Observational and genetic evidence highlight the association of human sleep behaviors with the incidence of fracture

Yu, Qian; Xia, Jiangwei; Liu, Ke-Qi; Xu, Lin; Xie, Songqiang; Chen, Guo-Bo; Cong, Peikuan; Khederzadeh, Saber; Zheng, Hou-Feng

doi:10.1038/s42003-021-02861-0

Cited by 25 publications

(21 citation statements)

References 47 publications

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“…Our study also found that waking up frequently during the night increased the risk of falls in elderly people with visual impairment. Previous studies have reported that subjective poor sleep quality ( 17 ), napping ( 18 ), short sleep duration ( 19 , 20 ), long sleep duration ( 20 ), and insomnia ( 21 ) were associated with an increased risk of falls and fractures ( 22 , 23 ). Waking up frequently at night is one kind of sleep disorders that reduce sleep quality ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

Risk factors of falls in elderly patients with visual impairment

Ouyang

Zheng

Lin

et al. 2022

Front. Public Health

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ObjectiveTo examine the risk factors for falls in elderly patients with visual impairment (VI) and assess the predictive performance of these factors.MethodsBetween January 2019 and March 2021, a total of 251 elderly patients aged 65–92 years with VI were enrolled and then prospectively followed up for 12 months to evaluate outcomes of accidental falls via telephone interviews. Information of demographics and lifestyle, gait and balance deficits, and ophthalmic and systemic conditions were collected during baseline visits. Forward stepwise multivariable logistic regression analysis was performed to identify independent risk factors of falls in elderly patients with VI, and a derived nomogram was constructed.ResultsA total of 143 falls were reported in 251 elderly patients during follow-up, with an incidence of 56.97%. The risk factors for falls in elderly patients with VI identified by multivariable logistic regression were women [odds ratio (OR), 95% confidence interval (CI): 2.71, 1.40–5.27], smoking (3.57, 1.34–9.48), outdoor activities/3 months (1.31, 1.08–1.59), waking up frequently during the night (2.08, 1.15–3.79), disorders of balance and gait (2.60, 1.29–5.24), glaucoma (3.12, 1.15–8.44), other retinal degenerations (3.31, 1.16–9.43) and best-corrected visual acuity (BCVA) of the better eye (1.79, 1.10–2.91). A nomogram was developed based on the abovementioned multivariate analysis results. The area under receiver operating characteristic curve of the predictive model was 0.779.ConclusionsGender, smoking, outdoor activities, waking up at night, disorders of balance and gait, glaucoma, other retinal degeneration and BCVA of the better eye were independent risk factors for falls in elderly patients with VI. The predictive model and derived nomogram achieved a satisfying prediction of fall risk in these individuals.

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Section: Discussionmentioning

confidence: 99%

Risk factors of falls in elderly patients with visual impairment

Ouyang

Zheng

Lin

et al. 2022

Front. Public Health

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“…In addition, the mediation analysis suggested that BMD had larger intermediary effect than falls between BMI and fracture risk. Interestingly, our previous study to investigate the relationship between insomnia and fracture suggested a larger intermediary effect by falls than BMD ( Qian et al., 2021 ).…”

Section: Discussionmentioning

confidence: 99%

“…Although there were some explanations for the controversial findings, leveraging genetic data to infer the causal relationship between exposure and outcome could be additional evidences for association ( Xia et al., 2020 ; Qian et al., 2021 ). Therefore, in the present study, we firstly conducted a prospective observational study to investigate the relationship between general obesity index (BMI), abdominal obesity indices (waist circumference adjusted for BMI [WCadjBMI], and hip circumference adjusted for BMI [HCadjBMI]) and fracture risk using the UK Biobank dataset.…”

Section: Introductionmentioning

confidence: 99%

General and abdominal obesity operate differently as influencing factors of fracture risk in old adults

et al. 2022

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“…4 Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, China. 5 Department of Dermatology, Hangzhou Hospital of Traditional Chinese Medicine, Zhejiang 310007, Hangzhou, China. 6 WBBC Shandong Center, Binzhou Medical University, Yantai, Shandong, China.…”

Section: Abbreviationsmentioning

confidence: 99%

“…Osteoporosis could be clinically diagnosed by measuring the bone mineral density (BMD), which is a highly heritable trait [ 2 ]. Some modifiable environmental factors such as body weight [ 3 ], physical activity [ 4 ], sleep behavior [ 5 ], and inflammatory disease [ 6 ] could have an impact on bone mass gain and the development of osteoporosis. Other non-modifiable factors included sex, age, and genetic factors.…”

Section: Introductionmentioning

confidence: 99%

Both indirect maternal and direct fetal genetic effects reflect the observational relationship between higher birth weight and lower adult bone mass

Xia

Zhang

et al. 2022

BMC Med

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Background Birth weight is considered not only to undermine future growth, but also to induce lifelong diseases; the aim of this study is to explore the relationship between birth weight and adult bone mass. Methods We performed multivariable regression analyses to assess the association of birth weight with bone parameters measured by dual-energy X-ray absorptiometry (DXA) and by quantitative ultrasound (QUS), independently. We also implemented a systemic Mendelian randomization (MR) analysis to explore the causal association between them with both fetal-specific and maternal-specific instrumental variables. Results In the observational analyses, we found that higher birth weight could increase the adult bone area (lumbar spine, β-coefficient= 0.17, P < 2.00 × 10−16; lateral spine, β-coefficient = 0.02, P = 0.04), decrease bone mineral content-adjusted bone area (BMCadjArea) (lumbar spine, β-coefficient= − 0.01, P = 2.27 × 10−14; lateral spine, β-coefficient = − 0.05, P = 0.001), and decrease adult bone mineral density (BMD) (lumbar spine, β-coefficient = − 0.04, P = 0.007; lateral spine; β-coefficient = − 0.03, P = 0.02; heel, β-coefficient = − 0.06, P < 2.00 × 10−16), and we observed that the effect of birth weight on bone size was larger than that on BMC. In MR analyses, the higher fetal-specific genetically determined birth weight was identified to be associated with higher bone area (lumbar spine; β-coefficient = 0.15, P = 1.26 × 10−6, total hip, β-coefficient = 0.15, P = 0.005; intertrochanteric area, β-coefficient = 0.13, P = 0.0009; trochanter area, β-coefficient = 0.11, P = 0.03) but lower BMD (lumbar spine, β-coefficient = − 0.10, P = 0.01; lateral spine, β-coefficient = − 0.12, P = 0.0003, and heel β-coefficient = − 0.11, P = 3.33 × 10−13). In addition, we found that the higher maternal-specific genetically determined offspring birth weight was associated with lower offspring adult heel BMD (β-coefficient = − 0.001, P = 0.04). Conclusions The observational analyses suggested that higher birth weight was associated with the increased adult bone area but decreased BMD. By leveraging the genetic instrumental variables with maternal- and fetal-specific effects on birth weight, the observed relationship could be reflected by both the direct fetal and indirect maternal genetic effects.

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Observational and genetic evidence highlight the association of human sleep behaviors with the incidence of fracture

Cited by 25 publications

References 47 publications

Risk factors of falls in elderly patients with visual impairment

Risk factors of falls in elderly patients with visual impairment

General and abdominal obesity operate differently as influencing factors of fracture risk in old adults

Both indirect maternal and direct fetal genetic effects reflect the observational relationship between higher birth weight and lower adult bone mass

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