ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1584610
This article is part of the Research TopicAddressing Fracture Risk in Aging Populations: Integrated Prevention TacticsView all 3 articles
Association of Skeletal Muscle Strength and Cardiorespiratory Fitness with Bone Mineral Density: A Cross-sectional Study
Provisionally accepted
beibei wei1
xinge yang2
shuning chen3xueying guo1jixiang wang1xu huang1hanping zhang1xuan wang1bin jia1*- 1Beijing DCN Orthopaedic Hospital, Beijing, China
- 2School of Sports and Human Sciences, Beijing Sport University, Beijing, Beijing Municipality, China
- 3China Sports Science (Beijing) Sports Development Co., LTD, beijing, China
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This cross-sectional study investigated gender-specific associations between skeletal muscle strength, cardiorespiratory endurance, and bone mineral density (BMD) in Chinese adults aged 30–60 years, aiming to inform osteoporosis prevention strategies. Grip strength (assessed via dynamometer), quadriceps isokinetic strength (measured with an isokinetic tester), and maximal oxygen uptake (VO₂max, determined by treadmill-based cardiopulmonary testing) were evaluated as indicators of upper-limb strength, lower-limb strength, and cardiorespiratory fitness, respectively. Thoracolumbar BMD T-scores were obtained using quantitative computed tomography (QCT). Multivariate stepwise regression models adjusted for age, BMI, lifestyle factors, vitamin D, and calcium levels revealed gender-stratified relationships.Key findings demonstrated significant positive associations between grip strength and BMD T-scores in the overall cohort (β=0.03, p<0.001), persisting in both genders (women: β=0.15; men: β=0.07; both p<0.001). Quadriceps strength showed gender-specific correlations, with a pronounced association in women (β=1.35, p<0.001) but no significance in men (β=0.42, p=0.230). VO₂max exhibited an overall positive correlation with BMD (β=0.28, p=0.009), which remained significant only in men (β=0.42, p=0.009) and not in women (p=0.884) after stratification.The study highlights gender-divergent mechanisms: lower-limb muscle strength predominantly influences bone density in women, while cardiorespiratory endurance shows stronger relevance in men. These findings suggest tailored prevention strategies—prioritizing resistance training for lower extremities in women and aerobic fitness interventions in men—to optimize bone health. The results underscore the necessity of gender-specific exercise prescriptions for osteoporosis prevention, providing evidence-based insights for public health initiatives targeting bone density preservation in middle-aged populations.
Keywords: isokinetic muscle strength test, Cardiorespiratory Endurance, Bone Density, QCT, Chinese adults
Received: 27 Feb 2025; Accepted: 30 Jun 2025.
Copyright: © 2025 wei, yang, chen, guo, wang, huang, zhang, wang and jia. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: bin jia, Beijing DCN Orthopaedic Hospital, Beijing, China
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