β), which are associated with many health outcomes, including depression, all-cause mortality, colorectal cancer, etc. Handgrip strength is used as a simple measure of muscle strength, not only is it highly correlated with overall muscle strength, but also serves as a diagnostic tool for many adverse health outcomes, including sarcopenia and frailty syndromes.PurposeThe association between CDAI and Handgrip strength (HGS) is currently unclear. This study investigated the association between CDAI (including its components) and HGS in 6,019 American adults.MethodThe research data were selected from the 2011–2014 National Health and Nutrition Survey (NHANES), and a total of 6,019 American adults were screened and included. A weighted generalized linear regression model was used to evaluate CDAI (including its components) and HGS.Results(1) CDAI was significantly positively correlated with HGS (β = 0.009, 0.005∼0.013, P < 0.001), and the trend test showed that compared with the lowest quartile of CDAI, the highest quartile of CDAI was positively correlated with HGS (β = 0.084, 0.042∼0.126, P = 0.002) and significant in trend test (P for trend < 0.0100). Gender subgroup analysis showed that male CDAI was significantly positively correlated with HGS (β = 0.015, 0.007∼0.023, P = 0.002), and the trend test showed that compared with the lowest quartile of CDAI, the highest quartile of CDAI was positively correlated with HGS (β = 0.131, 0.049∼0.213, P = 0.006) and the trend test was significant (P for trend < 0.0100). There was no correlation between female CDAI and HGS, and the trend test was not statistically significant (P > 0.05). (2) The intake of dietary vitamin E, Zinc and Selenium showed a significant positive correlation with HGS (β = 0.004, 0.002∼0.007, P = 0.006; β = 0.007, 0.004∼0.009, P < 0.001; β = 0.001, 0.001∼0.001, P < 0.001), vitamin A, vitamin C and carotenoid were significantly associated with HGS in the Crude Model, but this significant association disappeared in the complete model with the increase of control variables. Gender subgroup analysis showed that in model 3, male dietary intake levels of vitamin E, Zinc, and Selenium were significantly positively correlated with HGS (β = 0.005, 0.002∼0.009, P = 0.011; β = 0.007, 0.004∼0.011, P = 0.001; β = 0.001, 0.001∼0.001, P = 0.004), the rest of the indicators had no significant correlation with HGS. Among the female subjects, dietary zinc intake was significantly positively correlated with HGS (β = 0.005, 0.001∼0.008, P = 0.008), and there was no significant correlation between other indicators and HGS (P > 0.05).ConclusionThere was an association between the CDAI and HGS, but there was a gender difference, and there was an association between the CDAI and HGS in male, but the association was not significant in female. Intake of the dietary antioxidants vitamin E, selenium, and zinc was associated with HGS in male, but only zinc was associated with HGS among dietary antioxidants in female.

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Smoking and Alcohol Intake but Not Muscle Strength in Young Men Increase Fracture Risk at Middle Age: A Cohort Study Linked to the Swedish National Patient Registry

Cited by 18 publications

References 38 publications

Handgrip strength—a risk indicator for future fractures in the general population: findings from a prospective study and meta-analysis of 19 prospective cohort studies

Handgrip strength—a risk indicator for future fractures in the general population: findings from a prospective study and meta-analysis of 19 prospective cohort studies

Hip, vertebral, and wrist fracture risks and schizophrenia: a nationwide longitudinal study

Association between composite dietary antioxidant index and handgrip strength in American adults: Data from National Health and Nutrition Examination Survey (NHANES, 2011-2014)

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