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Scandinavian Journal of Public Health, Vol. 32, No. 5, 333-339 (2004)
DOI: 10.1080/14034940410026273
© 2004 Associations of Public Health in the Nordic Countries Regions

Is calcaneal stiffness more sensitive to physical activity than forearm bone mineral density? A population-based study of persons aged 20 - 79 years

Ann-Charlotte Grahn Kronhed

Primary Health Care Centre, Vadstena, Sweden, lotta.grahn-kronhed{at}telia.com, Division of Social Medicine and Public Health Science, Department of Health and Society, Faculty of Health Sciences, Linköping University, Linköping, Sweden

Inger Knutsson

Primary Health Care Laboratory, Vadstena, Sweden

Owe Löfman

Centre for Public Health Sciences, Department of Health and Society, Faculty of Health Sciences, Linköping University, Linköping, Sweden

Toomas Timpka

Division of Social Medicine and Public Health Science, Department of Health and Society, Faculty of Health Sciences, Linköping University, Linköping, Sweden

Göran Toss

Osteoporosis Unit, Department of Endocrinology, University Hospital of Linköping, Linköping, Sweden

Margareta Möller

Research and Development Unit, Primary Health Care, BorÅs, Sweden

Aims: The aim of this study was to investigate the associations between forearm bone mineral density (BMD), calcaneal stiffness, and physical activity levels in a normal population using different non-invasive methods. Methods: The participants were invited to undergo bone measurements using single photon absorptiometry of the forearm and quantitative ultrasound (QUS) of the calcaneal bone, and also to complete a questionnaire. Physical activity levels were designated low, moderate, and high in the question on leisure-time activity. Results: There were 956 participants included in the present study. Forearm BMD in the eighth age decade was 0.40 g/cm2 (95% CI 0.33 - 0.46 g/cm2) lower than in the third decade among women and 0.28 g/cm2 (95% CI 0.18 - 0.37 g/cm2) lower among men. The differences in calcaneal stiffness between the same age decades were 22.4 (95% CI 17.5 - 27.4) among women and 15.8 (95% CI 8.0 - 23.5) among men. The correlation between forearm BMD and calcaneal stiffness was 0.58 (95% CI 0.52 - 0.64) in women and 0.34 (95% CI 0.25 - 0.42) in men. Reported moderate and high leisure-time activity levels in both genders were associated with higher calcaneal stiffness but not with forearm BMD. Conclusions: The QUS may be used to measure the effect of present physical activity levels on calcaneal bone at the population level. Further longitudinal studies are warranted in order to determine the most appropriate non-invasive method in population-based studies.

Key Words: community-based interventions • osteoporosis • prevention • quantitative ultrasound • questionnaire • reference values • single photon absorptiometry.


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