Upper limb grip strength and total body bone mineral density: a cross-sectional study

Guan Guichao, Fu Zhanli, Qiang Yi

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Journal of Chongqing Medical University ›› 2025, Vol. 50 ›› Issue (03) : 381-388. DOI: 10.13406/j.cnki.cyxb.003649
Clinical research

Upper limb grip strength and total body bone mineral density: a cross-sectional study

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Abstract

Objective To investigate the correlation between upper limb grip strength and total body bone mineral density (BMD) using public data. Methods During the 2011-2012 and 2013-2014 cycles of National Health and Nutrition Examination Surveys,a total of 5148 participants with grip strength,BMD,and multiple potential confounding factors were identified,and baseline levels were calculated after weighting. R language survey package was used for the multiple linear regression analysis to investigate the correlation between grip strength and BMD,and then stratified analysis was performed based on sex and age. The rcssci package was used for curve fitting to analyze the curve relationship between the two indicators. Results A total of 5 148 participants(2 493 male participants and 2 655 female participants) were included in this study. The overall grip strength was (77.48±0.40) kg,with a value of (93.98±0.45) kg for male participants and (59.71±0.24) kg for female participants; overall left upper limb grip strength was (37.75±0.21) kg,with a value of (28.89±0.12) kg for female participants and (45.98±0.24) kg for male participants; overall right upper limb grip strength was (39.73±0.20) kg,with a value of (30.83±0.13) kg for female participants and (48.00±0.23) kg in male participants. Overall left grip strength values of body mass index was 46.87±0.33,with a value of 53.65±0.46 for male participants and 39.56±0.26 for female participants(P<0.000 1); overall right grip strength values of body mass index was 49.37±0.33,with a value of 56.01±0.47 for male participants and 42.21±0.26 for female participants; overall mean grip strength index was 48.12±0.33,with a value of 54.83±0.46 for male participants and 40.89±0.26 for female participants; overall BMD was (1.11±0.00) g/cm²,with a value of (1.15±0.00) g/cm² in male participants and (1.08±0.00) g/cm² in female participants. After exclusion of confounding factors,grip strength showed a significant positive correlation with total BMD(P<0.000 1),and in addition,age was negatively correlated with BMD. Black race(with Mexican descent as reference),college graduation or above(with the participants not graduated from high school as reference),body height,and body mass index(BMI) were positively correlated with BMD. Stratified analysis showed that age,sex,and BMI had interaction with BMD. The curve fitting results showed that there was only a linear relationship between grip strength and BMD(P<0.001),but there was an L-shaped curve relationship between grip strength index(mainly of the left side) and BMD. With the increases in grip strength and grip strength index,BMD increased in a linear and L-shaped curve(BMD increased slowly with the increase in grip strength index),with a variation range of 0.1 g/cm². Conclusion Grip strength of both upper limbs and grip strength index(mainly of the left side) are positively correlated with BMD,and BMD shows a linear relationship with grip strength and an L-shaped curve relationship with grip strength index. The results of this study further support the correlation between grip strength and BMD and provide important empirical data for understanding the impact of grip strength on BMD,which has important significance for further research on the regulatory mechanism of BMD and the prevention and treatment of osteoporosis.

Key words

bone mineral density / National Health and Nutrition Examination Surveys / grip strength / cross-sectional study

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Guan Guichao , Fu Zhanli , Qiang Yi. Upper limb grip strength and total body bone mineral density: a cross-sectional study. Journal of Chongqing Medical University. 2025, 50(03): 381-388 https://doi.org/10.13406/j.cnki.cyxb.003649

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