Calcifications in the abdominal aorta predict fractures in men: MINOS study
Calcifications in the abdominal aorta predict fractures in men: MINOS study
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DOI：
10.1359/jbmr.070903
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发表时间：
2008-01-01
影响因子：
6.2
通讯作者：
Delmas, Pierre D.
中科院分区：
文献类型：
--
作者：
Szulc, Pawel;Kiel, Douglas P.;Delmas, Pierre D.
在781名年龄≥ 50岁的男性队列中随访10年，腹主动脉中的广泛钙化与骨质疏松性骨折风险增加2- 3倍相关，而与BMD和福尔斯无关。我们评估了781名年龄≥ 50岁的男性主动脉钙化严重程度与BMD和骨折风险的关系。在10年的随访中，66名男性发生了临床骨折。通过半定量方法评估腹主动脉钙化，表示为主动脉钙化评分（ACS）。结果：ACS > 2与死亡风险增加2倍相关，校正年龄、体重、吸烟、合并症和药物后死亡风险增加2倍。校正年龄、体重指数（BMI）、吸烟和合并症后，ACS最高四分位数（>6）的男性前臂远端、桡骨远端和全身BMD低于较低四分位数的男性。当校正年龄、BMI、年龄与BMI的相互作用、普遍骨折、BMD和两次或两次以上福尔斯史（例如，髋部BMD; OR = 1.44; p < 0.02）。ACS、所有骨骼部位的BMD和两次或两次以上福尔斯跌倒史是骨折的独立预测因素。在调整混杂变量后，ACS > 6的男性骨折风险增加2- 3倍（OR = 2.54-3.04; P < 0.005-0.001）。这项长期前瞻性研究表明，ACS升高（>6）是老年男性发生骨折的一个可靠的独立风险因素，与年龄、BMI、BNID、普遍骨折、两次或多次福尔斯跌倒史、合并症和药物治疗。
In a cohort of 781 men >= 50 yr of age followed up for 10 yr, extended calcifications in the abdominal aorta were associated with a 2- to 3-fold increase in the risk of osteoporotic fractures regardless of BMD and falls.Introduction: Cardiovascular disease and osteoporotic fractures are public health problems that frequently coexist.Materials and Methods: We assessed the relation of the severity of aortic calcifications with BMD and the risk of fracture in 781 men >= 50 yr of age. During a 10-year follow-up, 66 men sustained incident clinical fractures. Calcifications in the abdominal aorta expressed as an aortic calcification score (ACS) were assessed by a semiquantitative method. BMD was measured at the lumbar spine, hip, whole body, and distal forearm.Results: ACS > 2 was associated with a 2-fold increase in the mortality risk after adjustment for age, weight, smoking, comorbidity, and medications. After adjustment for age, body mass index (BMI), smoking, and comorbidity, men in the highest quartile of ACS (>6) had lower BMD of distal forearm, ultradistal radius, and whole body than men in the lower quartiles. Log-transformed ACS predicted fractures when adjusted for age, BMI, age by BMI interaction, prevalent fractures, BMD, and history of two or more falls (e.g., hip BMD; OR = 1.44; p < 0.02). ACS, BMD at all the skeletal sites, and history of two or more falls were independent predictors of fracture. Men with ACS > 6 had a 2- to 3-fold increased risk of fracture after adjustment for confounding variables (OR = 2.54-3.04; p < 0.005-0.001 according to the site).Conclusions: This long-term prospective study showed that elevated ACS (>6) is a robust and independent risk factor for incident fracture in older men regardless of age, BMI, BNID, prevalent fractures, history of two or more falls, comorbidities, and medications.