Greater D3-creatine muscle mass and MRI thigh muscle volume are associated with higher bone strength in older adults: exploratory findings in The Study of Muscle, Mobility and Aging (SOMMA)

10/09/2026

AI Summary

Greater thigh muscle volume by MRI associated with higher distal tibia and radius failure load in both sexes.
Higher D3Cr whole-body muscle mass associated with greater distal tibia and radius failure load in women but not men.
Muscle size relationships with bone microarchitecture were variable and sex specific; increasing muscle mass may reduce fracture risk, warranting intervention studies.

AI Summary

Decreased muscle size also contributes to fracture risk; however, the relationship between muscle size and bone density, microarchitecture, and strength using state-of-the-art assessment methods is not clear.

In The Study of Muscle, Mobility and Aging, muscle size was assessed using whole-body muscle mass (kg, deuterated creatine [D3Cr] dilution method) and thigh muscle volume (L, by MRI).

We investigated cross-sectional associations between baseline D3Cr muscle mass and MRI thigh muscle volume with bone volumetric density, microarchitecture, and strength from HR-pQCT at the distal tibia (DT) and radius (DR), and hip areal BMD from DXA at the first annual follow-up visit (year 1).

Basic summary

JBMR Plus. 2026 Sep 4;10(10):ziag113. doi: 10.1093/jbmrpl/ziag113. eCollection 2026 Oct.

ABSTRACT

Low BMD and impaired bone strength are established risk factors for fractures in older adults. Decreased muscle size also contributes to fracture risk; however, the relationship between muscle size and bone density, microarchitecture, and strength using state-of-the-art assessment methods is not clear. In The Study of Muscle, Mobility and Aging, muscle size was assessed using whole-body muscle mass (kg, deuterated creatine [D₃Cr] dilution method) and thigh muscle volume (L, by MRI). We investigated cross-sectional associations between baseline D₃Cr muscle mass and MRI thigh muscle volume with bone volumetric density, microarchitecture, and strength from HR-pQCT at the distal tibia (DT) and radius (DR), and hip areal BMD from DXA at the first annual follow-up visit (year 1). Muscle and bone parameters were standardized within sex and analyses were stratified by sex. Linear regression models were adjusted for age, race, weight, ≥1 alcoholic drink/wk, ever cigarette smoker, total activity from wrist-worn accelerometry, multimorbidity count (0-11), arthritis, and tibia or ulna length. In 181 women (age 76.2 ± 4.7 yr, 86% White) and 118 men (age 76.1 ± 4.3 yr, 93% White), higher thigh muscle volume (per SD: 1.1 L women; 1.5 L men) was associated with higher DT and DR failure load (p < .05). Greater thigh muscle volume was associated with higher DXA total hip BMD in men but not in women. Greater D₃Cr muscle mass (per SD: 4.4 kg women; 5.5 kg men) was associated with higher DT and DR failure load (p < .05) in women only. Associations of muscle size with microarchitecture were variable and differed by sex. Given that failure load is a strong predictor of fracture risk, future studies should investigate whether interventions that target muscle size may impact fracture risk in older adults.

PMID:42713522 | PMC:PMC13552505 | DOI:10.1093/jbmrpl/ziag113

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