Coronary Calcification and Osteoporosis in Men and Postmenopausal Women Are Independent Processes Associated with Aging

Sinnott, Bridget; Syed, Irfan; Sevrukov, Alexander; Barengolts, Elena

doi:10.1007/s00223-005-0244-z

Cited by 115 publications

(92 citation statements)

References 61 publications

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“…(35) The mechanism of this association is unknown. Studies in the elderly population have found a significant relationship between osteoporosis and mortality in excess, mostly caused by CVD/atherosclerotic diseases (35,36) and frailty syndrome. (37) Beyond the potential cardiovascular confounders, when studying BMD in relation to mortality, it is important to thoroughly investigate whether a low BMD is not merely a marker of underlying illness.…”

Section: Discussionmentioning

confidence: 99%

Bone Mineral Density and Parathyroid Hormone as Independent Risk Factors for Mortality in Community-Dwelling Older Adults: A Population-Based Prospective Cohort Study in Brazil. The São Paulo Ageing & Health (SPAH) Study

Domiciano

Machado

Lopes

et al. 2016

Journal of Bone and Mineral Research

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Previous studies have shown a relationship between osteoporosis and increased mortality risk. However, none of these studies performed a concomitant evaluation of the parathyroid hormone (PTH)-calcium-vitamin D axis and bone mass to accurately determine the contribution of each of these parameters to survival in older subjects. Thus, we sought to investigate the association between bone parameters and mortality in a longitudinal, prospective, population-based cohort of 839 elderly subjects. Clinical data (including history of fractures and cardiovascular events) were assessed using a specific questionnaire. Laboratory exams, including serum 25OHD and PTH, were also performed. Bone mineral density (BMD) at the lumbar spine and hip were evaluated using DXA. All analyses were performed at baseline (2005 to 2007). Mortality was recorded during follow-up. Multivariate Cox proportional regression was used to compute hazard ratios for all-cause and cardiovascular mortality. Over a mean 4.06 AE 1.07 years, there were 132 (15.7%) deaths. These individuals were compared to 707 subjects who were alive at the end of the coverage period for mortality data collection. In a multivariate Cox proportional hazards model, age (HR 1.32; 95% CI, 1.13 to 1.55; p ¼ 0.001, for each 5-year increase), male gender (HR 1.90; 95% CI, 1.30 to 2.79; p ¼ 0.001), recurrent falls (more than two in the previous year; HR 1.65; 95% CI, 1.06 to 2.56; p ¼ 0.026), diabetes mellitus (HR 2.17; 95% CI, 1.46 to 3.21; p < 0.001), low physical activity score (HR 1.78; 95% CI, 1.14 to 2.79; p ¼ 0.011), prior cardiovascular event (HR 1.76; 95% CI, 1.18 to 2.63; p ¼ 0.006), total hip BMD (HR 1.41; 95% CI, 1.15 to 1.72; p ¼ 0.001, per each 1 SD decrease), and intact PTH (iPTH) (HR 1.06; 95% CI, 1.04 to 1.08; p < 0.001, per each 10 pg/mL increase) were independently associated with all-cause mortality. The subjects in the highest quartile of PTH (>49 pg/mL) were at a higher risk of cardiovascular death (HR 3.09; 95% CI, 1.36 to 6.99; p ¼ 0.007) compared with the subjects in the lowest quartile (<26 pg/mL). Low BMD and higher PTH were significantly associated with mortality in community-dwelling older adults. These findings support the notion that careful screening of these bone parameters might lead to better management of older patients and improve outcomes in this population.

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Section: Discussionmentioning

confidence: 99%

Bone Mineral Density and Parathyroid Hormone as Independent Risk Factors for Mortality in Community-Dwelling Older Adults: A Population-Based Prospective Cohort Study in Brazil. The São Paulo Ageing & Health (SPAH) Study

Domiciano

Machado

Lopes

et al. 2016

Journal of Bone and Mineral Research

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“…(6) A previous clinical study has shown that patients with self-reported myocardial infarction had significantly higher odds of having low hip bone mineral density (BMD). (7) In addition, the presence of coronary calcifications has been associated with a nonsignificant 8% lower lumbar spine BMD, (8) suggesting that there is an association between subclinical atherosclerosis and lower bone density in the elderly. Recently, it has been reported that cardiovascular disease (CVD), such as congestive heart failure and stroke, is associated with an increase in the risk of subsequent hip fracture, (9) providing further support for such a connection, even if the exact mechanism remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Hip fracture and risk of acute myocardial infarction: A nationwide study

Chiang

Liu

Chen

et al. 2012

Journal of Bone and Mineral Research

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Osteoporotic fractures are associated with increased mortality risk. However, little data are available on the risk of acute myocardial infarction (AMI) after hip fracture. Therefore, we investigated whether hip fracture increased the risk of AMI in a large, nationwide cohort study. We obtained data from 8758 patients diagnosed with hip fracture from 2000 to 2009 and from 4 matched controls for each patient from the Longitudinal Health Insurance Database (LHID 2000), Taiwan. Controls were matched for age, sex, comorbid disorders, and enrollment date. All subjects were followed up from the date of enrollment until AMI, death, or the end of data collection (2009). Cox's regression model adjusted for age, sex, comorbid disorders, and medication was used to assess independent factors determining the risk of development of AMI. As expected, despite the matching, the hip fracture patients had more risk factors for AMI at baseline. A total of 8758 subjects with hip fractures and 35,032 controls were identified. Among these patients, 1183 (257 hip fracture patients and 926 controls) developed AMI during the median 3.2-year (interquartile range 1.4 to 5.8 years) follow-up period. Patients with hip fractures had a higher incidence of AMI occurrence when compared with controls (8.7/1000 person-years versus 6.82/1000 person-years). Multivariate analysis adjusted for baseline covariates indicated that hip fracture was associated with a greater risk for AMI development (hazard ratio [HR] ¼ 1.29; 95% confidence interval [CI] 1.12-1.48; p < 0.001). We conclude that hip fracture is independently associated with a higher risk of subsequent AMI. ß

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“…Dyslipidemia and chronic inflammation, including the inflammation associated with rheumatoid arthritis, are known to accelerate vascular calcification. Other diseases such as osteoporosis ( 5 ) and diabetes mellitus (DM) ( 6 ) are also associated with vascular calcification. In addition to these conditions, CKD also contributes to vascular calcification, possibly by disturbing calcium and phosphate metabolism ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

Serum Osteoprotegerin as a Screening Tool for Coronary Artery Calcification Score in Diabetic Pre-Dialysis Patients

et al. 2008

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Although cardiovascular disease is a principal cause of death in patients with chronic kidney disease (CKD),it is often asymptomatic in diabetic patients. The coronary artery calcification score (CACS) measured by multidetector computed tomography (MDCT) is useful for screening ischemic heart disease in the general population. We investigated which clinical parameters predict high CACS in predialysis diabetic nephropa- IntroductionFor predialysis chronic kidney disease (CKD) patients, the risk for cardiovascular death has been reported to be higher than the risk for end-stage renal disease requiring renal replacement therapy ( 1 ). However, coronary artery disease (CAD) has not yet been thoroughly studied in these subjects. Given the high prevalence of asymptomatic CAD in diabetic patients, it might be better to screen CAD by some other method than invasive and expensive coronary angiography.Evaluation of coronary artery calcification score (CACS)From the 1)

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Coronary Calcification and Osteoporosis in Men and Postmenopausal Women Are Independent Processes Associated with Aging

Cited by 115 publications

References 61 publications

Bone Mineral Density and Parathyroid Hormone as Independent Risk Factors for Mortality in Community-Dwelling Older Adults: A Population-Based Prospective Cohort Study in Brazil. The São Paulo Ageing & Health (SPAH) Study

Bone Mineral Density and Parathyroid Hormone as Independent Risk Factors for Mortality in Community-Dwelling Older Adults: A Population-Based Prospective Cohort Study in Brazil. The São Paulo Ageing & Health (SPAH) Study

Hip fracture and risk of acute myocardial infarction: A nationwide study

Serum Osteoprotegerin as a Screening Tool for Coronary Artery Calcification Score in Diabetic Pre-Dialysis Patients

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