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Hu X, Ma S, Chen L, Tian C, Wang W. Association between osteoporosis and cardiovascular disease in elderly people: evidence from a retrospective study. PeerJ 2023; 11:e16546. [PMID: 38089913 PMCID: PMC10712301 DOI: 10.7717/peerj.16546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023] Open
Abstract
Objective This study aimed to investigate the associations between osteoporosis, biochemical indexes, bone mineral density (BMD), and cardiovascular disease. Methods A cross-sectional study design was used to examine the relationships between these parameters. Logistic regression and correlation analyses were conducted to assess the associations between elevated levels of triglyceride, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), homocysteine, and the presence of osteoporosis. Additionally, correlations between BMD and biochemical indexes were analyzed. The incidence of cardiovascular disease and its correlation with BMD were evaluated. Receiver operating characteristic (ROC) analysis was performed to determine the utility of BMD in identifying cardiovascular disease. Results The results revealed that elevated triglyceride, total cholesterol, and LDL levels were positively associated with osteoporosis, while higher HDL levels and homocysteine were negatively associated. Correlation analysis demonstrated negative correlations between triglyceride levels and BMD, and positive correlations between total cholesterol and HDL levels with BMD. LDL levels showed a weak negative correlation, and homocysteine levels exhibited a strong negative correlation with BMD. The osteoporosis group had lower BMD and a higher incidence of cardiovascular disease compared to the non-osteoporosis group. Logistic regression analysis confirmed the correlation between lower BMD and increased risk of cardiovascular disease. Conclusion This study provides evidence supporting the associations between osteoporosis, biochemical indexes, BMD, and cardiovascular disease. Aberrations in lipid profiles and homocysteine levels may contribute to osteoporosis development. Lower BMD, particularly in individuals with osteoporosis, appears to increase the risk of cardiovascular disease. BMD shows promise as a diagnostic tool for identifying individuals at risk of cardiovascular disease. Further research is needed to elucidate the underlying mechanisms and establish the clinical implications of these relationships. Future longitudinal studies are necessary to determine causality and long-term prognostic implications.
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Affiliation(s)
- Xiaoying Hu
- Geriatrics Department, Hengshui People’s Hospital (Harrison International Peace Hospital), Hengshui, China
| | - Shucan Ma
- Geriatrics Department, Hengshui People’s Hospital (Harrison International Peace Hospital), Hengshui, China
| | - Liman Chen
- Geriatrics Department, Hengshui People’s Hospital (Harrison International Peace Hospital), Hengshui, China
| | - Chunhui Tian
- Geriatrics Department, Hengshui People’s Hospital (Harrison International Peace Hospital), Hengshui, China
| | - Weiwei Wang
- Geriatrics Department, Hengshui People’s Hospital (Harrison International Peace Hospital), Hengshui, China
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Lin CY, Wang PH, Chen CC, Chen SC. Relationship between bone mineral density values and stroke risk. QJM 2023; 116:813. [PMID: 37261865 DOI: 10.1093/qjmed/hcad115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Indexed: 06/02/2023] Open
Affiliation(s)
- Chia-Yang Lin
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Po-Hui Wang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chun-Chieh Chen
- Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Occupational Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Shiuan-Chih Chen
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Occupational Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
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Ge Y, Chen Y, Liu G, Zhu S, Li B, Tian M, Zhang J, Wu X, Yang M. Association Between Hip Bone Mineral Density and Mortality Risk After Hip Fracture: A Prospective Cohort Study. Calcif Tissue Int 2023; 113:295-303. [PMID: 37347299 PMCID: PMC10449952 DOI: 10.1007/s00223-023-01109-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/09/2023] [Indexed: 06/23/2023]
Abstract
Factors related to mortality after osteoporotic hip fracture (HF) have been investigated intensively, except for proximal femoral bone mineral density (BMD), which is also the primary cause of osteoporosis. In this study, we aimed to investigate the association of hip BMD with mortality risk after HF. Four hundred and eleven elderly patients with HF in Beijing, China, were included and prospectively followed up with a median time of 3 years. At baseline, quantitative CT technique (QCT) was used to measure areal BMD (aBMD) of the unaffected hip. Areal BMDs of the total hip (TH), femoral neck (FN), trochanter (TR), and intertrochanter were analyzed with postoperative mortality as the primary outcome. A total of 394 patients (78.59 ± 7.59 years, 75.4% female) were included in our final analysis, with 86 (82.23 ± 7.00 years, 81.4% female) dead. All hip bone densities demonstrated a significant association with mortality risks in the unadjusted model, but only TR aBMD remained significantly correlated after adjusting for all covariates. Compared to the lower TR aBMD group, the higher TR aBMD group yielded significantly lower death risks (HR 0.21 95% CI 0.05-0.9, P = 0.036). Higher survival probabilities were observed for higher TH and TR aBMD in survival analysis (P < 0.001). Hip BMD, especially TR BMD assessed by QCT, is an independent risk factor for postoperative mortality following HF. QCT may present a promising avenue for opportunistic analysis in immobilized patients, providing valuable information for early detection and personalized interventions to enhance patient outcomes.
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Affiliation(s)
- Yufeng Ge
- Department of Orthopaedics and Traumatology, Peking University Fourth School of Clinical Medicine, Beijing Jishuitan Hospital, Beijing, China
| | - Yimin Chen
- Department of Orthopaedics and Traumatology, Peking University Fourth School of Clinical Medicine, Beijing Jishuitan Hospital, Beijing, China
| | - Gang Liu
- Department of Orthopaedics and Traumatology, Peking University Fourth School of Clinical Medicine, Beijing Jishuitan Hospital, Beijing, China
| | - Shiwen Zhu
- Department of Orthopaedics and Traumatology, Peking University Fourth School of Clinical Medicine, Beijing Jishuitan Hospital, Beijing, China
| | - Bo Li
- Department of Orthopaedics and Traumatology, Peking University Fourth School of Clinical Medicine, Beijing Jishuitan Hospital, Beijing, China
| | - Maoyi Tian
- The George Institute for Global Health at Peking University Health Science Centre, Beijing, China
| | - Jing Zhang
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Xinbao Wu
- Department of Orthopaedics and Traumatology, Peking University Fourth School of Clinical Medicine, Beijing Jishuitan Hospital, Beijing, China
| | - Minghui Yang
- Department of Orthopaedics and Traumatology, Peking University Fourth School of Clinical Medicine, Beijing Jishuitan Hospital, Beijing, China.
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Abstract
BACKGROUND Osteoporosis and cardiovascular disease are common diseases encountered globally, especially with advancing age. Osteoporosis occurs when there is a loss of bone mineral density leading to increased predisposition to fragility fracture. The conventional perception of osteoporosis is purely as a metabolic bone disease. However, there are mounting reports from recent studies that osteoporosis could be seen as a risk factor for cardiovascular disease just like other traditional risk factors such as hypertension, dyslipidaemia and diabetes. This is a paradigm shift with regards to the outlook of osteoporosis. Osteoporosis and cardiovascular disease have similar risk factors, including diabetes, smoking, excess alcohol, sedentary lifestyle, ageing and dyslipidaemia. This may partly explain the link between osteoporosis and cardiovascular disease. In addition, both osteoporosis and atherosclerosis, which underlies most cardiovascular disease, are both characterized by low grade chronic inflammation. Moreover, the processes involved in the calcification of atheroma are similar to what is seen in bone remodeling. Both processes also involve similar regulators such as osteoprotegerin and related proteins such as osteonectin, osteopontin and type 1 collagen are found in bone matrix and atheromatous plaques. CONCLUSION There is emerging evidence that individuals with osteoporosis are also at an increased risk of coronary artery disease and stroke even after controlling for other factors. The traditional risk factors for cardiovascular disease also predispose people to developing osteoporosis, suggesting that the same mechanism may be causing the two. Moreover, a number of anti-osteoporotic drugs have also been largely linked with cardiovascular disease. This calls for a change in the view of osteoporosis as a metabolic disease but as a cardio-metabolic disorder thereby emphasizing the need for intensified preventive strategies for the disease.
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Affiliation(s)
- Taoreed Adegoke Azeez
- Consultant Endocrinologist, Department of Medicine, Reddington Multi-Specialist Hospital, Lagos, Nigeria.
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Zheng L, Liu M, Gao Y, Liu D, Tian J. The association between total body bone mineral density and stroke: a mendelian randomization analyses. QJM 2022:6747965. [PMID: 36194020 DOI: 10.1093/qjmed/hcac225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 09/21/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Li Zheng
- Doctor, Department of Pharmacy, China Aerospace Science & Industry Corporation 731 Hospital, Beijing, 100074, China
- Doctor, Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, P. R. China
| | - Ming Liu
- Doctor, Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, P. R. China
- Doctor, Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, P. R. China
| | - Ya Gao
- Doctor, Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, P. R. China
- Doctor, Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, P. R. China
- Professor, Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, L8S4L8, Canada
| | - Deping Liu
- Professor, Department of Cardiovascular medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Jinhui Tian
- Doctor, Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, P. R. China
- Doctor, Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, P. R. China
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Zhu B. Response to letter from Dr Zheng entitled 'The association between total body bone mineral density and stroke: a mendelian randomization analyses'. QJM 2022:6747963. [PMID: 36194013 DOI: 10.1093/qjmed/hcac226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 04/05/2023] Open
Affiliation(s)
- Bin Zhu
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Kautzky-Willer A, Harreiter J, Thomas A, Burger J, Schneeweiß U, Deischinger C, Klein W, Moser H. Women With Cerebral Infarction Feature Worse Clinical Profiles at Admission but Comparable Success to Men During Long-Term Inpatient Neurorehabilitation. Front Aging Neurosci 2021; 13:663215. [PMID: 34867261 PMCID: PMC8637730 DOI: 10.3389/fnagi.2021.663215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 10/27/2021] [Indexed: 12/25/2022] Open
Abstract
Objective: Little is known about possible sex and gender differences in post-stroke neurorehabilitation outcomes. We aimed to analyze if functional performance, prevalence and impact of comorbidities at admission, and success of inpatient stroke-neurorehabilitation differ between men and women. Methods: Retrospective cohort analysis of 1,437 men and 907 women with prior cerebral infarction treated at a neurorehabilitation clinic between 2012 and 2017; multiple linear regression was used to examine the influence of sex/gender as well as multiple confounders on health and functional outcomes. The main outcome measures were Barthel index (BI) at admission and its change during 4 weeks inpatient neurorehabilitation. Results: Men had been diagnosed with osteoporosis less frequently than women but more often with type 2 diabetes mellitus, coronary artery or chronic kidney disease (p ≤ 0.01). Although twice as many women presented with pre-stroke depression compared to men, the risk of post-stroke depression detected during rehabilitation was comparable. Men were more likely to have less than 30 days between diagnosis and neurorehabilitation start than women (p < 0.03). At admission, women exhibited less autonomy, a lower BI, a higher pain score and worse 2-min walk test (2′WT) compared to men (p < 0.001). Among males osteoporosis and peripheral artery disease independently predicted BI at admission, in women it was pre-stroke depression, dementia, and arterial fibrillation. During neurorehabilitation, both sexes improved regarding BI, pain and walk tests (p < 0.001). Despite comparable rehabilitation effectiveness, women still had worse functional outcomes than males at discharge. Time after stroke to start of neurorehabilitation and length of the stay but, most strongly, the simple 2′WT at admission, and in women, pain intensity independently predicted post-stroke functional status and recovery. Conclusion: Women presented with worse functional status at admission to neurorehabilitation. Although men and women showed similar rehabilitation effectiveness, women still displayed worse clinical outcome measures and higher levels of pain at discharge. Early access and gender-sensitive, personalized post-stroke care with more focus on different comorbidities and psychosocial factors like pain levels and management, could further improve neurorehabilitation outcomes.
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Affiliation(s)
- Alexandra Kautzky-Willer
- Gender Medicine Institute, Gars am Kamp, Austria.,Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Jürgen Harreiter
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Anita Thomas
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Johannes Burger
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Ulrich Schneeweiß
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Carola Deischinger
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Wolfhard Klein
- Neurologisches Therapiezentrum Gmundnerberg, Altmünster, Austria
| | - Hermann Moser
- Neurologisches Therapiezentrum Gmundnerberg, Altmünster, Austria
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