Valeh Touraj, Gharibzadeh Safoora, Tajrishi Farbod Zahedi, Fahimfar Noushin, Meibodi Hamid Reza Aghaei, Shafiee Gita, Heshmat Ramin, Ostovar Afshin, Sanjari Mahnaz, Nabipour Iraj, Larijani Bagher
Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Department of Epidemiology and Biostatistics, Pasteur Institute of Iran, Tehran, Iran.
J Diabetes Metab Disord. 2020 May 16;19(1):461-468. doi: 10.1007/s40200-020-00532-1. eCollection 2020 Jun.
Smoking has been linked with osteoporosis, but further evidence is required, especially concerning the effects of different types of tobacco smoking. We sought to examine the association between smoking and bone health in a large cohort of elderly Iranians.
The data from 2377 participants aged >60 years of Bushehr Elderly Health (BEH) program were used. Regardless of the type of smoking, participants were initially classified as non-smokers, ex-smokers and current smokers. Current smokers were also categorized based on the smoking type (pure cigarette, pure hookah and both). Dual-energy X-ray absorptiometry was used to evaluate bone density as well as Trabecular Bone Score (TBS). T-score ≤ -2.5 in either of the femoral neck, total hip or spinal sites was applied to determine the osteoporosis. The association of smoking and osteoporosis was assessed using multivariable modified Poisson regression model and reported as adjusted prevalence ratios (APR). The linear regression model was used to assess the association between smoking and TBS, adjusting for potential factors.
A total of 2377 (1225 women) were enrolled [mean age: 69.3 (±6.4) years], among which 1054 (44.3%) participants were nonsmokers. In all, 496 (20.9%) participants were current smokers. Multivariable regression analysis revealed no significant association between smoking (either current or past) and osteoporosis in women. In men, current smoking was negatively associated with osteoporosis (APR: 1.51, 95%CI: 1.16-1.96). Among current users, cigarette smoking was associated with osteoporosis (APR: 1.57, 95%CI: 1.20-2.03); however, we could not detect a significant association between current smoking of hookah and osteoporosis. In men, a significant association was also detected between current cigarette smoking and TBS (coefficient: -0.03, 95%CI: -0.01, -0.04).
Current cigarette smoking is associated with both the quantity and quality of bone mass in elderly men. Although we could not detect a significant association between hookah and osteoporosis in men, considering the prevalence of hookah smoking in the middle eastern countries, further studies are needed to determine the effect of hookah smoking on bone health.
吸烟与骨质疏松症有关，但仍需进一步证据，尤其是关于不同类型吸烟的影响。我们试图在一大群伊朗老年人中研究吸烟与骨骼健康之间的关联。
使用了布什尔老年健康（BEH）项目中2377名年龄大于60岁参与者的数据。无论吸烟类型如何，参与者最初被分为非吸烟者、已戒烟者和当前吸烟者。当前吸烟者还根据吸烟类型（纯香烟、纯水烟以及两者都吸）进行分类。采用双能X线吸收法评估骨密度以及骨小梁骨评分（TBS）。股骨颈、全髋或脊柱部位中任何一个部位的T值≤ -2.5用于确定骨质疏松症。使用多变量修正泊松回归模型评估吸烟与骨质疏松症的关联，并报告为调整患病率比（APR）。线性回归模型用于评估吸烟与TBS之间的关联，并对潜在因素进行校正。
总共纳入了2377名（1225名女性）参与者[平均年龄：69.3（±6.4）岁]，其中1054名（44.3%）参与者为非吸烟者。总共有496名（20.9%）参与者为当前吸烟者。多变量回归分析显示，吸烟（当前或过去吸烟）与女性骨质疏松症之间无显著关联。在男性中，当前吸烟与骨质疏松症呈负相关（APR：1.51，95%CI：1.16 - 1.96）。在当前吸烟者中，吸香烟与骨质疏松症有关（APR：1.57，95%CI：1.20 - 2.03）；然而，我们未检测到当前吸水烟与骨质疏松症之间存在显著关联。在男性中，当前吸香烟与TBS之间也存在显著关联（系数：-0.03，95%CI：-0.01，-0.04）。
当前吸香烟与老年男性骨量的数量和质量均有关。尽管我们未检测到男性吸水烟与骨质疏松症之间存在显著关联，但考虑到中东国家水烟吸食的普遍性，需要进一步研究以确定水烟吸食对骨骼健康的影响。
