Evolving debate suggests that handgrip strength, a measure of muscular strength, might be associated with the risk of fractures; however, the evidence is conflicting. We aimed to assess the association of handgrip strength with the risk of fracture in the general population. Handgrip strength, measured using a dynamometer, was assessed at baseline in a population-based sample of 853 men and women aged 61–73 years in the Kuopio Ischemic Heart Disease prospective cohort. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated for incident fractures. Incident fractures (hip, humeral, or wrist) (n = 159) occurred during a median follow-up of 16.7 years. Comparing extreme tertiles of handgrip strength, the age- and sex-adjusted hazard ratio (95% CI) for fractures was 0.80 (0.55–1.18). The association remained similar on further adjustment for other potential confounders: HR (95% CI) of 0.82 (0.55–1.21). In a meta-analysis of 19 population-based prospective cohort studies (including the current study) comprising 220,757 participants and 9199 fractures (including 1302 hip fractures), the fully adjusted relative risk (RR) (95% confidence interval, CI) for incident fractures was 0.70 (0.61–0.80) comparing the top versus bottom thirds of handgrip strength. The association remained significant after trim-and-fill correction for publication bias. The corresponding RR (95% CI) for hip fractures (9 studies) was 0.61 (0.54–0.70). Handgrip was only modestly associated with fracture risk in the primary analysis, which may be driven by the low event rate. Pooled prospective cohort evidence suggests that elevated handgrip strength is associated with reduced future fracture risk.

不断发展的争论表明，握力（肌肉力量的衡量标准）可能与骨折风险相关。然而，证据是相互矛盾的。我们的目的是评估一般人群握力与骨折风险的关系。在 Kuopio 缺血性心脏病前瞻性队列中，对 853 名 61-73 岁男性和女性的人群样本进行了基线评估，使用测力计测量了握力。对发生骨折的风险比 (HR) 和 95% 置信区间 (CI) 进行了估计。中位随访时间为 16.7 年，发生骨折（髋部、肱骨或腕部）（n = 159）。比较握力的极端三分位数，年龄和性别调整后的骨折风险比 (95% CI) 为 0.80 (0.55–1.18)。在对其他潜在混杂因素进行进一步调整后，这种关联仍然相似：HR (95% CI) 为 0.82 (0.55–1.21)。在对 19 项基于人群的前瞻性队列研究（包括当前的研究）进行的荟萃分析中，该研究包括 220,757 名参与者和 9199 例骨折（包括 1302 例髋部骨折），事件的完全调整相对风险 (RR)（95% 置信区间，CI）比较顶部和底部三分之一的握力强度，骨折率为 0.70 (0.61–0.80)。在对发表偏倚进行修剪和填充校正后，这种关联仍然显着。髋部骨折（9 项研究）的相应 RR (95% CI) 为 0.61 (0.54–0.70)。在初步分析中，握力与骨折风险只有适度的相关性，这可能是由于事件发生率低所致。汇总的前瞻性队列证据表明，握力的增强与未来骨折风险的降低相关。