Association of severe disc degeneration with all-cause mortality and abdominal aortic calcification assessed prospectively in older men: findings of a single-center prospective study of osteoporosis in men.

Abstract

To assess the association of disc degeneration with all-cause mortality and with the severity and rate of progression of abdominal aortic calcification (AAC) in older men. Men >50 years of age (n = 766) underwent lateral spine radiography and blood collection and were monitored prospectively. We assessed the association of disc degeneration with all-cause mortality (at 10 years), AAC severity (at baseline), and AAC progression (at 7.5 years). After adjustment for confounders, including AAC, the total overall grade score for AAC predicted all-cause mortality (hazard ratio [HR] 1.20 per SD increase [95% confidence interval (95% CI) 1.01-1.43]). The highest tertile of the total overall grade score was associated with higher mortality rates (39.3/1,000 person-years for a score of >8 versus 20.9/1,000 person-years for a score of 0-8; adjusted HR 1.47 [95% CI 1.05-2.06]). The odds of severe AAC (score of >5) increased with the total disc space narrowing score (adjusted HR 1.44 per SD [95% CI 1.11-1.87]). The highest tertile of the total disc space narrowing score was associated with higher odds of severe AAC (adjusted HR 2.42 versus the lowest tertile [95% CI 1.24-4.73]). The probability of long-term AAC stability decreased with an increasing total osteophyte score (adjusted HR 0.66 per SD [95% CI 0.49-0.88]). The highest tertile of the total osteophyte score was associated with a lower probability of AAC stability (adjusted HR 0.35 versus the lowest tertile [95% CI 0.18-0.71]). Older men with severe disc degeneration have greater AAC severity, faster AAC progression, and higher all-cause mortality rates.