Reduced Peripheral Nerve Function Is Related to Lower Hip BMD and Calcaneal QUS in Older White and Black Adults: The Health, Aging, and Body Composition Study

Authors

  • Elsa S Strotmeyer PhD, MPH,

    Corresponding author
    1. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
    • Department of Epidemiology, University of Pittsburgh, 130 North Bellefield Avenue, Room 515, Pittsburgh, PA 15213, USA
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  • Jane A Cauley,

    1. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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  • Ann V Schwartz,

    1. Department of Epidemiology and Biostatistics, The University of California, San Francisco, California, USA
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  • Nathalie de Rekeneire,

    1. Centers for Disease Control, Atlanta, Georgia, USA
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  • Helaine E Resnick,

    1. Department of Epidemiology and Statistics, MedStar Research Institute, Hyattsville, Maryland, USA
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  • Joseph M Zmuda,

    1. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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  • Ronald I Shorr,

    1. Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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  • Frances A Tylavsky,

    1. Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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  • Aaron I Vinik,

    1. Eastern Virginia Medical School, Norfolk, Virginia, USA
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    • Dr Vinik serves as a consultant for Neurometrix, R.W. Johnson Pharmaceutical Research Institute, Takeda, TEVA Pharmaceutical Industries, Astrazeneca, Sanofi-Aventis, DLife, Health ABC, Mitsubishi Pharma America, Inc., and Paramount Biosciences. All other authors state that they have no conflicts of interest.

  • Tamara B Harris,

    1. Laboratory of Epidemiology, Demography and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA
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  • Anne B Newman,

    1. Department of Epidemiology and Division of Geriatric Medicine, University of Pittsburgh Graduate School of Public Health and School of Medicine, Pittsburgh, Pennsylvania, USA
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  • for the Health ABC Study


Abstract

Bone tissue is innervated, and peripheral nerve function may impact BMD. Older black and white men and women (N = 2200) in the Health, Aging, and Body Composition Study with worse sensory and motor peripheral nerve function had lower hip BMD and calcaneal BUA independent of lean mass, strength, physical ability, and diabetes. Poor peripheral nerve function may directly affect bone.

Introduction: Bone tissue is innervated, yet little is known about the impact of nerve function on BMD. Poor peripheral nerve function may contribute to lower BMD and higher fracture risk, particularly in those with diabetic neuropathy.

Materials and Methods: The Health, Aging, and Body Composition (Health ABC) Study included annual exams in white and black men and women 70–79 years of age recruited from Pittsburgh and Memphis. Nerve function in legs/feet was assessed by 1.4- and 10-g monofilament detection, vibration threshold, and peroneal motor nerve conduction velocity (NCV) and amplitude (CMAP). Total hip BMD, heel broadband ultrasound attenuation (BUA), and total fat and lean mass were measured 1 year later (QDR 4500A, Sahara QUS; Hologic).

Results: Participants (N = 2200) were 48% men and 37% black. Poor nerve function (lower monofilament detection, higher vibration threshold, lower CMAP, lower NCV) was associated with 1.4–5.7% lower BUA and significant for all but NCV, adjusted for demographics, diabetes, body composition, and physical ability. Results were similar for adjusted hip BMD, with 1.0–2.9% lower BMD, significant for monofilament and CMAP testing. When considering the components of BMD, total hip area was 1.8–4.9% higher in those with the worst nerve function, although BMC showed little difference. Lower monofilament detection and CMAP were independently associated with lower heel BUA (p < 0.01), and monofilament detection was associated with lower hip BMD (p < 0.05) in regression additionally adjusted for lifestyle factors, bone-active medications, and diabetes-related complications.

Conclusions: Poor peripheral nerve function may directly related to lower BMD, likely through an increase in bone area in older adults, independent of lean mass, strength, physical ability, and diabetes. Whether those with impaired nerve function are at higher risk for fracture independent of falls needs to be studied.

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