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We aimed to determine the relationship between handgrip strength, smoking and alcohol consumption in young men and fracture risk at middle age. Thus, we carried out a cohort study including young men undergoing conscription examination in Sweden September 1969-May 1970 at typical age 18 years. Data on muscle strength, height, weight and lifestyle factors were linked to the National Patient Register 1987-2010.Handgrip strength was considered the main exposure, and smoking and alcohol consumption as secondary exposures. Outcomes were all fractures (except face, skull, digits), major osteoporotic fractures (thoracic/lumbar spine, proximal humerus, distal forearm or hip) and major traumatic fractures (shaft of humerus, forearm, femur, or lower leg) based on ICD-9 and 10 codes. We used Cox regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI) according to handgrip strength as a continuous variable (per 1 SD), after adjustment for weight, height, parental education, smoking, and alcohol consumption. A total of 40 112 men were included, contributing 892 572 person-years. Overall, 3974 men fractured in middle age with the incidence rate (95%CI) of 44.5 (43.2-45.9) per 1000 person-years. The corresponding rates were12.2 and 5.6per 1000 person-years for major osteoporotic and traumatic fractures, respectively. Handgrip strength-adjusted HR (95%CI) was 1.01 (0.98-1.05), 0.94 (0.88-1.00) and 0.98 (0.88-1.08) per SD for all, major osteoporotic, and major traumatic fractures, respectively. Adjusted HR (95%CI) for smokers (>21cigarettes/day):1.44 (1.21, 1.71) for all fractures, while the association between alcohol consumption and hazards of fracture was J-shaped. Therefore, young adult handgrip strength was not associated with fracture risk in middle-age men, though smoking and high alcohol consumption did confer an increased risk. This article is protected by copyright. All rights reserved.

Original publication

DOI

10.1002/jbmr.3917

Type

Journal article

Journal

J bone miner res

Publication Date

12/11/2019

Keywords

epidemiology, fracture, general population, prevention, skeletal muscle