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老年人骨密度与心血管疾病的关系。

Association between bone mineral density and cardiovascular disease in older adults.

机构信息

Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

出版信息

Front Public Health. 2023 Jun 23;11:1103403. doi: 10.3389/fpubh.2023.1103403. eCollection 2023.

Abstract

BACKGROUND AND AIMS

Cardiovascular disease and osteoporosis are common diseases in older adults with high morbidity. The study on the interaction between the two in pathogenic mechanisms has been paid much attention by the majority of researchers. This study aimed to explore the relationship between bone mineral density and cardiovascular disease in older adults.

METHODS

The primary data was downloaded from the National Health and Nutrition Examination Survey database of the United States. Multivariate logistic regression model, generalized additive model, and smooth curve fitting were used to explore the relationship between bone mineral density and cardiovascular events risk. When a curve relationship was found, a two-piecewise linear model was used to calculate the inflection point. In addition, subgroup analysis was also performed.

RESULTS

A total of 2097 subjects were included in this study. After adjusting for potential confounders, no significant association was found between lumbar bone mineral density and cardiovascular disease, while femur bone mineral density had a non-linear relationship with cardiovascular disease, with an inflection point of 0.741 gm/cm. When bone mineral density was <0.741 gm/cm, the risk of cardiovascular disease decreased speedily. Once bone mineral density exceeded this value, the risk of cardiovascular disease continued to decrease, but the trend became significantly slower. Compared with patients with normal bone mass, osteoporosis was associated with a 2.05-fold increased risk of cardiovascular disease (95% CI 1.68-5.52). There were no significant differences in interaction tests of all subgroups ( for interaction >0.05) except race.

CONCLUSION

Our results indicated that bone mineral density was closely associated with the prevalence of cardiovascular disease in older adults over 60 years old, especially the femur bone mineral density was negatively non-linear associated with cardiovascular disease risk, with an inflection point of 0.741 gm/cm.

摘要

背景与目的

心血管疾病和骨质疏松症是老年人中常见的高发病率疾病。两者在发病机制中的相互作用研究受到了大多数研究人员的关注。本研究旨在探讨老年人骨密度与心血管疾病之间的关系。

方法

主要数据来自美国国家健康和营养调查数据库。采用多元逻辑回归模型、广义加性模型和光滑曲线拟合来探讨骨密度与心血管事件风险之间的关系。当发现曲线关系时,使用两段线性模型计算拐点。此外,还进行了亚组分析。

结果

本研究共纳入 2097 名受试者。在调整了潜在混杂因素后,腰椎骨密度与心血管疾病之间无显著关联,而股骨骨密度与心血管疾病呈非线性关系,拐点为 0.741 gm/cm。当骨密度<0.741 gm/cm 时,心血管疾病的风险迅速降低。一旦骨密度超过该值,心血管疾病的风险继续下降,但趋势明显放缓。与正常骨量的患者相比,骨质疏松症与心血管疾病的风险增加 2.05 倍(95%CI 1.68-5.52)。除种族外,所有亚组的交互检验均无统计学差异(交互检验>0.05)。

结论

我们的结果表明,骨密度与 60 岁以上老年人心血管疾病的患病率密切相关,尤其是股骨骨密度与心血管疾病风险呈负相关的非线性关系,拐点为 0.741 gm/cm。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c551/10328748/6e949b29b6d4/fpubh-11-1103403-g001.jpg

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