Total bone mineral density is inversely associated with stroke: a family osteoporosis cohort study in rural China

Background The relationship of osteoporosis and stroke is still not fully clarified. Apart from the well-known risk factors for stroke, bone mineral density (BMD) has gained more interest in recent years. Aim To further elucidate the relationship between BMD and stroke risk, a prospective cohort study in the Chinese rural population was conducted. Design Retrospective analysis of a family osteoporosis cohort. Methods Our subjects were selected from an osteoporosis cohort conducted in Anqing, China. All participants underwent a questionnaire assessment, clinical examinations and laboratory assessments. During the follow-up period, the number of people who had a stroke was recorded. Generalized estimating equation regression analysis was performed to determine the significance of the association between BMD and stroke. Results A total of 17868 people were included. A two-way interaction test of sex and BMD on stroke was significant (P = 0.002). There was a significant difference in BMD and stroke morbidity in the male group (P = 0.003). When BMD was assessed as quartiles and the lowest quartile was used as reference, a significantly lower risk for stroke was observed in Q2-4. Notably, no significant difference was observed in female participants with adjusted odds ratio (P > 0.05). The P-value for interaction was calculated. The body mass index (P = 0.014) and waist-to-hip ratio (P = 0.027) were found to be significantly associated with BMD and stroke risk in female participants. Conclusions In Chinese rural areas, total BMD may negatively correlated with stroke, especially in men.

Automated summary

In rural areas of China, total bone mineral density (BMD) may be negatively correlated with stroke, especially in men. There was a significant difference in BMD and stroke morbidity in the male group, with no significant difference observed in female participants. Body mass index and waist-to-hip ratio were found to be significantly associated with BMD and stroke risk in female participants.