He Yixuan, Sun Juan, Li Jie, Gao Lu, Pan Bo
Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
BMC Musculoskelet Disord. 2025 Apr 22;26(1):397. doi: 10.1186/s12891-025-08416-2.
Osteoarthritis (OA) is a common joint disease that poses a significant public health burden, particularly in older adults. Despite research on its impact, the role of bone mineral density (BMD) in OA prognosis remains underexplored. This study investigates the association between BMD, measured using dual-energy X-ray absorptiometry (DXA), and all-cause mortality in individuals with OA using data from the National Health and Nutrition Examination Survey (NHANES).
This retrospective cohort study utilized NHANES data from 1999 to 2018, including participants aged 20 years and older (n = 55,081). After excluding individuals with missing BMD or mortality data, 1,573 participants diagnosed with OA were analyzed.
The multivariate-adjusted hazard ratio (HR) for BMD and all-cause mortality was 0.344 (0.153, 0.774), indicating a protective effect of higher BMD. We observed an L-shaped relationship between BMD and mortality: a 1-unit decrease in BMD was associated with a 97.3% increased HR for mortality when BMD was below 1.216 g/cm² (HR 0.027, 95% CI 0.010-0.069). No significant association was found for higher BMD levels (HR 4.490, 95% CI 0.431-46.754). In age-stratified analysis, a significant association was found in both those under and over 50 years old.
This study reveals an L-shaped association between BMD and all-cause mortality in individuals aged 20 and older with OA, underscoring the importance of maintaining bone health in this population. These findings highlight BMD as a prognostic marker and suggest that monitoring BMD could improve clinical outcomes for OA patients.
Not applicable.
骨关节炎（OA）是一种常见的关节疾病，给公共卫生带来了重大负担，尤其是在老年人中。尽管对其影响进行了研究，但骨矿物质密度（BMD）在OA预后中的作用仍未得到充分探索。本研究利用国家健康与营养检查调查（NHANES）的数据，调查了使用双能X线吸收法（DXA）测量的BMD与OA患者全因死亡率之间的关联。
这项回顾性队列研究利用了1999年至2018年的NHANES数据，包括20岁及以上的参与者（n = 55,081）。在排除BMD或死亡率数据缺失的个体后，对1573名被诊断为OA的参与者进行了分析。
BMD与全因死亡率的多变量调整风险比（HR）为0.344（0.153，0.774），表明较高的BMD具有保护作用。我们观察到BMD与死亡率之间呈L形关系：当BMD低于1.216 g/cm²时，BMD每降低1个单位，死亡率的HR增加97.3%（HR 0.027，95%CI 0.010 - 0.069）。对于较高的BMD水平，未发现显著关联（HR 4.490，95%CI 0.431 - 46.754）。在年龄分层分析中，50岁以下和50岁以上的人群均发现了显著关联。
本研究揭示了20岁及以上OA患者中BMD与全因死亡率之间的L形关联，强调了在该人群中维持骨骼健康的重要性。这些发现突出了BMD作为一种预后标志物，并表明监测BMD可以改善OA患者的临床结局。
不适用。
