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Yang Y, Huang Y. Association between bone mineral density and cardiovascular disease in older adults. Front Public Health 2023; 11:1103403. [PMID: 37427263 PMCID: PMC10328748 DOI: 10.3389/fpubh.2023.1103403] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 05/12/2023] [Indexed: 07/11/2023] Open
Abstract
Background and aims Cardiovascular disease and osteoporosis are common diseases in older adults with high morbidity. The study on the interaction between the two in pathogenic mechanisms has been paid much attention by the majority of researchers. This study aimed to explore the relationship between bone mineral density and cardiovascular disease in older adults. Methods The primary data was downloaded from the National Health and Nutrition Examination Survey database of the United States. Multivariate logistic regression model, generalized additive model, and smooth curve fitting were used to explore the relationship between bone mineral density and cardiovascular events risk. When a curve relationship was found, a two-piecewise linear model was used to calculate the inflection point. In addition, subgroup analysis was also performed. Results A total of 2097 subjects were included in this study. After adjusting for potential confounders, no significant association was found between lumbar bone mineral density and cardiovascular disease, while femur bone mineral density had a non-linear relationship with cardiovascular disease, with an inflection point of 0.741 gm/cm2. When bone mineral density was <0.741 gm/cm2, the risk of cardiovascular disease decreased speedily. Once bone mineral density exceeded this value, the risk of cardiovascular disease continued to decrease, but the trend became significantly slower. Compared with patients with normal bone mass, osteoporosis was associated with a 2.05-fold increased risk of cardiovascular disease (95% CI 1.68-5.52). There were no significant differences in interaction tests of all subgroups (p for interaction >0.05) except race. Conclusion Our results indicated that bone mineral density was closely associated with the prevalence of cardiovascular disease in older adults over 60 years old, especially the femur bone mineral density was negatively non-linear associated with cardiovascular disease risk, with an inflection point of 0.741 gm/cm2.
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Jiang C, Yan C, Duan J. Bone Mineral Density Is Inversely Associated With Mortality in Chronic Kidney Disease Patients: A Meta-Analysis. J Bone Miner Res 2022; 37:2094-2102. [PMID: 36055677 DOI: 10.1002/jbmr.4681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/09/2022] [Accepted: 08/14/2022] [Indexed: 11/09/2022]
Abstract
Low bone mineral density (BMD) is suggested to be associated with increased mortality in the general health population, but the relationship in chronic kidney disease (CKD) patients is still unclear. We performed a meta-analysis to investigate the association of BMD in different sites with risk of all-cause mortality in CKD patients. We searched PubMed, EMBASE, and Web of Science to identify eligible cohort studies that evaluated the association between BMD at different sites and risk of all-cause mortality in CKD patients. Twelve cohort studies were identified, which included 2828 CKD patients and 1052 deaths. Compared with normal/high level of total body BMD, lower total body BMD was associated with 25% higher risk of all-cause mortality. The pooled relative risk (RR) was 1.25 (95% confidence interval [CI] 1.09, 1.42) with little heterogeneity across studies. Regarding BMD measured at different sites, the risk of all-cause mortality was highest for lower BMD at hip/femoral neck (pooled RR = 1.69; 95% CI 1.20, 2.40). The pooled RRs were 1.26 (95% CI 1.04, 1.53) and 1.17 (95% CI 1.00, 1.37) for lower BMD at arm and spine, respectively. Similarly, the risk of death for per SD decrease in BMD was also higher at hip/femoral neck (pooled RR = 1.43, 95% CI 1.15, 1.77) compared with arm (pooled RR = 1.03, 95% CI 1.00, 1.06) and spine (pooled RR = 1.17, 95% CI 0.98, 1.39). In conclusion, lower BMD values at hip, arm, spine, as well as the whole body are associated with increased risk of all-cause mortality in CKD patients. The excess risk is highest for patients with lower BMD at hip/femoral neck, suggesting BMD measured at hip region may be the best indicator of mortality risk in CKD patients. © 2022 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Chao Jiang
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chongnan Yan
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jingzhu Duan
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
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Bartoli-Leonard F, Turner ME, Zimmer J, Chapurlat R, Pham T, Aikawa M, Pradhan AD, Szulc P, Aikawa E. Elevated lipoprotein(a) as a predictor for coronary events in older men. J Lipid Res 2022; 63:100242. [PMID: 35724702 PMCID: PMC9304778 DOI: 10.1016/j.jlr.2022.100242] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/07/2022] [Accepted: 06/12/2022] [Indexed: 02/09/2023] Open
Abstract
Elevated circulating lipoprotein (a) [Lp(a)] is associated with an increased risk of first and recurrent cardiovascular events; however, the effect of baseline Lp(a) levels on long-term outcomes in an elderly population is not well understood. The current single-center prospective study evaluated the association of Lp(a) levels with incident acute coronary syndrome to identify populations at risk of future events. Lp(a) concentration was assessed in 755 individuals (mean age of 71.9 years) within the community and followed for up to 8 years (median time to event, 4.5 years; interquartile range, 2.5–6.5 years). Participants with clinically relevant high levels of Lp(a) (>50 mg/dl) had an increased absolute incidence rate of ASC of 2.00 (95% CI, 1.0041) over 8 years (P = 0.04). Moreover, Kaplan-Meier cumulative event analyses demonstrated the risk of ASC increased when compared with patients with low (<30 mg/dl) and elevated (30–50 mg/dl) levels of Lp(a) over 8 years (Gray’s test; P = 0.16). Within analyses adjusted for age and BMI, the hazard ratio was 2.04 (95% CI, 1.0–4.2; P = 0.05) in the high versus low Lp(a) groups. Overall, this study adds support for recent guidelines recommending a one-time measurement of Lp(a) levels in cardiovascular risk assessment to identify subpopulations at risk and underscores the potential utility of this marker even among older individuals at a time when potent Lp(a)-lowering agents are undergoing evaluation for clinical use.
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Affiliation(s)
- Francesca Bartoli-Leonard
- Center for Interdisciplinary Cardiovascular Sciences, Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mandy E Turner
- Center for Interdisciplinary Cardiovascular Sciences, Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jonas Zimmer
- Center for Interdisciplinary Cardiovascular Sciences, Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Roland Chapurlat
- INSERM UMR 1033, University of Lyon, Hospices Civils de Lyon, 69437 Lyon, France
| | - Tan Pham
- Center for Interdisciplinary Cardiovascular Sciences, Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Masanori Aikawa
- Center for Interdisciplinary Cardiovascular Sciences, Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Center for Excellence in Vascular Biology, Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Aruna D Pradhan
- Division of Preventive Medicine, Brigham and Woman's Hospital Harvard Medical School, Boston, MA, USA; Division of Cardiovascular Medicine, VA Boston Medical Centre, Boston, MA, USA
| | - Pawel Szulc
- INSERM UMR 1033, University of Lyon, Hospices Civils de Lyon, 69437 Lyon, France.
| | - Elena Aikawa
- Center for Interdisciplinary Cardiovascular Sciences, Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Center for Excellence in Vascular Biology, Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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Tozzi R, Masi D, Cipriani F, Contini S, Gangitano E, Spoltore ME, Barchetta I, Basciani S, Watanabe M, Baldini E, Ulisse S, Lubrano C, Gnessi L, Mariani S. Circulating SIRT1 and Sclerostin Correlates with Bone Status in Young Women with Different Degrees of Adiposity. Nutrients 2022; 14:nu14050983. [PMID: 35267956 PMCID: PMC8912833 DOI: 10.3390/nu14050983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 11/28/2022] Open
Abstract
Sirtuin1 (SIRT1) and sclerostin play important roles in adipose tissue and bone metabolism. We evaluated the circulating SIRT1 and sclerostin relationship with mass and quality of bone while considering the degree of adiposity. Sixty-six premenopausal women (16 underweight, 25 normal weight and 25 with obesity), aged <50 years, were enrolled. Plasma SIRT1, sclerostin and DXA body composition (total fat mass (FM), abdominal visceral adipose tissue, lean mass, trabecular bone score (TBS) and lumbar spine and femoral neck (FN) bone mineral density (BMD)) were assessed. The patients with obesity showed the lowest SIRT1 and TBS values and the highest sclerostin concentrations; BMD increased with FM and BMI and had an inverse association with SIRT1. Sclerostin was negatively correlated with SIRT1 (ρ = −0.37, p = 0.002). When spine BMD, FN BMD and TBS were standardized for BMI, a positive correlation with SIRT1 and a negative correlation with sclerostin were seen (p < 0.005). In the regression analysis, sclerostin was the best independent, negative predictor for BMD and TBS, while SIRT1 directly predicted TBS (p < 0.05). In conclusion, blood measurement of SIRT1 and sclerostin could represent a snapshot of the bone status that, taking into account the degree of adiposity, may reduce the interference of confounding factors in the interpretation of bone health parameters.
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Affiliation(s)
- Rossella Tozzi
- Department of Molecular Medicine, “Sapienza” University of Rome, 00161 Rome, Italy;
| | - Davide Masi
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
| | - Fiammetta Cipriani
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
| | - Savina Contini
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
| | - Elena Gangitano
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
| | - Maria Elena Spoltore
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
| | - Ilaria Barchetta
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
| | - Sabrina Basciani
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
| | - Mikiko Watanabe
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
| | - Enke Baldini
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (S.U.)
| | - Salvatore Ulisse
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (S.U.)
| | - Carla Lubrano
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
| | - Lucio Gnessi
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
| | - Stefania Mariani
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
- Correspondence: ; Tel.: +39-06499-70721; Fax: +39-06446-1450
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You F, Ma C, Sun F, Liu L, Zhong X. The risk factors of heart failure in elderly patients with hip fracture: what should we care. BMC Musculoskelet Disord 2021; 22:832. [PMID: 34583660 PMCID: PMC8479890 DOI: 10.1186/s12891-021-04686-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 08/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Heart failure is a common adverse postoperative complication in elderly patients. It is necessary to explore the risk factors of heart after the operation of elderly patients with hip fracture during hospitalization. METHODS Patients with hip fractures admitted to our hospital from January 1, 2019 to December 31 2020 were included, all the patients received internal fixation surgery. The characteristics of patients with and without postoperative heart failure were compared. Multivariate logistic regression analyses were applied to analyze the risk factors of heart failure in elderly patients with hip fracture. RESULTS A total of 283 patients with hip fractures were included, the incidence of heart failure was 12.37 %. There were significant differences in the age, hypertension, anemia hypoalbuminemia and duration of surgery between heart failure and no heart failure group(all p < 0.05). There were no significant differences in the gender, BMI, diabetes mellitus, hyperlipidemia, history of heart failure, cognitive dysfunction, type of fracture, preoperative oxygen saturation, white blood cell count, platelet count, red blood cell count, creatinine, alanine aminotransferase, aspartate aminotransferase and estimated blood loss during surgery between heart failure and no heart failure group(all p > 0.05). Logistic regression analyses indicated that age ≥ 70y(OR2.446, 95% CI1.044 ~ 4.149), hypertension(OR2.152, 95% CI1.125 ~ 4.023), anemia(OR3.094, 95% CI1.294 ~ 5.907), hypoalbuminemia(OR2.377, 95% CI1.205 ~ 4.537), duration of surgery ≥ 120 min(OR1.683, 95% CI1.094 ~ 2.782) were the risk factors of heart failure in elderly patients with hip fracture(all p < 0.05). CONCLUSIONS The incidence of postoperative heart failure in elderly patients with hip fracture is relatively high, which is the result of a combination of high-risk factors. Peri-period risk assessment and prevention of related risks are the keys to a good prognosis for patients.
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Affiliation(s)
- Fei You
- Department of Rehabilitation Medicine, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and Technology, No.26 Shengli Street, Jiang'an District, Wuhan City, Hubei Province, China.
| | - Chaoyang Ma
- Department of Rehabilitation Medicine, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and Technology, No.26 Shengli Street, Jiang'an District, Wuhan City, Hubei Province, China
| | - Fangfang Sun
- Department of Rehabilitation Medicine, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and Technology, No.26 Shengli Street, Jiang'an District, Wuhan City, Hubei Province, China.
| | - Lian Liu
- Department of Rehabilitation Medicine, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and Technology, No.26 Shengli Street, Jiang'an District, Wuhan City, Hubei Province, China
| | - Xiuwen Zhong
- Department of Rehabilitation Medicine, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and Technology, No.26 Shengli Street, Jiang'an District, Wuhan City, Hubei Province, China
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