Relationship of calf circumference with bone mineral density and hip geometry: a hospital-based cross-sectional study

Calf circumference has significant predictive value for bone mineral density (BMD) at hip and spine and for fracture at spine in both genders and hence may be used as a clinical risk factor for fracture when BMD is not available.

Lean muscle mass and higher regular physical ability has been shown to correlate with BMD and hip geometry. Calf circumference is an indicator of muscle mass. We examined the association of calf circumference (CC), thigh circumference (TC), and physical performances with BMD and hip geometry.

Females above 45 years (at least 5 years postmenopausal) and males above 55 years were enrolled. Bilateral CC and TC were measured, and BMD was assessed at neck of femur (NF), trochanter (TR), inter-trochanter (IT), spine, and forearm. Dual energy X-ray absorptiometry scan-based hip geometry parameters were analyzed.

One hundred sixteen subjects (29 males and 87 females) were enrolled. CC correlated significantly with BMD at NF, IT, TR, and spine in male and female, respectively, and at forearm in female. Multivariate regression analysis showed CC as a significant predictor of BMD (at TR, IT, NF, and spine in both genders) and fracture (at spine in both genders). CC had significant positive correlation with hip parameters-cross-sectional area; cortical thickness; and section modulus at NF, IT, and TR in both genders and negative correlation with buckling ratio at NF and IT in females.

CC is a significant predictor of BMD at hip and spine and fracture at spine in both genders.