期刊
JOURNAL OF BONE AND MINERAL RESEARCH
卷 34, 期 11, 页码 2052-2060出版社
WILEY
DOI: 10.1002/jbmr.3830
关键词
ABDOMINAL AORTIC CALCIFICATION; VASCULAR CALCIFICATION; LATERAL SPINE IMAGING; BONE MINERAL DENSITY; HEEL QUANTITATIVE ULTRASOUND; OSTEOPOROSIS; FRACTURE; ELDERLY WOMEN
资金
- Kidney Health Australia [S07 10]
- Healthway Health Promotion Foundation of Western Australia
- Sir Charles Gairdner Hospital Research Advisory Committee Grant
- National Health and Medical Research Council of Australia [254627, 303169, 572604]
- National Health and Medical Research Council (NHMRC) of Australia Career Development Fellowship [1107474]
- NHMRC fellowship
- National Institute of Arthritis, Musculoskeletal and Skin Diseases [R01 AR 41398]
Although a relationship between vascular disease and osteoporosis has been recognized, its clinical importance for fracture risk evaluation remains uncertain. Abdominal aortic calcification (AAC), a recognized measure of vascular disease detected on single-energy images performed for vertebral fracture assessment, may also identify increased osteoporosis risk. In a prospective 10-year study of 1024 older predominantly white women (mean age 75.0 +/- 2.6 years) from the Perth Longitudinal Study of Aging cohort, we evaluated the association between AAC, skeletal structure, and fractures. AAC and spine fracture were assessed at the time of hip densitometry and heel quantitative ultrasound. AAC was scored 0 to 24 (AAC24) and categorized into low AAC (score 0 and 1, n = 459), moderate AAC (score 2 to 5, n = 373), and severe AAC (score >6, n = 192). Prevalent vertebral fractures were calculated using the Genant semiquantitative method. AAC24 scores were inversely related to hip BMD (r(s) = -0.077, p = 0.013), heel broadband ultrasound attenuation (r(s) = -0.074, p = 0.020), and the Stiffness Index (r(s) = -0.073, p = 0.022). In cross-sectional analyses, women with moderate to severe AAC were more likely to have prevalent fracture and lumbar spine imaging-detected lumbar spine fractures, but not thoracic spine fractures (Mantel-Haenszel test of trend p < 0.05). For 10-year incident clinical fractures and fracture-related hospitalizations, women with moderate to severe AAC (AAC24 score >1) had increased fracture risk (HR 1.48; 95% CI, 1.15 to 1.91; p = 0.002; HR 1.46; 95% CI, 1.07 to 1.99; p = 0.019, respectively) compared with women with low AAC. This relationship remained significant after adjusting for age and hip BMD for clinical fractures (HR 1.40; 95% CI, 1.08 to 1.81; p = 0.010), but was attenuated for fracture-related hospitalizations (HR 1.33; 95% CI, 0.98 to 1.83; p = 0.073). In conclusion, older women with more marked AAC are at higher risk of fracture, not completely captured by bone structural predictors. These findings further support the concept that vascular calcification and bone pathology may share similar mechanisms of causation that remain to be fully elucidated (c) 2019 American Society for Bone and Mineral Research
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据