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The skeleton is subdivided into two major divisions—the axial skeleton and the appendicular skeleton. The axial skeleton forms the vertical, central axis of the body. It includes all of the bones of the head, neck, chest, and back. It protects the brain, spinal cord, heart, and lungs. It also serves as the attachment site for muscles that move the head, neck, and back and for muscles that act across the shoulder and hip joints to move their corresponding limbs.
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All bones comprise an outer layer of compact bone, and an interior made up of spongy bone tissue, also called cancellous or trabecular bone. In long bones, spongy bone tissue is mainly found in the interior of the epiphyses (broad ends of the bone).
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Is trabecular bone score associated with appendicular lean mass?

Lora M Giangregorio1, Mackenzie Ryann Alexiuk2,3, Navdeep Tangri2,3

  • 1University of Waterloo and Schlegel-UW Research Institute for Aging, Waterloo, Canada. lora.giangregorio@uwaterloo.ca.

Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
|September 8, 2025
PubMed
Summary
This summary is machine-generated.

Appendicular lean mass index (ALMI) is linked to trabecular bone score (TBS) in adults over 40. Higher ALMI is associated with better TBS, suggesting a connection between muscle mass and bone health.

Keywords:
Body compositionBone densitometryFractureLean massOsteoporosisSarcopeniaTrabecular bone score

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Area of Science:

  • Gerontology and Bone Health
  • Musculoskeletal Physiology
  • Medical Imaging and Diagnostics

Background:

  • Trabecular Bone Score (TBS) is a recognized independent risk factor for fractures.
  • Mechanical loading from muscle on bone is a proposed stimulus for bone formation (osteogenesis).

Purpose of the Study:

  • To investigate the association between appendicular lean mass index (ALMI) and Trabecular Bone Score (TBS).
  • To determine if muscle mass, assessed by ALMI, correlates with bone microarchitecture, as measured by TBS.

Main Methods:

  • Analysis of data from the Manitoba DXA Registry (n=60,196) including individuals aged 40 and older.
  • Estimation of ALMI, lean mass index (LMI), and fat mass index (FMI) using DXA data.
  • Linear and logistic regression models were used, adjusting for age, sex, FMI, and tissue thickness.

Main Results:

  • A significant positive association was found between ALMI and TBS after adjusting for age and sex.
  • This association strengthened when further adjusted for FMI and abdominal tissue thickness (β=0.058, p<0.001).
  • An increase of 1 kg/m² in ALMI corresponded to a 0.058 increase in TBS, representing approximately 4.7% of the average TBS value.

Conclusions:

  • Appendicular lean mass index (ALMI) is independently associated with Trabecular Bone Score (TBS) in adults aged 40 and over.
  • Findings suggest a link between muscle mass and bone structural integrity, independent of fat mass and age.