Bone mineral density and stroke.
ABSTRACT We sought to assess the long-term predictive usefulness of bone mineral density (BMD) for stroke incidence and stroke mortality.
The First National Health and Nutrition Examination Survey data were obtained from a nationally representative sample of noninstitutionalized civilians. A cohort of 3402 white and black subjects 45 through 74 years of age at baseline (1971 to 1975) was observed through 1992. Hospital records and death certificates were used to identify a total of 416 new stroke cases.
Results were evaluated to determine the relative risk (RR) for stroke per 1-SD decrease in BMD, after controlling for age at baseline, smoking status, alcohol consumption, history of diabetes, history of heart disease, education, body mass index, recreational physical activity, and blood pressure medication. In Cox proportional-hazards analyses, incidence of stroke was not associated with a decrease in BMD in any of the 3 race-sex groups: white men (RR, 1.01; 95% CI, 0.86 to 1.19; P=0.88), white women (RR, 1.13; 95% CI, 0.93 to 1.38; P=0.21), or blacks (RR, 0.93; 95% CI, 0.72 to 1.21; P=0.60). No association between BMD and stroke mortality was found (RR, 1.03; 95% CI, 0.86 to 1.23; P=0.77).
In a large national study, no significant associations of BMD and stroke incidence or mortality were found for whites or blacks.
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ABSTRACT: Context: Low bone mineral density (BMD) has been associated with increased all-cause mortality. Cause-specific mortality studies have been controversial. Objective: To investigate associations between BMD and all-cause mortality and in-depth cause-specific mortality. Design and setting: Two cohorts from the prospective Rotterdam Study (RS), initiated in 1990 (RS-I) and 2000 (RS-II) with average follow-up of 17.1 (RS-I) and 10.2 (RS-II) years until January 2011. Baseline femoral neck BMD was analyzed in standard deviations. Deaths were classified according to International Classification of Diseases into 7 groups: cardiovascular diseases, cancer, infections, external, dementia, chronic lung diseases and other causes. Gender-stratified Cox and competing-risks models were adjusted for age, body mass index and smoking. Participants: 5779 (RS-I); 2055 (RS-II) subjects. Main outcome measurements: all-cause; cause-specific mortality. Results: A significant inverse association between BMD and all-cause mortality was found in males (HR(95%CI) RS-I: 1.07 (1.01-1.13), p=0.020; RS-II: 1.31 (1.12-1.55), p=0.001) but not in females (RS-I: 1.05 (0.99-1.11), p=0.098; RS-II: 0.91 (0.74-1.12), p=0.362). An inverse association with chronic lung disease mortality was found in males (RS-I: 1.75 (1.34-2.29), p <0.001; RS-II: 2.15 (1.05-4.42), p=0.037) and in RS-I in females (1.72 (1.16-2.57), p=0.008) persisting after multiple adjustments and excluding prevalent chronic obstructive pulmonary disease. A positive association between BMD and cancer mortality was detected in females in RS-I (0.89 (0.80-0.99), p=0.043). No association was found with cardiovascular mortality. Conclusions: BMD is inversely associated with mortality. The strong association of BMD with chronic lung disease mortality is a novel finding that needs further analysis to clarify underlying mechanisms.The Journal of Clinical Endocrinology and Metabolism 02/2014; 99(5):jc20133819. DOI:10.1210/jc.2013-3819 · 6.31 Impact Factor
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ABSTRACT: To determine the incidence of comorbidities in women with and without osteoporosis, incidence rates per 1,000 person-years were calculated using electronic health records from an integrated healthcare system. The overall comorbidity burden and health service utilization were greater in women with osteoporosis than in the controls.Osteoporosis International 05/2014; 25(8). DOI:10.1007/s00198-014-2740-3 · 4.17 Impact Factor
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ABSTRACT: The objective of the present study was to investigate the association of low bone mass with the risk of stroke and death in community residents of China. This study was based on the follow-up data acquired from 5,136 postmenopausal women aged 50 years or older between July 2006 and June 2011. Baseline and the follow-up bone mineral density (BMD) in these patients were measured by dual energy X-ray absorptiometry scanning. The association of BMD and risk of stroke and death was further evaluated by Cox proportional hazard analysis. During the follow-up, 148 subjects (2.9 %) sustained prospective stroke, and 261 subjects (5.1 %) died. After adjustments for age and BMI, our results indicated that neck BMD and osteoporosis were independent predictors of stroke (HR for neck BMD = 1.35, 95 % CI = 1.21-1.62; HR for osteoporosis = 2.24, 95 % CI = 1.47-3.58) and were also associated with increased risk of death (HR for neck BMD = 1.39, 95 % CI = 1.24-1.71; HR for osteoporosis = 1.97, 95 % CI = 1.21-2.97). Our results also suggest that low neck BMD and osteoporosis are associated with significantly elevated risk of stroke and death in Chinese postmenopausal women.Cell Biochemistry and Biophysics 12/2014; DOI:10.1007/s12013-014-0392-8 · 2.38 Impact Factor