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Bone density loss on computed tomography at 3-year follow-up in current compared to former male smokers.

Abstract

OBJECTIVES

Cigarette smoking negatively affects bone quality and increases fracture risk. Little is known on the effect of smoking cessation and computed tomography (CT)-derived bone mineral density (BMD) decline in the spine. We evaluated the association of current and former smoking with BMD decline after 3-year follow-up.

METHODS

Male current and former smokers participating in a lung cancer screening trial who underwent baseline and 3-year follow-up CT were included. BMD was measured by manual placement of a region of interest in the first lumbar vertebra and expressed in Hounsfield Unit (HU). Multiple linear regression analysis was used to evaluate the association between pack years smoked and smoking status with BMD decline.

RESULTS

408 participants were included with median (25th-75th percentile) age of 59.4 (55.9-63.5) years. At the start of the study, 197 (48.3%) participants were current smokers and 211 (51.7%) were former smokers and had a similar amount of pack years. Current smokers had quit smoking for 6 (4-8) years prior to inclusion. There was no difference in BMD between current and former smokers at baseline (109±34 HU vs. 108±32 HU, p=0.96). At 3-year follow-up, current smokers had a mean BMD decline of -3±13 HU (p=0.001), while BMD in former smokers did not change as compared to baseline (1±13 HU, p=0.34). After adjustment for BMD at baseline and body mass index, current smoking was independently associated with BMD decline (-3.8 HU, p=0.003). Age, pack years, and the presence of a fracture at baseline did not associate with BMD decline.

CONCLUSIONS

Current smokers showed a more rapid BMD decline over a 3-year period compared to former smokers. This information might be important to identify subjects at risk for osteoporosis and emphasizes the importance of smoking cessation in light of BMD decline.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Pulmonology, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: e.pompe@umcutrecht.nl.

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    Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.

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    Department of Geriatric Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.

    ,

    Department of Public Health, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.

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    Department of Public Health, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.

    ,

    University of Groningen, University Medical Center Groningen, Groningen, Department of Radiology, The Netherlands.

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    University of Groningen, University Medical Center Groningen, Groningen, Department of Radiology, The Netherlands; University of Groningen, University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, Groningen, The Netherlands.

    ,

    Department of Pulmonology, University Medical Center Utrecht, Utrecht, The Netherlands.

    ,

    Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.

    Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.

    Source

    European journal of radiology 89: 2017 Apr pg 177-181

    MeSH

    Absorptiometry, Photon
    Aged
    Bone Density
    Early Detection of Cancer
    Follow-Up Studies
    Humans
    Lumbar Vertebrae
    Lung Neoplasms
    Male
    Middle Aged
    Osteoporosis
    Osteoporotic Fractures
    Smoking
    Tomography, X-Ray Computed

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    28267536

    Citation

    Pompe, E, et al. "Bone Density Loss On Computed Tomography at 3-year Follow-up in Current Compared to Former Male Smokers." European Journal of Radiology, vol. 89, 2017, pp. 177-181.
    Pompe E, Bartstra J, Verhaar HJ, et al. Bone density loss on computed tomography at 3-year follow-up in current compared to former male smokers. Eur J Radiol. 2017;89:177-181.
    Pompe, E., Bartstra, J., Verhaar, H. J., de Koning, H. J., van der Aalst, C. M., Oudkerk, M., ... Mohamed Hoesein, F. A. A. (2017). Bone density loss on computed tomography at 3-year follow-up in current compared to former male smokers. European Journal of Radiology, 89, pp. 177-181. doi:10.1016/j.ejrad.2017.02.011.
    Pompe E, et al. Bone Density Loss On Computed Tomography at 3-year Follow-up in Current Compared to Former Male Smokers. Eur J Radiol. 2017;89:177-181. PubMed PMID: 28267536.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Bone density loss on computed tomography at 3-year follow-up in current compared to former male smokers. AU - Pompe,E, AU - Bartstra,J, AU - Verhaar,H J, AU - de Koning,H J, AU - van der Aalst,C M, AU - Oudkerk,M, AU - Vliegenthart,R, AU - Lammers,J-W J, AU - de Jong,P A, AU - Mohamed Hoesein,F A A, Y1 - 2017/02/09/ PY - 2016/05/24/received PY - 2017/01/29/revised PY - 2017/02/07/accepted PY - 2017/3/8/entrez PY - 2017/3/8/pubmed PY - 2017/6/3/medline KW - Bone mineral density KW - Cigarette smoking KW - Computed tomography KW - Osteoporosis KW - Screening SP - 177 EP - 181 JF - European journal of radiology JO - Eur J Radiol VL - 89 N2 - OBJECTIVES: Cigarette smoking negatively affects bone quality and increases fracture risk. Little is known on the effect of smoking cessation and computed tomography (CT)-derived bone mineral density (BMD) decline in the spine. We evaluated the association of current and former smoking with BMD decline after 3-year follow-up. METHODS: Male current and former smokers participating in a lung cancer screening trial who underwent baseline and 3-year follow-up CT were included. BMD was measured by manual placement of a region of interest in the first lumbar vertebra and expressed in Hounsfield Unit (HU). Multiple linear regression analysis was used to evaluate the association between pack years smoked and smoking status with BMD decline. RESULTS: 408 participants were included with median (25th-75th percentile) age of 59.4 (55.9-63.5) years. At the start of the study, 197 (48.3%) participants were current smokers and 211 (51.7%) were former smokers and had a similar amount of pack years. Current smokers had quit smoking for 6 (4-8) years prior to inclusion. There was no difference in BMD between current and former smokers at baseline (109±34 HU vs. 108±32 HU, p=0.96). At 3-year follow-up, current smokers had a mean BMD decline of -3±13 HU (p=0.001), while BMD in former smokers did not change as compared to baseline (1±13 HU, p=0.34). After adjustment for BMD at baseline and body mass index, current smoking was independently associated with BMD decline (-3.8 HU, p=0.003). Age, pack years, and the presence of a fracture at baseline did not associate with BMD decline. CONCLUSIONS: Current smokers showed a more rapid BMD decline over a 3-year period compared to former smokers. This information might be important to identify subjects at risk for osteoporosis and emphasizes the importance of smoking cessation in light of BMD decline. SN - 1872-7727 UR - https://www.unboundmedicine.com/medline/citation/28267536/Bone_density_loss_on_computed_tomography_at_3_year_follow_up_in_current_compared_to_former_male_smokers_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0720-048X(17)30056-6 DB - PRIME DP - Unbound Medicine ER -