Association between fat mass by bioelectrical impedance analysis and bone mass by quantitative ultrasound in relation to grip strength and serum 25-hydroxyvitamin D in postmenopausal Japanese women: the Unzen study

Association Between Bone Ultrasonometry and Cardiovascular Morbimortality: A Systematic Review and Meta-analysis

Context

Quantitative ultrasound (QUS) can estimate bone mineral density and predict fracture risk, but its association with cardiovascular outcomes remains unclear.

Objective

We aimed to assess the associations between bone QUS parameters and cardiovascular event risk, cardiovascular mortality (CVM) and all-cause mortality (ACM).

Data Sources

Pubmed, Embase, Cochrane Library databases, and grey literature were searched.

Study Selection

We considered studies including people aged >40 years who reported associations between bone QUS parameters (any bone site) and our outcomes.

Data Extraction

Two reviewers selected eligible studies, extracted and analyzed data, and assessed risk of bias with the Risk of Bias in Non-randomized Studies of Exposure tool. Adjusted hazard ratios (HR) with 95% confidence intervals (CIs), estimated for 1 SD reduction of QUS parameters, were pooled using random effects meta-analyses.

Data Synthesis

We included 9 studies with 275 to 477 683 (median = 3244) participants (follow-up duration range 2.8-12.8 years). All studies presented associations based on calcaneal QUS parameters; only 2 reported associations with cardiovascular events with discordant results. Seven studies reported associations with CVM and 7 with ACM. Meta-analyses based on 3 studies showed that broadband ultrasound attenuation (BUA) was inversely associated with CVM (HR = 1.22, 95% CI: 1.11-1.34, I 2 = 0%) and ACM (HR = 1.16, 95% CI: 1.10-1.23, I 2 = 0%). Meta-analyses, based on 4 and 3 studies, respectively, showed that speed of sound (SOS) was also inversely associated with CVM (HR = 1.19, 95% CI: 1.11-1.27, I 2 = 29%) and ACM (HR = 1.15, 95% CI: 1.07-1.23, I 2 = 0%).

Conclusion

In a cohort of middle-aged individuals, a decrease in calcaneal BUA and SOS were both independently associated with higher cardiovascular and ACM.

Association between physical performance and bone mass in community-dwelling postmenopausal Japanese women: The Unzen study

BACKGROUND

Low bone mass is an independent risk factor for osteoporotic fractures. We examined the association between physical performance and bone mass using quantitative ultrasound in community-dwelling postmenopausal Japanese women.

METHODS

We conducted a cross-sectional study on 524 community-dwelling postmenopausal Japanese women who were not being administered osteoporosis medications. Physical performance was assessed on the basis of grip strength, chair stand time, and functional reach. The stiffness index was measured as a quantitative ultrasound parameter for heel bone mass.

RESULTS

Physical performance, assessed by grip strength, chair stand time, and functional reach, and the stiffness index significantly decreased with age (both p<0.001). The multiple linear regression analysis showed that grip strength (p = 0.001), chair stand time (p = 0.004), and functional reach (p = 0.048) were significantly associated with the stiffness index after adjusting for age, body mass index, smoking, drinking, and exercise.

CONCLUSIONS

Physical performance was significantly associated with heel bone mass in community-dwelling postmenopausal Japanese women.