1
|
Usiskin IM, Mitchell GF, Bouxsein ML, Liu CT, Kiel DP, Samelson EJ. Vascular function and skeletal fragility: A study of tonometry, brachial hemodynamics, and bone microarchitecture. J Bone Miner Res 2024:zjae071. [PMID: 38709885 DOI: 10.1093/jbmr/zjae071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 04/18/2024] [Accepted: 05/03/2024] [Indexed: 05/08/2024]
Abstract
Osteoporosis and cardiovascular disease frequently occur together in older adults; however, a causal relationship between these two common conditions has not been established. By the time clinical cardiovascular disease develops, it is often too late to test whether vascular dysfunction developed before or after the onset of osteoporosis. Therefore, we assessed the association of vascular function, measured by tonometry and brachial hemodynamic testing, with bone density, microarchitecture, and strength, measured by high-resolution peripheral quantitative computed tomography (HR-pQCT), in 1391 individuals in the Framingham Heart Study. We hypothesized that decreased vascular function (pulse wave velocity, primary pressure wave, brachial pulse pressure, baseline flow amplitude and brachial flow velocity) contributes to deficits in bone density, microarchitecture and strength, particularly in cortical bone, which is less protected from excessive blood flow pulsatility than the trabecular compartment. We found that individuals with increased carotid-femoral pulse wave velocity had lower cortical volumetric bone mineral density (tibia: -0.21 [-0.26,-0.15] standardized beta [95% confidence interval], radius: -0.20 [-0.26,-0.15]), lower cortical thickness (tibia: -0.09 [-0.15,-0.04], radius: -0.07 [-0.12,-0.01]) and increased cortical porosity (tibia: 0.20 [0.15,0.25], radius: 0.21 [0.15,0.27]). However, these associations did not persist after adjustment for age, sex, height, and weight. These results suggest that vascular dysfunction with aging may not be an etiologic mechanism that contributes to the co-occurrence of osteoporosis and cardiovascular disease in older adults. Further study employing longitudinal measures of HR-pQCT parameters is needed to fully elucidate the link between vascular function and bone health.
Collapse
Affiliation(s)
- Ilana M Usiskin
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, MA
| | | | - Mary L Bouxsein
- Center for Advanced Orthopedic Studies (CAOS), Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center, Boston, MA
| | - Ching-Ti Liu
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA, United States
| | - Douglas P Kiel
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
- Harvard Medical School, Boston, MA
| | - Elizabeth J Samelson
- Harvard Medical School, Boston, MA
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| |
Collapse
|
2
|
Guo L, Zhang N, Zhang Y, Xing L, Xu W, Li W, Zhang L, Hou X, Chen S, Wu S, Tian F. Arterial stiffness and risk of new-onset fragility fracture in Chinese men and women: The Kailuan cohort study. Bone 2024; 180:116991. [PMID: 38141749 DOI: 10.1016/j.bone.2023.116991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND Previous studies have shown an association between increased arterial stiffness and reduced bone mineral density. However, the relationship between arterial stiffness and fragility fracture remains unclear. In this study, we explored the impact of arterial stiffness on the risk of new-onset fragility fracture. METHODS The study included 53,107 participants in the Kailuan Study in whom brachial-ankle pulse wave velocity (baPWV) measurements were obtained between 2010 and 2021. All participants were free of fragility fractures at baseline. A Cox proportional hazard regression model was used to estimate the hazard ratio (HR) and 95 % confidence interval (CI) for incident fragility fracture on the baseline baPWV groups: <1400 cm/s (reference), 1400 ≤ baPWV < 1800 cm/s, and ≥1800 cm/s. RESULTS In total, 327 incident fragility fractures were recorded during an average follow-up of 4.99 ± 3.02 years. After adjustment for potential confounders, the HR for the risk of new-onset fragility fracture was 1.66 (95 % CI 1.14-2.42) for the arterial stiffness group in comparison with the normal baPWV group. The risk of fragility fracture was higher in men (HR 1.64, 95 % CI 1.05-2.57). There was a linear association between higher baPWV and fragility fracture. CONCLUSIONS Arterial stiffness as measured by baPWV was associated with the risk of fragility fracture.
Collapse
Affiliation(s)
- Lu Guo
- The School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Nan Zhang
- Department of Orthopedics, Kailuan General Hospital, Tangshan, Hebei, China
| | - Yimeng Zhang
- Medical Department, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Lei Xing
- Department of General Practice, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, China
| | - Wenqi Xu
- The School of Clinical Medicine, North China University of Science and Technology, Tangshan, Hebei, China
| | - Wenjuan Li
- The School of Clinical Medicine, North China University of Science and Technology, Tangshan, Hebei, China
| | - Lisha Zhang
- The School of Clinical Medicine, North China University of Science and Technology, Tangshan, Hebei, China
| | - Xiaoli Hou
- The School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Faming Tian
- The School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China.
| |
Collapse
|
3
|
Kim S, Singh H. Sex-specific associations among total bone-specific physical activity score, aortic parameters, and body composition in healthy young adults. J Exerc Sci Fit 2022; 20:27-31. [PMID: 34976077 PMCID: PMC8683586 DOI: 10.1016/j.jesf.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/22/2021] [Accepted: 12/06/2021] [Indexed: 11/12/2022] Open
Abstract
Background/Objective Physical inactivity is one of the major cardiovascular disease risk factors; however, not much is known regarding lifetime bone-specific physical activity and arterial stiffness. The aim of this cross-sectional study was to determine whether total bone-specific physical activity score (tBPAQ) was related to arterial stiffness and body composition in healthy young adults. Methods Healthy young women (n = 56, 20.3 ± 1.3 years) and men (n = 52, 21.0 ± 1.2 years) between 18 and 25 years were recruited for this study. The tBPAQ was used to obtain a comprehensive account of lifetime bone-loading physical activity. We measured the carotid to femoral pulse wave velocity (cfPWV) to evaluate arterial stiffness using the novel oscillometric device (SphygmoCor XCEL). Dual energy X-ray absorptiometry was used to measure bone free lean body mass (BFLBM, kg) and % total body fat. Results Partial correlations analyses showed a significant inverse relationship between tBPAQ and cfPWV (r = - 0.371, p = 0.007) in young women; however, this relationship was not found in young men (p > 0.05). There were significant negative correlations between tBPAQ and % total body fat in both young women (r = - 0.265, p = 0.048) and men (r = - 0.327, p = 0.018). No significant relationships were found between tBPAQ and BFLBM (p > 0.05). Conclusion Our study provides preliminary evidence of sex-specificity of negative relationships of tBPAQ with i) cfPWV (women only) and ii) % total body fat (men and women). Whether bone-loading physical activity can lead to better cardiometabolic outcomes needs to be examined.
Collapse
Affiliation(s)
- SoJung Kim
- Department of Health and Exercise Science, School of Nursing & Health Professions, Rowan University, Glassboro, NJ, 08028, USA
| | - Harshvardhan Singh
- Department of Physical Therapy, University of Alabama, 1716 9th Avenue South, Birmingham, AL, 35294, USA
| |
Collapse
|
4
|
Chai H, Ge J, Li L, Li J, Ye Y. Hypertension is associated with osteoporosis: a case-control study in Chinese postmenopausal women. BMC Musculoskelet Disord 2021; 22:253. [PMID: 33678168 PMCID: PMC7938480 DOI: 10.1186/s12891-021-04124-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/24/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Osteoporosis and cardiovascular disease (CVD) are age-related diseases. It is reported that patients with CVD have a higher risk of bone loss. This retrospective study sought to reveal the association between osteoporosis and CVD in Chinese women. Although epidemiological evidence has indicated a relationship between the two, clinical data in southeast China are lacking. METHODS In total, 2873 participants completed the baseline survey from January 2007 to October 2019, and 2039 were included in this retrospective study. We divided all subjects into an osteoporosis group and a non-osteoporosis group based on their bone mineral density (BMD). Dual-energy X-ray absorptiometry (DXA) was used to examine BMD. The general information came from the questionnaire survey. Cardiovascular diseases were defined by asking participants at the first visit and checking relevant medical records if they had suffered from hypertension, coronary heart disease, or cerebral infarction. RESULTS According to the criterion, the osteoporosis group had 678 subjects, and the non-osteoporosis group had 1361 subjects. Subjects in the osteoporosis group had a significantly higher prevalence of hypertension and coronary heart disease. Besides, the proportion of subjects who drank tea and drank milk were relatively higher in the osteoporosis group. The odds ratio (OR) for suffering from osteoporosis was high if the patients had hypertension. CONCLUSIONS This study indicated that Chinese postmenopausal women with osteoporosis had a higher prevalence of hypertension. Hypertension was significantly associated with osteoporosis.
Collapse
Affiliation(s)
- Hao Chai
- Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jirong Ge
- Key Research Laboratory of Osteoporosis Syndrome Genomics, Fujian Academy of Chinese Medical Sciences, 282 Wusi Road, Fuzhou, 350003, China.
| | - Li Li
- Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jianyang Li
- Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yunjin Ye
- Key Research Laboratory of Osteoporosis Syndrome Genomics, Fujian Academy of Chinese Medical Sciences, 282 Wusi Road, Fuzhou, 350003, China
| |
Collapse
|
5
|
Tang K, Zhang Q, Peng N, Hu Y, Xu S, Zhang M, Wang R, Shi L. Brachial-ankle pulse wave velocity is associated with the risk of osteoporosis: a cross-sectional evidence from a Chinese community-based cohort. J Orthop Surg Res 2021; 16:3. [PMID: 33397452 PMCID: PMC7783987 DOI: 10.1186/s13018-020-02125-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 11/27/2020] [Indexed: 12/30/2022] Open
Abstract
Background Association of arterial stiffness and osteoporosis has been well documented in elderly population. However, it is not clear whether they co-progress from the early stages through common mechanisms. The object of this study was to evaluate possible associations between arterial stiffness and osteoporosis by measuring brachial-ankle pulse wave velocity (baPWV) and the Osteoporosis Self-Assessment Tool for Asia (OSTA) index among a healthy population of Chinese aged 40 years and older. Whether baPWV can be used as a predictor of osteoporosis on OSTA was further assessed. Methods This study was cross-sectional in design. Of 3984 adults aged 40 years and older in the Yunyan district of Guiyang (Guizhou, China) who underwent both OSTA and baPWV measurements within 1 month, 1407 were deemed eligible for inclusion (women, 1088; men, 319). Results The mean baPWV was 1475 ± 302 cm/s (range,766–3459 cm/s). baPWV in 110 individuals with high risk of osteoporosis (OSTA index < − 4) was higher than that of individuals with non-high risk (1733 ± 461 cm/s vs. 1447 ± 304 cm/s, P < 0.001). OSTA index was negatively correlated with baPWV(ρ = − 0.296, P < 0.001) after adjusting for age, sex, body mass index, waist circumference, diastolic blood pressure, and creatinine clearance rate. baPWV was an independent predictor for the presence of high risk of osteoporosis (β = − 0.001, P < 0.001) and was consistent across age and sex subgroups, and the optimal baPWV cutoff value for predicting the presence of high risk of osteoporosis and fracture was 1693 cm/s. The AUC was 0.722 (95% confidence interval [CI], 0.667–0.777; P < 0.001, sensitivity of 52.8% and specificity of 83.6%). Conclusions We conclude that arterial stiffness measured by baPWV is well correlated with the severity of osteoporosis evaluated by OSTA. baPWV index may be a valuable tool for identifying individuals with risk of developing osteoporosis. Supplementary Information The online version contains supplementary material available at 10.1186/s13018-020-02125-3.
Collapse
Affiliation(s)
- Kun Tang
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China.,Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China
| | - Qiao Zhang
- Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China
| | - Nianchun Peng
- Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China
| | - Ying Hu
- Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China
| | - Shujing Xu
- Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China
| | - Miao Zhang
- Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China
| | - Rui Wang
- Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China
| | - Lixin Shi
- Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China.
| |
Collapse
|
6
|
Raisi-Estabragh Z, Biasiolli L, Cooper J, Aung N, Fung K, Paiva JM, Sanghvi MM, Thomson RJ, Curtis E, Paccou J, Rayner JJ, Werys K, Puchta H, Thomas KE, Lee AM, Piechnik SK, Neubauer S, Munroe PB, Cooper C, Petersen SE, Harvey NC. Poor Bone Quality is Associated With Greater Arterial Stiffness: Insights From the UK Biobank. J Bone Miner Res 2021; 36:90-99. [PMID: 32964541 PMCID: PMC7613252 DOI: 10.1002/jbmr.4164] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 07/26/2020] [Accepted: 08/05/2020] [Indexed: 12/20/2022]
Abstract
Osteoporosis and ischemic heart disease (IHD) represent important public health problems. Existing research suggests an association between the two conditions beyond that attributable to shared risk factors, with a potentially causal relationship. In this study, we tested the association of bone speed of sound (SOS) from quantitative heel ultrasound with (i) measures of arterial compliance from cardiovascular magnetic resonance (aortic distensibility [AD]); (ii) finger photoplethysmography (arterial stiffness index [ASI]); and (iii) incident myocardial infarction and IHD mortality in the UK Biobank cohort. We considered the potential mediating effect of a range of blood biomarkers and cardiometabolic morbidities and evaluated differential relationships by sex, menopause status, smoking, diabetes, and obesity. Furthermore, we considered whether associations with arterial compliance explained association of SOS with ischemic cardiovascular outcomes. Higher SOS was associated with lower arterial compliance by both ASI and AD for both men and women. The relationship was most consistent with ASI, likely relating to larger sample size available for this variable (n = 159,542 versus n = 18,229). There was no clear evidence of differential relationship by menopause, smoking, diabetes, or body mass index (BMI). Blood biomarkers appeared important in mediating the association for both men and women, but with different directions of effect and did not fully explain the observed effects. In fully adjusted models, higher SOS was associated with significantly lower IHD mortality in men, but less robustly in women. The association of SOS with ASI did not explain this observation. In conclusion, our findings support a positive association between bone and vascular health with consistent patterns of association in men and women. The underlying mechanisms are complex and appear to vary by sex. © 2020 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Collapse
Affiliation(s)
- Zahra Raisi-Estabragh
- William Harvey Research Institute, National Institute for Health Research (NIHR) Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health National Health Service (NHS) Trust, London, UK
| | - Luca Biasiolli
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Jackie Cooper
- William Harvey Research Institute, National Institute for Health Research (NIHR) Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health National Health Service (NHS) Trust, London, UK
| | - Nay Aung
- William Harvey Research Institute, National Institute for Health Research (NIHR) Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health National Health Service (NHS) Trust, London, UK
| | - Kenneth Fung
- William Harvey Research Institute, National Institute for Health Research (NIHR) Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health National Health Service (NHS) Trust, London, UK
| | - José M Paiva
- William Harvey Research Institute, National Institute for Health Research (NIHR) Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, UK
| | - Mihir M Sanghvi
- William Harvey Research Institute, National Institute for Health Research (NIHR) Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health National Health Service (NHS) Trust, London, UK
| | - Ross J Thomson
- Department of Cardiology, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK
| | - Elizabeth Curtis
- Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Julien Paccou
- Rheumatology Department, Lille University Hospital, CHU Lille, MABlab ULR 4490, 59037 Lille, France
| | - Jennifer J Rayner
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Konrad Werys
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Henrike Puchta
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Katharine E Thomas
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Aaron M Lee
- William Harvey Research Institute, National Institute for Health Research (NIHR) Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, UK
| | - Stefan K Piechnik
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Patricia B Munroe
- William Harvey Research Institute, National Institute for Health Research (NIHR) Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, UK
| | - Cyrus Cooper
- Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, UK
- National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Steffen E Petersen
- William Harvey Research Institute, National Institute for Health Research (NIHR) Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health National Health Service (NHS) Trust, London, UK
| | - Nicholas C Harvey
- Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, UK
| |
Collapse
|
7
|
Tap L, Kirkham FA, Mattace-Raso F, Joly L, Rajkumar C, Benetos A. Unraveling the Links Underlying Arterial Stiffness, Bone Demineralization, and Muscle Loss. Hypertension 2020; 76:629-639. [DOI: 10.1161/hypertensionaha.120.15184] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The effects of elevated arterial stiffness on cardiovascular outcomes are widely studied, whereas the relation to noncardiovascular outcomes relevant to older persons, such as the effect on bones and muscles, is less well established. Arterial stiffness, bone demineralization, and muscle loss are all age-related processes with common risk factors, however, whether these are just parallel age-related alterations or whether these processes share common pathways is not yet understood. In this review, we outline previous literature using different assessments of arterial stiffness in various populations across the world to produce a comprehensive overview. Although there are many studies showing an association between arterial stiffness and loss of bone and muscle, the majority are cross-sectional and there is limited longitudinal evidence to justify causal conclusions. We also give an in-depth review of hypotheses and possible mechanisms which may underlie these associations including hormone dysregulation, impaired glucose metabolism, and inflammation. This narrative review highlights the associations between vessels, bones, and muscles with aging, offering insights into possible shared pathways.
Collapse
Affiliation(s)
- Lisanne Tap
- From the Department of Internal Medicine, Section of Geriatric Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands (L.T., F.M.-R.)
| | - Frances A. Kirkham
- Brighton and Sussex Medical School, University of Sussex, United Kingdom (F.A.K., C.R.)
| | - Francesco Mattace-Raso
- From the Department of Internal Medicine, Section of Geriatric Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands (L.T., F.M.-R.)
| | - Laure Joly
- Department of Geriatrics, FHU-CARTAGE, CHRU de Nancy, and INSERM DCAC, Université de Lorraine, France (L.J., A.B.)
| | - Chakravarthi Rajkumar
- Brighton and Sussex Medical School, University of Sussex, United Kingdom (F.A.K., C.R.)
| | - Athanase Benetos
- Department of Geriatrics, FHU-CARTAGE, CHRU de Nancy, and INSERM DCAC, Université de Lorraine, France (L.J., A.B.)
| |
Collapse
|
8
|
Turusheva A, Frolova E, Kotovskaya Y, Petrosyan Y, Dumbadze R. Association Between Arterial Stiffness, Frailty and Fall-Related Injuries in Older Adults. Vasc Health Risk Manag 2020; 16:307-316. [PMID: 32764951 PMCID: PMC7381780 DOI: 10.2147/vhrm.s251900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 06/30/2020] [Indexed: 01/11/2023] Open
Abstract
Purpose This study was conducted to investigate the relationships between arterial stiffness, frailty and fall-related injuries among community-dwelling older adults. Materials and Methods A cross-sectional study of a random sample of older adults aged 60 years and older was conducted. Main study parameters: arterial stiffness was measured by the determining the cardio-ankle vascular index (CAVI); Frailty status was defined using a 7-item frailty screening scale, developed in Russia. This questionnaire included question about falls and fall-related injuries. Orthostatic test and anthropometric tests were done. Medical history (comorbidity, medications), the Osteoporosis Self-assessment Tool (OST), nutritional, physical, cognitive and functional status were evaluated. Results The study population included 163 people aged 60–89 years. The average predicted value of CAVI in women aged 60–69 was 9.13 ± 0.13, in men, 9.49 ± 0.05; in women aged 70–79, it was 9.49 ± 0.16, in men, 9.73 ±0.11; in women aged 80 and older it was 10.04 ±0.18, in men, 10.24 ±0.10 units. The CAVI above the predicted value was associated with fall-related injuries even after adjustment for age, sex, use of β-blockers (BBs), history of stroke, and region of residence with the odds ratio 3.52 (95% CI: 1.03 −12.04). Conclusion Our study revealed an independent association between arterial stiffness and fall-related injuries in older adults over 60 years. The findings suggest that clinicians, especially geriatricians, should pay attention to arterial stiffness of patients with fall-related injuries. Similarly, the patients with CAVI above age-predicted value should be evaluated for risk of falls for prevention of fall-related injuries. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/4G5FYK8dZWY
Collapse
Affiliation(s)
- Anna Turusheva
- The North-Western State Medical University Named After I.I. Mechnikov, St. Petersburg, Russia
| | - Elena Frolova
- The North-Western State Medical University Named After I.I. Mechnikov, St. Petersburg, Russia
| | - Yulia Kotovskaya
- Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Yurij Petrosyan
- The North-Western State Medical University Named After I.I. Mechnikov, St. Petersburg, Russia
| | - Rauli Dumbadze
- The North-Western State Medical University Named After I.I. Mechnikov, St. Petersburg, Russia
| |
Collapse
|
9
|
Park YJ, Lee JM, Kwon SH. Association of the second derivative of photoplethysmogram with age, hemodynamic, autonomic, adiposity, and emotional factors. Medicine (Baltimore) 2019; 98:e18091. [PMID: 31764845 PMCID: PMC6882620 DOI: 10.1097/md.0000000000018091] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The second derivative of photoplethysmogram (SDPTG) is used as an arterial stiffness marker. This study aimed to examine the associations between SDPTG indices and age, in addition to hemodynamic, autonomic, adiposity, and emotional factors.This study had a cross-sectional chart review design, and electronic medical records of 262 women outpatients (mean ± SD,|38.57| ± |11.64 years) were reviewed. Among SDPTG measurements, b/a, c/a, d/a, and (b-c-d)/a were considered. Hemodynamic measurements included systolic and diastolic blood pressure (SBP and DBP) and cardiac output. Autonomic measurements included low and high frequency (LF and HF) values of the heart rate variability. Adiposity measurements included body mass index (BMI) and waist-hip ratio (WHR). Tension, anger, depression, fatigue, confusion, and vigor scores using the Profile of the Mood States were included as emotional markers. All data were normalized through the Box-Cox transformation, and 4 hierarchical regression models were constructed.Age was independently predictive of SDPTG, hemodynamic, autonomic, and adiposity factors (β; 0.143-0.648).After the adjustment for age, SBP and DBP showed negative correlations with d/a (r = -0.201, -0.262), whereas BMI, WHR, LF, and HF showed positive correlations with c/a (r = 0.126, 0.131, 0.151, 0.234). In the hierarchical regression modeling, age and hemodynamic factors were directly predictive of SDPTG indices (β; 0.103-0.626). Age had moderating effects between diastolic blood pressure, heart rate, depression scores, and SDPTG indices (β; 0.104-0.176).In conclusion, age, hemodynamic, adiposity, and autonomic factors may be independently associated with SDPTG indices for women. As age has moderating effects between hemodynamic, emotional factors, and SDPTG indices, its moderating effects should be considered when assessing arterial stiffness using SDPTG indices.
Collapse
Affiliation(s)
- Young-Jae Park
- Department of Biofunctional Medicine and Diagnostics, College of Korean Medicine, Kyung Hee University
- Department of Diagnosis and Biofunctional Medicine, Kyung Hee University Hospital at Gangdong
- Department of Human Informatics of Korean Medicine, Graduate School, Kyung Hee University
| | - Jin-Moo Lee
- Department of Women Health Clinic, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Soon-Hyuk Kwon
- Department of Human Informatics of Korean Medicine, Graduate School, Kyung Hee University
| |
Collapse
|