Total Hip Between Bone Mineral Density Research Articles

Correlation between bone mineral density and bone metabolic markers in postmenopausal women with osteoporotic fractures at different C-terminal telopeptide of type 1 collagen levels: a retrospective analysis study.

This study aimed to analyze the correlation between bone mineral density (BMD) and bone resorption markers in postmenopausal women with osteoporosis fractures and identify risk factors for second fractures. This retrospective analysis of 1,239 older women with fractures with a median age of 70 years who attended Shanghai General Hospital from January 2007 to December 2016, included a first fracture group (1,008 cases) and a second fractures group (231 cases). The risk factors for fractures were analyzed by comparing these groups on clinical characteristics, BMD, and bone metabolism markers stratified by quartiles of serum C-terminal telopeptide of type 1 collagen (CTX). Binary logistic regression analysis was used to identify risk factors for second fractures. In the whole sample, BMD was negatively correlated with age and serum osteocalcin and positively correlated with body mass index (BMI). In women with first fractures, those in the highest quartile of serum CTX had the lowest spine and hip BMD. Second fractures were significantly associated with BMI, lower spine and hip BMD, and higher serum osteocalcin but not CTX. Binary logistic regression analysis showed that high BMI (odds ratio [OR], 1.08 [95% CI, 1.03-1.14]; P = 0.001), low lumbar BMD (OR, 0.24 [95% CI, 0.07-0.82]; P = 0.023), low total hip BMD (OR, 0.05 [95% CI, 0.00-0.88]; P = 0.041), and lack of antiosteoporosis treatment (OR, 2.71 [95% CI, 2.71-4.08]; P < 0.001) were independent risk factors for second fractures. In older women with fractures, BMD was significantly lower in women with second fractures than in those with first fractures. Higher levels of serum CTX and osteocalcin, which indicates increased bone resorption, were negatively correlated with BMD. In women with a first fracture, serum CTX higher than 605 pg/mL was negatively correlated with BMD, whereas no correlation was found between different CTX and BMD in women with second fractures. High BMI and low BMD as well as not receiving antiosteoporosis treatment were independent risk factors for second fractures.

Sex- and race-specific associations of bone mineral density with incident heart failure and its subtypes in older adults.

Previous studies have suggested an association between bone mineral density (BMD) and heart failure (HF) risk that may be race-dependent. We evaluated the relationship between BMD and incident HF in a cohort of older adults, the Health, Aging, and Body Composition (Health ABC) study (n=2835), and next performed a pooled analysis involving a second older cohort, the Cardiovascular Health Study (n=1268). Hip BMD was measured by dual-energy X-ray absorptiometry in both cohorts and spine BMD by computed tomography in a subset from Health ABC. In Health ABC, lower BMD at the total hip was associated with higher incident HF in Black women after multivariable adjustment. Similar associations were found for BMD at the femoral neck and spine. In both cohorts, pooled analysis again revealed an association between lower total hip BMD and increased risk of HF in Black women (HR=1.41 per 0.1-g/cm2 decrement [95% CI=1.23-1.62]), and showed the same to be true for White men (HR=1.12 [1.03-1.21]). There was a decreased risk of HF in Black men (HR 0.80 [0.70-0.91]), but no relationship in White women. The associations were numerically stronger with HFpEF for Black women and White men, and with HFrEF for Black men. Findings were similar for femoral neck BMD. Sensitivity analyses delaying HF follow-up by 2 years eliminated the association in Black men. Lower BMD was associated with higher risk of HF and especially HFpEF in older Black women and White men, highlighting the need for additional investigation into underlying mechanisms.

Abstract 15085: Association Between Bone Mineral Density and Incident Heart Failure in a Biracial Cohort of Older Adults: The Health, Aging, and Body Composition Study

Background: Osteoporosis and heart failure (HF) are age-related disorders that share some pathogenetic features and may influence each other. Previous studies have suggested an association between bone mineral density (BMD) and HF risk, which may be race-dependent. We sought to further investigate race- and sex-specific associations of BMD with HF in a longitudinal study of older adults. Methods: We evaluated the relationship between BMD and HF in the Health, Aging, and Body Composition study, a sample of community-dwelling adults aged 70-79. BMD was measured by dual-energy X-ray absorptiometry (DXA) of the total hip and femoral neck, and in half the cohort by computed tomography of the spine. Analyses were stratified a priori by sex and race, and Cox models were used to estimate risk after adjustment for potential confounders. Results: Of 2835 participants, 572 (49% women, 42% black) developed HF during a median follow up of 12.2 years. Lower BMD of the total hip by DXA was associated with higher risk of HF in black women (adj. HR 1.84 [95% CI, 1.43 - 2.37] per SD decrement), with suggestion of lower risk in black men that was not significant (adj. HR 0.81 [0.64 - 1.02]). Corresponding analyses failed to reveal significant associations in white women (adj. HR 0.86 [0.71-1.04]) or white men (adj. HR 1.10 [0.93 - 1.30]). There were a significant interaction of total hip BMD by sex among blacks (p=0.002), but not whites (p=0.363), as well as by race among women (p=0.026) and men (p=0.049). Relationships of BMD of the femoral neck were similar in all groups. Likewise, lower volumetric BMD of the spine was associated with higher risk in black women (adj. HR 1.34 [1.02 - 1.77] per SD decrement), but there were no significant associations in black men (adj. HR 0.91 [0.78 - 1.18]), white women (adj. HR 0.83 [0.64 - 1.08]), or white men (adj. HR 1.17 [0.95 - 1.44]). Conclusions: Among a biracial cohort of older adults, lower BMD was associated with higher risk of HF in black women, with no clear evidence of an association in white women or in men of either race. Further research is needed to understand the factors that may account for the particular association in black women, and whether these can be leveraged for therapeutic intervention.

SUN-395 Pelvic Bone Density Is Lower Than Bone Density of Hip and Femoral Neck in Postmenopausal Women

Pelvic fractures represent 7% of all fragility fractures; they account for 5% of the cost of osteoporotic fracture care, and are commonly (> 50%) associated with loss of independence in the elderly. The incidence of pelvic fractures has increased significantly over the past 3 decades. However, little is known about the relationship between bone mineral density (BMD) and pelvic fractures. We have conducted a pilot cross-sectional study to establish a method of measuring pelvic BMD and to correlate BMD of the pelvis with BMD at other skeletal sites. Postmenopausal women without a history of pelvis and hip fragility fractures were enrolled. Hip, spine, and pelvis DXA scans were obtained using a Hologic DXA machine. Pelvic BMD was calculated using Hologic Research Software from 3 areas of the pelvis (R1: public symphysis, R2: inferior pubic ramus, and R3: superior pubic ramus), corresponding to common fracture locations. Pelvis BMD was the average of the 3 pelvis sites. Pelvic BMD measurement precision error was calculated using the root mean square method (Recommended by International Society of Clinical Densitometry (ISCD)). Statistical analysis was used to compare BMD at different sites. Alpha error was set at 0.05. Of 73 postmenopausal women who were enrolled in the study (average age 64 years, average 15 years postmenopausal), 3% had chronic kidney disease, 7% had type 2 DM, 3% were on corticosteroids and none were smokers. BMD of femoral neck assessed on pelvic DXA was not significantly different from femoral neck BMD measured on standard DXA (P=0.09). To assess pelvis BMD measurement precision, 15 patients underwent 3 separate pelvic DXA images after repositioning. BMD precision error was 0.011g/cm2 which is slightly lower than the precision total hip BMD at our center (0.007 g/cm2). BMD of R1, R2, and R3 pelvic areas were measured as 0.44±0.15, 0.41± 0.15, and 0.62 ±0.19 g/cm2, respectively. Notably, BMD of R3 was significantly higher than the other 2 areas (P<0.001, ANOVA). Average BMD (0.49±0.14 g/cm2) of pelvis was significantly lower than BMD of femoral neck (0.72± 0.16 g/cm2), total hip (0.86±17 g/cm2) and spine (0.97± 19 g/cm2)(P <0.001). Average BMD of pelvis was significantly lower in participants with osteopenia and osteoporosis of the hip and femoral neck compared to participants with normal BMD in those locations. In summary, we report a precise method of measuring BMD of commonly fractured areas of the pelvis. Pelvis BMD is lower than hip, femoral neck, and spine. Bone density of the pelvis correlates with hip and femoral neck bone density. The results of this pilot study can be used for future studies looking at pelvic low bone density in patients with pelvic fragility fractures which could help identify patients at risk for pelvic fragility fractures and change how osteoporosis is defined based on DXA images.

2444-PUB: Bone Mineral Density and Bone Biomarkers in Women with Type 2 Diabetes Mellitus of Buryat Ethnic Group

There is a difference of bone tissue state of women belonging to various ethnic groups. We have conducted a study of bone tissue state among postmenopausal women of Buryat origin. Buryats are a main northern group of Mongolians, they are a core population of Siberia with a compact residence close to Lake Baikal. We have examined the associations between bone mineral density (BMD), trabecular bone score (TBS) and bone biomarkers in 17 postmenopausal women with T2D (59 years, diabetes duration 5.2 years, A1c &amp;lt;8.0%) and 21 postmenopausal women without diabetes (56 years). Collagen type 1 cross-linked C-telopeptide (CTX), 25-hydroxyvitamin D, ionized calcium (iCa), femoral neck BMD were similar between two groups. T2D postmenopausal women had lower osteocalcin (OC), procollagen type 1 N propeptide (P1NP), TBS and higher BMD total hip, BMD lumbar spine 1-4 (L1-L4) compared to the controls (Table). Total hip BMD in women with T2D was associated with body mass index (BMI). TBS was positively correlated with iCa. Twenty-five-hydroxyvitamin D was associated with lower OC, P1NP and CTX. Total hip BMD and BMD L1-L4 were positively correlated with BMI in women without diabetes. Femoral neck BMD was positively correlated with P1NP and inversely correlated with women’s age. T2D in Buryat women is associated with low levels of osteosynthesis markers, TBS and higher BMD. TBS was positively correlated only with iCa. Disclosure T. Bardymova: None. M. Mistiakov: None. M. Berezina: None. S. Tsyretorova: None. V. Velm: None.

The сhanges of bone mineral density on the risk of progression of osteoarthritis of the knee

To find the relationship between bone mineral density (BMD) and risk of knee OA progression in a 5-year prospective study. 110 females with knee OA were examined twice with 5-year interval. Examination included filling questionnaires, VAS pain assessment, plain knee radiography and axial skeleton densitometry. I stage knee OA was established in 33 (30%) patients, II stage - in 46 (41.8%), III stage - in 26 (23.6%), and IV - in 5 (4.5%). Normal lumbar vertebrae densitometry BMD values were found in 45 patients (40.9%), osteopenia - corresponding BMD values - in 33 (30.0%), and osteoporosis - in 32 (29.1%). Normal femoral neck BMD values were identified in 60 (54.5%) patients, osteopenia - level BMD - in 48 (43.7%), osteoporosis - in 2 (1.8%). In all premenopausal patients (n=15) axial skeleton BMD values were normal. In 5-year interval radiographic progression was established in 40 patients (Group 2), while in 70 (Group 1) patients no progression occurred. Both groups were comparable in terms of age and disease duration, although, more patients from Group 2 tended to have normal baseline densitometry BMD values - both in lumbar vertebrae and femoral neck: 47.5% vs 37.1%, and 62.5% vs 44.3% as compared to Group 1 patients. Patients from Group 1 more often had BMD values corresponding to osteoporosis and osteopenia: 32.9% vs 22.5%, and 55.7% vs 37.5%, respectively, as compared to Group 2 patients, although not achieving statistical significance. These differences were still identifiable after 5-year interval. Absolute BMD values at the second examination in 5 years were indicative of statistically significant increase in femoral neck and total hip BMD in Group 2 patients with knee OA progression: 0.79±0.11 vs 0.73±0.16, р.

Association Between Bone Mineral Density, Bone Turnover Markers, and Serum Cholesterol Levels in Type 2 Diabetes.

Purpose: The association between bone mineral density (BMD), bone turnover markers, and serum cholesterol in healthy population has already been proved. However, in patients with type 2 diabetes mellitus (T2D), it has not been adequately analyzed. In this study, we investigated the correlation between BMD, bone turnover markers, and serum cholesterol levels in people with T2D.Methods: We enrolled 1,040 men and 735 women with T2D from Zhongshan Hospital between October 2009 and January 2013. Their general condition, history of diseases and medication, serum markers, and BMD data were collected. We used logistic regression analysis to identify the association between serum cholesterol levels and BMD as well as bone turnover markers.Results: In multivariate regression analysis, we observed that in men with T2D, high high-density lipoprotein-cholesterol and total cholesterol levels were significantly associated with low total lumbar, femur neck, and total hip BMD, while low-density lipoprotein-cholesterol level was only inversely associated with total lumbar and femur neck BMD. Total cholesterol and low-density lipoprotein-cholesterol levels were also negatively associated with osteocalcin, procollagen type I N-terminal propeptide, and β-crosslaps. In women with T2D, high-density lipoprotein-cholesterol level was observed to be negatively correlated with total lumbar, femur neck, and total hip BMD, while total cholesterol and low-density lipoprotein-cholesterol levels were only associated with BMD at the total lumbar. Furthermore, total cholesterol was also negatively associated with osteocalcin, procollagen type I N-terminal propeptide, and β-crosslaps; high-density lipoprotein-cholesterol was only related to osteocalcin and parathyroid hormone, while low-density lipoprotein-cholesterol was only related to β-crosslaps in women.Conclusion: Our study suggests a significantly negative correlation between serum cholesterol levels and BMD in both men and women with T2D. The associations between serum cholesterol levels and bone turnover markers were also observed in T2D patients.

Bone Mineral Density and the Risk of Hip and Knee Osteoarthritis: The Johnston County Osteoarthritis Project.

To address knowledge gaps regarding the relationship between bone mineral density (BMD) and incident hip or knee osteoarthritis (OA); specifically, lack of information regarding hip OA or symptomatic outcomes. Using data (n = 1,474) from the Johnston County Osteoarthritis Project's first (1999-2004) and second (2005-2010) followup of participants ages ≥45 years, we examined the association between total hip BMD and both hip and knee OA. Total hip BMD was measured using dual x-ray absorptiometry, and participants were classified into sex-specific quartiles (low, intermediate low, intermediate high, and high). Radiographic OA (ROA) was defined as development of Kellgren/Lawrence grade ≥2. Symptomatic ROA (sROA) was defined as onset of both ROA and symptoms. Weibull regression modeling was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs). Median followup time was 6.5 years (range 4.0-10.2 years). In multivariate models, and compared with participants with low BMD, those with intermediate high and high BMD were less likely to develop hip sROA (HR 0.52 [95% CI 0.31-0.86] and 0.56 [95% CI 0.31-0.86], respectively; P = 0.024 for trend); high BMD was not associated (HR 0.69 [95% CI 0.45-1.06]) with risk of hip ROA. Compared with participants with low BMD, those with intermediate low and intermediate high total hip BMD were more likely to develop knee sROA (HR 2.15 [95% CI 1.40-3.30] and 1.65 [95% CI 1.02-2.67], respectively; P = 0.325 for trend); similar associations were seen with knee ROA. Our findings suggest that higher BMD may reduce the risk of hip sROA, while intermediate levels may increase the risk of both knee sROA and ROA.

Associations between systemic bone mineral density, knee cartilage defects and bone marrow lesions in patients with knee osteoarthritis.

The relationship between bone mineral density (BMD) and osteoarthritis (OA) remains controversial. This study aimed to explore the cross-sectional associations between BMD at the total body, hip and spine and joint structural abnormalities including cartilage defects and bone marrow lesions (BMLs) in patients with knee OA. One hundred and eight-five subjects with symptomatic knee OA were included in this study. T2-weighted fast spin echo magnetic resonance imaging was used to assess knee cartilage defects and BMLs. Total body, hip and spine BMD were measured using dual-energy X-ray absorptiometry. After adjustment for potential confounders, total hip BMD was negatively associated with medial tibial cartilage defects, lateral femoral cartilage defects, medial tibial BMLs and lateral tibial BMLs. Spine and total body BMD were negatively associated with lateral femoral cartilage defects, but not with BMLs. We concluded that BMD particularly at the hip was negatively associated with knee cartilage defects and BMLs.

Location of Vertebral Fractures is Associated with Bone Mineral Density and History of Traumatic Injury.

The upper and lower thoracolumbar spine have been associated with different biomechanical outcomes. This concept, as it applies to osteoporotic fracture risk, has not been well documented. This was a case-control study of 120 patients seen in an osteoporosis clinic. Vertebral fractures were identified from lateral radiographs using Genant's semi-quantitative assessment method. An association between bone mineral density (BMD) T-scores and vertebral fracture location was assessed. In an additional analysis, the association between a history of any traumatic injury and possible predictor variables was also explored. The median age of patients was 75 (IQR 67-80), and 84.2% of patients were female. A history of trauma was reported by 46.7% of patients. A vertebral fracture in the lower thoracolumbar spine (T11-L4) was associated with significantly higher femoral neck (p < 0.001), lumbar (p = 0.005), trochanteric (p = 0.002), intertrochanteric (p < 0.001), and total hip (p = 0.0006) BMD T-scores. The odds of having a femoral neck (OR 0.24, 95% CI 0.07-0.75, p = 0.01) or total hip (OR 0.19, 95% CI 0.06-0.65, p = 0.008) T-score less than -2.5 was also lower among patients with vertebral fractures in the lower thoracolumbar spine. A fracture in the upper thoracolumbar spine (T4-T10) decreased the odds of having a history of traumatic injury (OR 0.32, 95% CI 0.14-0.76, p = 0.01), while a non-vertebral fracture increased the odds of such an injury (OR 2.41, 95% CI 1.10-5.32, p = 0.03). Vertebral fractures in the lower thoracolumbar spine are associated with higher BMD T-scores. This should be studied further to understand possible correlations with patients' future fracture risk.

FRI0080 Bone Mineral Density, Sclerostin and Insulin Are Independently Associated with Coronary-Artery Atherosclerosis in Patients with Established Rheumatoid Arthritis

BackgroundRheumatoid arthritis (RA) is associated with premature atherosclerosis and increased prevalence of cardiovascular disease (CVD). Inverse associations have been described between bone mineral density (BMD) and Coronary Artery Calcification (CAC)...

Associations Between Bone Mineral Density and Subclinical Atherosclerosis: A Cross-Sectional Study of a Chinese Population

The significance of associations between bone mineral density (BMD) and atherosclerosis in the Asian population is less clear. The aim of this study was to explore the population-level associations between BMD and subclinical atherosclerosis. This was a community-based cross-sectional study conducted in Shenyang, China. A total of 385 Chinese women and men aged 37-87 years were studied. The BMD was measured at the total hip and lumbar spine using dual-energy x-ray absorptiometry. The ankle-brachial index (ABI), pulse wave velocity (PWV), and carotid intima-media thickness (CIMT) were measured to assess atherosclerosis. Multiple regression analysis was applied to study the associations. Multicolinearity was examined using the variance inflation factor, condition index, and variance proportions. Factor analysis and principal component regression were used to remove the problem of multicolinearity. The differences of ABI, PWV, and CIMT among the normal BMD, osteopenia, and osteoporosis groups were not found. Total hip BMD was correlated with ABI in women after adjustment for age (r = 0.156). Sex-specific regression models included adjustment for age, body mass index, cigarette smoking, alcohol consumption, menopausal status (women), systolic blood pressure, diastolic blood pressure, triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting blood glucose, serum uric acid, estimated glomerular filtration rate, high-sensitivity C-reactive protein, and fibrinogen. Total hip BMD was associated with ABI in women after adjustment for age (per SD decrease in ABI: -0.130 g/cm(2), P = .022), but the association was borderline significant after full adjustment (P = .045). Total hip BMD and lumbar spine BMD were not associated with ABI, PWV, and CIMT after full adjustment in participants without a fracture history. The risk of osteoporosis was not associated with ABI, PWV, and CIMT. Low BMD is not associated with subclinical atherosclerosis as assessed by ABI, PWV, and CIMT.

Association between g.19163A&gt;G and g.23298T&gt;C genetic variants of the osteoprotegerin gene and bone mineral density in Chinese women

Osteoporosis is a serious and common health issue of considerable complexity among postmenopausal women. The osteoprotegerin gene (OPG) is considered to play an important role in the pathogenesis of osteoporosis. The objective of this study was to detect single nucleotide polymorphisms (SNPs) in the OPG gene and assess the association between bone mineral density (BMD) and SNPs in postmenopausal women. BMD was measured at the lumbar spine (L₂₋₄), neck, and total hip by dual energy X-ray absorptiometry (DEXA). The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), created restriction site-PCR (CRS-PCR), and DNA sequencing methods were used to identify the g.19163A>G and g.23298T>C polymorphisms and genotypes in 739 Chinese postmenopausal women. Our data suggest that g.19163A>G was significantly associated with adjusted spine BMD, neck hip BMD, and total hip BMD. Subjects with genotype AA had significantly higher BMD value than those of genotypes AG and GG (P <0.05). We failed to detect any statistically significant association between g.23298T>C and adjusted spine BMD and neck hip BMD, while it almost reached a significant association with the adjusted total hip BMD (P = 0.058). These findings indicate that the OPG gene is related to BMD and osteoporosis in Chinese postmenopausal women.

Low bone mineral density is associated with metabolic syndrome in South Korean men but not in women: The 2008–2010 Korean National Health and Nutrition Examination Survey

We examined the relationships between bone mineral density (BMD) and metabolic syndrome in 6,659 men and 7,826 women from South Korean. After adjusting for age, body mass index (BMI), tobacco and alcohol use, and regular exercise, low BMD is especially associated with metabolic syndrome in South Korean men. This study examined the relationships between BMD and metabolic syndrome (MS) in South Korean adults. A total of 14,485 adults (6,659 men and 7,826 women) in the Korea National Health and Nutrition Examination Survey conducted from 2008 to 2010 were analyzed. We used multivariable regression models to examine the relationship between low BMD and MS. We calculated homeostasis model assessment and insulin resistance (HOMA-IR). MS was defined according to AHA/NHLBI criteria for Asians. BMD was measured at the lumbar spine (LS), femur neck (FN), total hip (TH), trochanter, and intertrochanter. After adjustment for age, BMI, tobacco and alcohol use, and regular exercise, the TH and FN BMD were significantly lower in men with MS than in men without MS (p < 0.05). However, there were no differences in premenopausal and postmenopausal women. In men, BMD was positively correlated with BMI, and high density lipoprotein cholesterol, but was negatively correlated with insulin, HOMA-IR, and triglyceride at all three sites (p < 0.05). Along with an increase of BMD (0.1 g/cm²), the odds ratios (ORs) for obesity and abdominal obesity were all greater than 1 at all sites in both genders. The ORs for hypertension and MS were 0.937 (0.879-0.998) and 0.899 (0.840-0.962), respectively at FN, and the OR for diabetes mellitus was 1.103 (1.017-1.196) at LS in men. In postmenopausal women, the OR for hypertension was 1.133 (1.029-1.246) at LS. Low BMD was especially associated with MS in South Korean men.

Identification of genes for bone mineral density variation by computational disease gene identification strategy

We previously used five freely available bioinformatics tools (Prioritizer, Geneseeker, PROSPECTR and SUSPECTS, Disease Gene Prediction, and Endeavour) to analyze the thirteen well-replicated osteoporosis susceptibility loci and identify a subset of most likely candidate osteoporosis susceptibility genes (Huang et al. in J Hum Genet 53:644-655, 2008). In the current study, we experimentally tested the association between bone mineral density (BMD) and the 9 most likely candidate genes [LAMC2(1q25-q31), MATN3(2p24-p23), ITGAV(2q31-q32), ACVR1(2q23-q24), TDGF1(3p21.31), EGF(4q25), IGF1(12q22-q23), ZIC2(13q32), BMP2(20p12)] which were pinpointed by 4 or more bioinformatics tools. Forty tag SNPs in nine candidate genes were genotyped in a southern Chinese female case-control cohort consisting of 1643 subjects. Single- and multi-marker association analyses were performed using logistic regression analysis implemented by PLINK. Potential transcription factor binding sites were predicted by MatInspector. The strongest association was observed between rs10178256 (MATN3) and trochanter (P < 0.001) and total hip BMD (P = 0.002). The SNP rs6214 (IGF1) showed consistent association with BMD at all the four measured skeletal sites (P = 0.005-0.044). Prediction of transcription factor binding suggested that the minor allele G of rs10178256 might abolish the binding of MESP1 and MESP2 which play vital roles in bone homeostasis, whereas the minor allele G of rs6214 might create an additional binding site for XBP1, a constitutive regulator of endoplasmic reticulum stress response. Our data suggested that variants in MATN3 and IGF1 were involved in BMD regulation in southern Chinese women.

Low bone mineral density is associated with increased risk for myocardial infarction in men and women

The association between bone mineral density (BMD) and myocardial infarction (MI) was investigated in 6,872 men and women. For both men and women, lower BMD in the femoral neck and hip was associated with increased risk of MI largely independent of smoking, hypertension, hypertriglyceridemia, and diabetes. The relationship between BMD and cardiovascular disease is not completely understood. The objective of this prospective study was to investigate the risk of MI in relation to bone mineral density and to determine if cardiovascular risk factors could explain this association. Dual energy X-ray absorptiometry was performed in 5,490 women and 1,382 men to determine total hip and femoral neck BMD (in grams per square centimeters) and estimate femoral neck volumetric BMD (in grams per cubic centimeters). During a mean follow-up time of 5.7 years, 117 women and 79 men suffered an initial MI. After adjustment for age and BMI, lower BMD of the femoral neck and total hip was associated with increased risk of MI for both women [hazard ratio (HR) = 1.33, 95% confidence interval (CI) 1.08-1.66 per standard deviation (SD) decrease in femoral neck BMD] and men (HR = 1.74, 95% CI 1.34-2.28 per SD decrease in total hip BMD). After additional adjustment for smoking, hypertension, hypertriglyceridemia, and diabetes, the associations were slightly attenuated in men (HR = 1.42-1.88 in the age and BMI-adjusted model versus 1.33-1.77 in the fully adjusted model) while similar attenuations were seen in women (HR = 1.06-1.25 versus 1.05-1.22). Lower BMD was associated with an increase in MI risk for both men and women. Women had consistently lower HRs compared to men in all models. Adjusting for smoking, hypertension, hypertriglyceridemia, and diabetes did not distinctively weaken these associations.

High-Trauma Fractures and Low Bone Mineral Density in Older Women and Men

It is widely believed that fractures resulting from high trauma are not osteoporotic; however, this assumption has not been studied prospectively. To examine the association between bone mineral density (BMD) and high-trauma fracture and between high-trauma fracture and subsequent fracture in older women and men. Two prospective US cohort studies in community-dwelling adults 65 years or older from geographically diverse sites. The Study of Osteoporotic Fractures followed up 8022 women for 9.1 years (1988-2006). The Osteoporotic Fractures in Men Study followed up 5995 men for 5.1 years (2000-2007). Hip and spine BMD were assessed by dual-energy x-ray absorptiometry. Incident nonspine fractures were confirmed by radiographic report. Fractures were classified, without knowledge of BMD, as high trauma (due to motor vehicle crashes and falls from greater than standing height) or as low trauma (due to falls from standing height and less severe trauma). Overall, 264 women and 94 men sustained an initial high-trauma fracture and 3211 women and 346 men sustained an initial low-trauma fracture. For women, each 1-SD reduction in total hip BMD was similarly associated with an increased risk of high-trauma fracture (multivariate relative hazard [RH], 1.45; 95% confidence interval [CI], 1.23-1.72) and low-trauma fracture (RH, 1.49; 95% CI, 1.42-1.57). Results were consistent in men (high-trauma fracture RH, 1.54; 95% CI, 1.20-1.96; low-trauma fracture RH, 1.69; 95% CI, 1.49-1.91). Risk of subsequent fracture was 34% (95% CI, 7%-67%) greater among women with an initial high-trauma fracture and 31% (95% CI, 20%-43%) greater among women with an initial low-trauma fracture, compared with women having no high- or low-trauma fracture, respectively. Risk of subsequent fracture was not modeled for men. Similar to low-trauma nonspine fractures, high-trauma nonspine fractures are associated with low BMD and increased risk of subsequent fracture in older adults. High-trauma nonspine fractures should be included as outcomes in osteoporosis trials and observational studies.

Outdoor air pollution and bone mineral density in elderly men - the Oslo Health Study

The association between bone mineral density (BMD) and outdoor air pollution has not previously been explored. In this study including 590 elderly men, total body BMD was inversely associated with indicators of air pollution. Further studies to address any relation between air pollution and BMD and bone fracture are warranted. The relation between air pollution and bone mineral density (BMD) is unknown. Based on higher fracture rates and more osteoporosis in urban compared to rural populations, this exploratory study aimed at investigating the association between indicators of air pollution and BMD. In an osteoporosis sub-study of the population-based Oslo Health Study (2000-2001) BMD of total body and total hip (mg/cm(2)) was measured by DXA in 590 men 75-76 years old. Exposure to air pollution (particulate matter (PM(10) and PM(2.5)) and nitrogen dioxide (NO(2))) at each participant's home address was estimated from 1992 to 2001. Air pollution was inversely associated with total body BMD, whereas no significant association was found for total hip BMD. The adjusted odds ratio (OR) [95% confidence interval] for low total body BMD (Z-score <or=-1) was per standard deviation increase 1.33 [1.05-1.70] for PM(2.5), 1.28 [1.00-1.63] for PM(10), and 1.24 [0.97-1.59] for NO(2). Stratified by smoking status the adjusted OR for PM(2.5) was 1.73 [1.02-2.95] in current smokers, 1.40 [1.03-1.90] in former smokers and 0.83 [0.43-1.58] in non-smokers. There was a weak but statistically significant inverse association between indicators of air pollution and total body BMD. Further investigations are warranted.

Bone density in relation to alcohol intake among men and women in the United States

Studies of postmenopausal women have shown a positive association between BMD and alcohol intake. We found that BMD was higher in men, and possibly postmenopausal women, who drank alcohol compared with those who abstained. Drinking alcohol, but not binge drinking, may benefit bone health of men and postmenopausal women. Osteoporotic fractures account for over 2.5 million physician visits annually for persons ages >or=45 years in the United States. Studies of postmenopausal women show a positive association between bone mineral density (BMD) and alcohol intake, but for men and premenopausal women, the bone-alcohol relationship remains unclear. We examined the association between total hip (TH) and femoral neck (FN) BMD and alcohol intake of men and pre- and postmenopausal women. We conducted multiple regression analyses using data from 13,512 persons ages >or=20 years from the Third National Health and Nutrition Examination Survey, 1988-1994. Alcohol intake and binge drinking were measured by questionnaire and hip BMD by dual energy X-ray absorptiometry (DXA). Accounting for covariates, TH BMD was higher in men (n = 6,868) who had 5-29 (+2.1%, p < 0.01) and >29 drinking occasions/month (+1.7%, p < 0.05) than men who abstained. BMD of premenopausal women (n = 4,136) who drank alcohol did not differ from those who abstained. FN BMD was 3.8% higher in postmenopausal women (n = 2,043) who had >29 drinking occasions/month than those who abstained (p = 0.06). Binge drinking was not associated with BMD of men or women. Drinking alcohol, but not binge drinking, appears to be beneficial to bone health of men and possibly postmenopausal women.