The muscle–bone unit in children and adolescents: insights from the Canadian Health Measures Survey
Authors' conclusion
In conclusion, we found that the effect of muscle size on bone mass was in part mediated by muscle power. Subcutaneous fat, muscle density, weight, and BMI were determinants of the muscle-bone relationship.
Study context
- Population
- Canadian children and adolescents aged 6 to 19.9 years, Canadian Health Measures Survey (CHMS)
- Participants
- 3,225 children
- Outcome
- Association between calf muscle CSA z-score (66% site, peripheral quantitative computed tomography (pQCT)) and tibia shaft BMC z-score (38% site), with Pmax z-score as mediator
Methodological detailsnational, population-based, path analysis
- National
- Population-based
- Path analysis
Main finding
As reported in the abstract
- Association of muscle cross-sectional area (CSA) z-score with tibia bone mineral content (BMC) z-score, β
- 0.64 (95% CI 0.62 to 0.67)
- Calf subcutaneous fat CSA z-score as determinant, β
- −0.04 (95% CI −0.07 to −0.01)
- Muscle density z-score as determinant, β
- 0.08 (95% CI 0.03 to 0.13)
- Weight z-score as determinant, β
- 0.10 (95% CI 0.05 to 0.15)
- Body mass index (BMI) z-score as determinant, β
- 0.14 (95% CI 0.07 to 0.21)
Observational data: associations, not effects.
Original publication
The muscle–bone unit in children and adolescents: insights from the Canadian Health Measures Survey. J Bone Miner Res. Published 25 September 2026. doi:10.
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