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High hip fracture risk in men with severe aortic calcification: MrOS study.
J Bone Miner Res. 2014 Apr; 29(4):968-75.JB

Abstract

A significant link between cardiovascular disease and osteoporosis is established in postmenopausal women, but data for men are scarce. We tested the hypothesis that greater severity of abdominal aortic calcification (AAC) was associated with an increased risk of nonspine fracture in 5994 men aged ≥ 65 years. AAC was assessed on 5400 baseline lateral thoracolumbar radiographs using a validated visual semiquantitative score. Total hip bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry. Incident nonspine fractures were centrally adjudicated. After adjustment for age, body mass index (BMI), total hip BMD, fall history, prior fracture, smoking status, comorbidities, race, and clinical center, the risk of nonspine fracture (n=805) was increased among men with higher AAC (hazard ratio [HR] quartile 4 [Q4] [AAC score ≥ 9] versus quartile 1 [Q1] [0-1], 1.36; 96% confidence interval [CI], 1.10-1.68). This association was due to an increased risk of hip fracture (n=178) among men with higher AAC (HR Q4 versus Q1, 2.33; 95% CI, 1.41-3.87). By contrast, the association between AAC and the risk of nonspine, nonhip fracture was weaker and not significant (HR Q4 versus Q1, 1.22; 95% CI, 0.96-1.55). The findings regarding higher AAC and increased risk of fracture were not altered in additional analyses accounting for degree of trauma, estimated glomerular filtration rate, presence of lumbar vertebral fractures (which may bias AAC assessment), preexisting cardiovascular disease, ankle brachial index, or competing risk of death. Thus, in this large cohort of elderly men, greater AAC was independently associated with an increased risk of hip fracture, but not with other nonspine fractures. These findings suggest that AAC assessment may be a useful method for identification of older men at high risk of hip fracture.

Authors+Show Affiliations

Institut National de la Santé et de la Recherche Médicale (INSERM) Unité Mixte de Recherche (UMR) 1033, University of Lyon, Lyon, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

23983224

Citation

Szulc, Pawel, et al. "High Hip Fracture Risk in Men With Severe Aortic Calcification: MrOS Study." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 29, no. 4, 2014, pp. 968-75.
Szulc P, Blackwell T, Schousboe JT, et al. High hip fracture risk in men with severe aortic calcification: MrOS study. J Bone Miner Res. 2014;29(4):968-75.
Szulc, P., Blackwell, T., Schousboe, J. T., Bauer, D. C., Cawthon, P., Lane, N. E., Cummings, S. R., Orwoll, E. S., Black, D. M., & Ensrud, K. E. (2014). High hip fracture risk in men with severe aortic calcification: MrOS study. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 29(4), 968-75. https://doi.org/10.1002/jbmr.2085
Szulc P, et al. High Hip Fracture Risk in Men With Severe Aortic Calcification: MrOS Study. J Bone Miner Res. 2014;29(4):968-75. PubMed PMID: 23983224.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High hip fracture risk in men with severe aortic calcification: MrOS study. AU - Szulc,Pawel, AU - Blackwell,Terri, AU - Schousboe,John T, AU - Bauer,Douglas C, AU - Cawthon,Peggy, AU - Lane,Nancy E, AU - Cummings,Steven R, AU - Orwoll,Eric S, AU - Black,Dennis M, AU - Ensrud,Kristine E, PY - 2013/07/01/received PY - 2013/08/14/revised PY - 2013/08/20/accepted PY - 2013/8/29/entrez PY - 2013/8/29/pubmed PY - 2014/12/15/medline KW - ABDOMINAL AORTIC CALCIFICATION KW - HIP FRACTURE KW - MEN SP - 968 EP - 75 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J Bone Miner Res VL - 29 IS - 4 N2 - A significant link between cardiovascular disease and osteoporosis is established in postmenopausal women, but data for men are scarce. We tested the hypothesis that greater severity of abdominal aortic calcification (AAC) was associated with an increased risk of nonspine fracture in 5994 men aged ≥ 65 years. AAC was assessed on 5400 baseline lateral thoracolumbar radiographs using a validated visual semiquantitative score. Total hip bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry. Incident nonspine fractures were centrally adjudicated. After adjustment for age, body mass index (BMI), total hip BMD, fall history, prior fracture, smoking status, comorbidities, race, and clinical center, the risk of nonspine fracture (n=805) was increased among men with higher AAC (hazard ratio [HR] quartile 4 [Q4] [AAC score ≥ 9] versus quartile 1 [Q1] [0-1], 1.36; 96% confidence interval [CI], 1.10-1.68). This association was due to an increased risk of hip fracture (n=178) among men with higher AAC (HR Q4 versus Q1, 2.33; 95% CI, 1.41-3.87). By contrast, the association between AAC and the risk of nonspine, nonhip fracture was weaker and not significant (HR Q4 versus Q1, 1.22; 95% CI, 0.96-1.55). The findings regarding higher AAC and increased risk of fracture were not altered in additional analyses accounting for degree of trauma, estimated glomerular filtration rate, presence of lumbar vertebral fractures (which may bias AAC assessment), preexisting cardiovascular disease, ankle brachial index, or competing risk of death. Thus, in this large cohort of elderly men, greater AAC was independently associated with an increased risk of hip fracture, but not with other nonspine fractures. These findings suggest that AAC assessment may be a useful method for identification of older men at high risk of hip fracture. SN - 1523-4681 UR - https://www.unboundmedicine.com/medline/citation/23983224/High_hip_fracture_risk_in_men_with_severe_aortic_calcification:_MrOS_study_ L2 - https://doi.org/10.1002/jbmr.2085 DB - PRIME DP - Unbound Medicine ER -