Association of bone mineral density with hemoglobin and change in hemoglobin among older men and women: The Cardiovascular Health Study

Abstract

Purpose: Osteoblasts and their precursors support hematopoiesis in the bone marrow. We hypothesized that declines in Hgb levels are associated with bone mineral density (BMD). Methods: The Cardiovascular Health Study is a prospective longitudinal study that enrolled 5,888 community-dwelling adults aged >65 years and measured hemoglobin twice, in 1989–90 and 1992–93, as well as BMD by dual-energy X-ray absorptiometry (DXA) in 1994–95. In a subset of 1,513 men and women with a Hgb in 1992–93 and BMD, we used linear regression to estimate associations of Hgb (per standard deviation (SD)) with total hip (TH), lumbar spine (LS) and total body (TB) BMD, and used Poisson regression to estimate associations of anemia (in 1992–93; Hgb <13 g/dL in men; <12 g/dL in women) with “low BMD” defined as T-score less than −1 at the TH. In 1,277 participants with Hgb measured on average 2.9 years apart and BMD, we used linear regression to estimate the associations of annualized change in Hgb with TH, LS and TB BMD. All models included age, sex, study-site, race, smoking, alcohol use, weight, height, steroid use, physical activity score, self-reported health, previous cardiovascular disease and prior anti-fracture medication use. Results: No significant association was observed between Hgb, measured a mean 2.2 years prior to BMD, and BMD at the TH and LS in men (TH beta = −0.60 [x 10−2g/cm2per 1.1 g/dL Hgb], 95% CI: −1.88 to 0.68; LS beta = −1.69, 95% CI: −3.83 to 0.45) or women (TH beta = −0.49 [x 10−2g/cm2per 1.3 g/dL Hgb], 95% CI: −1.57 to 0.59; LS beta = −0.40, 95% CI: −2.57 to 1.76). Anemia was not observed to be significantly associated with low BMD in men (RR = 0.99, 95% CI: 0.72– 1.40) nor women (RR = 0.98, 95% CI: 0.82– 1.17). The mean change in Hgb was a loss of 0.06 g/dL/year (SD = 0.32). Change in Hgb was not observed to be significantly associated with BMD in men (TH beta = −0.55[x 10−2g/cm2per 1g/dL annualized Hgb change], 95% CI: −4.28 to 3.19; LS beta = 0.63, 95% CI: −5.38 to 6.65) or women (TH beta = 0.92, 95% CI: −1.96 to 3.79; LS beta = −1.77, 95% CI: −7.52 to 3.98). No significant association was observed between anemia and low bone density by T-score in men and women. Conclusions: These findings support neither the hypothesis that low Hgb prior to bone density or decreases in Hgb are associated with bone density in older community-dwelling adults nor the use of Hgb level as a case-finding tool to prompt BMD measurement.

Bone Mineral Density as a Predictor of Atherogenic Indexes of Cardiovascular Disease, Especially in Nonobese Adults

“…Our study also showed significant linear associations between Cre and TG levels and between Cre and AIs and an inverse correlation between Cre and HDL-C levels. A previous study found partial positive associations between Hb level and BMD in men but negative associations in women [33], whereas another study showed no relationship [34]. Interestingly, our data showed a significant positive association of Hb level with lipid profile, except HDL-C level, which showed a significant negative relationship, and AIs.…”

Association of bone mineral density with peripheral blood cell counts and hemoglobin in Chinese postmenopausal women

“…[ 24 ] However, a prospective longitudinal study based on cardiovascular health concluded that there was no correlation between the decrease of HGB level and BMD, and neither a single HGB measurement nor longitudinal change in HGB would be useful as a marker of low BMD in the short-term. [ 25 ] Therefore, the clinical utility of these studies remains to be seen.…”

High platelet count is associated with low bone mineral density: The MrOS Sweden cohort

“…A recent population-based study showed that high platelet counts are associated with osteoporosis and osteopenia [ 11 ]. Others showed no consistent association between platelet count and bone mineral density (BMD) [ 12 , 13 ]. A few studies have reported a negative association between low hemoglobin (hgb) or anemia and bone density [ 14 , 15 ], or a high annual loss of BMD [ 12 ], although not supported by others [ 13 ].…”

“…Others showed no consistent association between platelet count and bone mineral density (BMD) [ 12 , 13 ]. A few studies have reported a negative association between low hemoglobin (hgb) or anemia and bone density [ 14 , 15 ], or a high annual loss of BMD [ 12 ], although not supported by others [ 13 ]. Studies on the association between white blood cells and its subtypes and BMD have shown conflicting results [ 12 , 13 , 16 ].…”