Raisi-Estabragh Zahra, Biasiolli Luca, Cooper Jackie, Aung Nay, Fung Kenneth, Paiva José M, Sanghvi Mihir M, Thomson Ross J, Curtis Elizabeth, Paccou Julien, Rayner Jennifer J, Werys Konrad, Puchta Henrike, Thomas Katharine E, Lee Aaron M, Piechnik Stefan K, Neubauer Stefan, Munroe Patricia B, Cooper Cyrus, Petersen Steffen E, Harvey Nicholas C
William Harvey Research Institute, National Institute for Health Research (NIHR) Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, UK.
Barts Heart Centre, St Bartholomew's Hospital, Barts Health National Health Service (NHS) Trust, London, UK.
J Bone Miner Res. 2021 Jan;36(1):90-99. doi: 10.1002/jbmr.4164. Epub 2020 Sep 22.
Osteoporosis and ischemic heart disease (IHD) represent important public health problems. Existing research suggests an association between the two conditions beyond that attributable to shared risk factors, with a potentially causal relationship. In this study, we tested the association of bone speed of sound (SOS) from quantitative heel ultrasound with (i) measures of arterial compliance from cardiovascular magnetic resonance (aortic distensibility [AD]); (ii) finger photoplethysmography (arterial stiffness index [ASI]); and (iii) incident myocardial infarction and IHD mortality in the UK Biobank cohort. We considered the potential mediating effect of a range of blood biomarkers and cardiometabolic morbidities and evaluated differential relationships by sex, menopause status, smoking, diabetes, and obesity. Furthermore, we considered whether associations with arterial compliance explained association of SOS with ischemic cardiovascular outcomes. Higher SOS was associated with lower arterial compliance by both ASI and AD for both men and women. The relationship was most consistent with ASI, likely relating to larger sample size available for this variable (n = 159,542 versus n = 18,229). There was no clear evidence of differential relationship by menopause, smoking, diabetes, or body mass index (BMI). Blood biomarkers appeared important in mediating the association for both men and women, but with different directions of effect and did not fully explain the observed effects. In fully adjusted models, higher SOS was associated with significantly lower IHD mortality in men, but less robustly in women. The association of SOS with ASI did not explain this observation. In conclusion, our findings support a positive association between bone and vascular health with consistent patterns of association in men and women. The underlying mechanisms are complex and appear to vary by sex. © 2020 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
骨质疏松症和缺血性心脏病（IHD）是重要的公共卫生问题。现有研究表明，这两种疾病之间存在关联，且这种关联并非仅仅归因于共同的风险因素，二者可能存在因果关系。在本研究中，我们检测了定量足跟超声骨声速（SOS）与以下各项的关联：（i）心血管磁共振成像测量的动脉顺应性指标（主动脉扩张性[AD]）；（ii）手指光电容积脉搏波描记法（动脉僵硬度指数[ASI]）；以及（iii）英国生物银行队列中的新发心肌梗死和IHD死亡率。我们考虑了一系列血液生物标志物和心血管代谢疾病的潜在中介作用，并按性别、绝经状态、吸烟、糖尿病和肥胖情况评估了差异关系。此外，我们还考虑了与动脉顺应性的关联是否能解释SOS与缺血性心血管结局的关联。较高的SOS与男性和女性较低的动脉顺应性均通过ASI和AD相关联。这种关系与ASI最为一致，可能是因为该变量的样本量更大（n = 159,542，而AD为n = 18,229）。没有明确证据表明绝经、吸烟、糖尿病或体重指数（BMI）存在差异关系。血液生物标志物在介导男性和女性的关联中似乎都很重要，但作用方向不同，且并未完全解释观察到的效应。在完全调整模型中，较高的SOS与男性显著较低的IHD死亡率相关，但在女性中相关性较弱。SOS与ASI的关联并不能解释这一观察结果。总之，我们的研究结果支持骨骼与血管健康之间存在正相关，且在男性和女性中存在一致的关联模式。其潜在机制复杂，且似乎因性别而异。© 2020作者。《骨与矿物质研究杂志》由Wiley Periodicals LLC代表美国骨与矿物质研究协会（ASBMR）出版。
