Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, 6027, Australia.
School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
Osteoporos Int. 2022 Jul;33(7):1557-1567. doi: 10.1007/s00198-022-06317-x. Epub 2022 Feb 11.
Osteoporosis has been linked with increased risk of cardiovascular disease previously. However, few studies have detailed bone and vascular information. In a prospective study of older women, we demonstrated heel quantitative ultrasound measures were associated with increased cardiovascular and all-cause mortality, independent of established cardiovascular risk factors.
Osteoporosis and low bone mineral density (BMD) have been previously linked to cardiovascular disease (CVD) and mortality. Calcaneal quantitative ultrasound (QUS) is used to evaluate bone material properties, especially in older women. However, it is uncertain whether it is related to risk of mortality. This study was aimed to investigate the association between calcaneal QUS measurements and 15-year all-cause and CVD mortality in 1404 older women (mean age 75.2 ± 2.7 years).
One thousand four hundred four older women, participants of Calcium Intake Fracture Outcome study (CAIFOS), had calcaneal bone measured at baseline (1998) and followed for 15 years. The primary outcomes, any deaths, and deaths attributable to cardiovascular causes ascertained by using linked data were obtained from Western Australia data linkage system.
Over the 15 years of follow-up (17,955 person years), 584 of the women died, and 223 from CVD. For every standard deviation (SD), reduction in broadband ultrasound attenuation (BUA) in minimally and multivariable-adjusted model including cardiovascular risk factors increased relative hazards for all-cause (multivariable-adjusted HR 1.15; 95%CI: 1.06-1.26, p = 0.001) and CVD mortality (multivariable-adjusted HR 1.20; 95%CI: 1.04-1.38, p = 0.010). Such relationships also persisted when hip BMD was included in the model (all-cause mortality HR 1.19; 95%CI: 1.07-1.33, p = 0.002; CVD mortality HR 1.28; 95%CI: 1.07-1.53, p = 0.008).
BUA is associated with all-cause and CVD mortality in older women independent of BMD and established CVD risk factors. Understanding why and how these are related may provide further insights about the bone-vascular nexus as well as therapeutic targets benefiting both systems.
骨质疏松症与心血管疾病风险增加先前有联系。然而，很少有研究详细描述骨骼和血管信息。在一项对老年女性的前瞻性研究中，我们证明跟骨定量超声测量与心血管和全因死亡率增加相关，独立于已确立的心血管危险因素。
1404 名老年女性（平均年龄 75.2 ± 2.7 岁）参加了钙摄入骨折结局研究（CAIFOS），在基线（1998 年）时测量了跟骨骨，并进行了 15 年的随访。主要结局为任何死亡和通过西澳大利亚数据链接系统获得的心血管原因死亡。
在 15 年的随访期间（17955 人年），有 584 名女性死亡，223 人死于心血管疾病。在最小和多变量调整模型中，宽带超声衰减（BUA）每降低一个标准差，全因（多变量调整 HR 1.15；95%CI：1.06-1.26，p=0.001）和心血管疾病死亡率（多变量调整 HR 1.20；95%CI：1.04-1.38，p=0.010）的相对危险度增加。当将髋部 BMD 纳入模型时，这种关系仍然存在（全因死亡率 HR 1.19；95%CI：1.07-1.33，p=0.002；心血管疾病死亡率 HR 1.28；95%CI：1.07-1.53，p=0.008）。
BUA 与老年女性的全因和心血管疾病死亡率相关，独立于 BMD 和已确立的心血管危险因素。了解为什么以及如何相关可能会进一步深入了解骨骼-血管联系以及有益于这两个系统的治疗靶点。
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