Abstract
PurposeHeart failure (HF) had been reported with increased risk of hip fractures. However, the relationship between circulating biomarkers and bone mineral density (BMD) in chronic HF remained unclear.MethodsThis is a cross-sectional study which recruited stable chronic HF from registry of the Heart Failure Center of National Taiwan University Hospital. Patients underwent dual-energy x-ray absorptiometry (DEXA) measurements at hip and lumbar spines and biochemical assessments including B-type natriuretic peptide (BNP-32), myostatin, follistatin and osteoprotegerin (OPG).ResultsA total of 115 stable chronic HF individuals with left ventricular ejection fraction (EF) <45% (74% of male, mean age at 59) were recruited with 24 patients in NYHA class I, 73 patients in NYHA class II and 18 patients in NYHA class III. Results of BMD showed that Z scores of hip in NYHA III group (−0.12±1.15) was significantly lower than who were NYHA II (0.58±1.04). Serum OPG was significantly higher in subjects of NYHA III (9.3±4.6 pmol/l) than NYHA II (7.4±2.8 pmol/l) or NYHA I (6.8±3.6 pmol/l) groups. There’s a significant negative association between log transformed serum OPG and trochanteric BMD (R = −0.299, P = 0.001), which remained significant after multivariate analysis.ConclusionsOur study demonstrated an inverse association between serum OPG and trochanteric BMD in patients with HF. OPG may be a predictor of BMD and an alternative to DEXA for identifying at risk HF patients for osteoporosis.
Highlights
Heart failure (HF) and osteoporosis, both as disabling conditions, are two common chronic conditions in elderly which are gaining importance for healthcare recently due to the associated significant morbidity and mortality [1]
A direct causal association between these circulating biomarkers and osteoporosis or risk of fractures has not been established in elderly patients with chronic HF, nor does these associations hold true in all HF patients
The diagnosis of heart failure was based on the criteria of symptoms compatible with the diagnosis in the presence of objective evidence of systolic dysfunction which defined by left ventricular ejection fraction (LVEF) below 45% from echocardiography, radionuclide angiography and/or cine angiography
Summary
Heart failure (HF) and osteoporosis, both as disabling conditions, are two common chronic conditions in elderly which are gaining importance for healthcare recently due to the associated significant morbidity and mortality [1]. These two disabling conditions adversely affect quality of life especially in frail elderly individuals. A direct causal association between these circulating biomarkers and osteoporosis or risk of fractures has not been established in elderly patients with chronic HF, nor does these associations hold true in all HF patients. The present study was aimed to evaluate the associations between osteoporosis and HF in elderly patients, and to assess the circulating biomarkers on this association
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