title: High hip fracture risk in men with severe aortic calcification: MrOS study.
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: Institut National de la Santé et de la Recherche Médicale (INSERM) Unité Mixte de Recherche (UMR) 1033, University of Lyon, Lyon, France.
authors: Pawel
authors: P
authors: Szulc
authors: Terri
authors: T
authors: Blackwell
authors: John T
authors: JT
authors: Schousboe
authors: Douglas C
authors: DC
authors: Bauer
authors: Peggy
authors: P
authors: Cawthon
authors: Nancy E
authors: NE
authors: Lane
authors: Steven R
authors: SR
authors: Cummings
authors: Eric S
authors: ES
authors: Orwoll
authors: Dennis M
authors: DM
authors: Black
authors: Kristine E
authors: KE
authors: Ensrud
mesh_terms: D000368:Aged; D001018:Aortic Diseases / Q000150:complications*; D015519:Bone Density; D002114:Calcinosis / Q000150:complications*; D006620:Hip Fractures / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D008297:Male; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: ABDOMINAL AORTIC CALCIFICATION; HIP FRACTURE; MEN
references: Am J Kidney Dis. 2008 Jan;51(1):38-44
references: 18155531
references: J Bone Miner Res. 1993 Sep;8(9):1137-48
references: 8237484
references: Age Ageing. 2010 Sep;39(5):592-7
references: 20650874
references: J Bone Miner Res. 2005 Oct;20(10):1813-9
references: 16160738
references: Trends Mol Med. 2009 Sep;15(9):405-16
references: 19733120
references: QJM. 2005 Aug;98(8):575-9
references: 15983022
references: Osteoporos Int. 2009 Dec;20(12):2071-8
references: 19308300
references: Osteoporos Int. 2005 Oct;16(10):1184-92
references: 16096713
references: Osteoporos Int. 2013 Apr;24(4):1177-84
references: 22872071
references: J Bone Miner Res. 2007 Feb;22(2):211-9
references: 17059373
references: Bone. 2011 Jan;48(1):44-53
references: 20601294
references: Circulation. 2009 May 5;119(17):2305-12
references: 19380619
references: Bone. 2004 Jan;34(1):195-202
references: 14751578
references: Ann N Y Acad Sci. 2007 Nov;1117:40-50
references: 18056036
references: Genes Dev. 1998 May 1;12(9):1260-8
references: 9573043
references: J Bone Miner Res. 2010 Mar;25(3):545-53
references: 19775201
references: J Bone Miner Res. 2009 Dec;24(12):2032-8
references: 19453262
references: Clin Chem. 2007 Apr;53(4):766-72
references: 17332152
references: Arterioscler Thromb Vasc Biol. 2006 Jul;26(7):1510-6
references: 16690876
references: Ann Rheum Dis. 2008 Sep;67(9):1249-55
references: 18065499
references: JAMA. 2007 Nov 28;298(20):2381-8
references: 18042915
references: Calcif Tissue Int. 2012 Dec;91(6):370-8
references: 23052223
references: Heart. 2012 Jul;98(13):988-94
references: 22668866
references: J Am Geriatr Soc. 2008 Aug;56(8):1434-41
references: 18662213
references: Rheumatology (Oxford). 2012 Sep;51(9):1714-20
references: 22661554
references: J Bone Miner Res. 2007 Sep;22(9):1449-54
references: 17542685
references: Osteoporos Int. 2008 Aug;19(8):1161-6
references: 18180973
references: J Clin Endocrinol Metab. 2009 Aug;94(8):2773-80
references: 19454586
references: Osteoporos Int. 2012 Mar;23(3):1177-82
references: 21308362
references: J Intern Med. 2005 Jan;257(1):117-9
references: 15606383
references: Osteoporos Int. 2012 May;23(5):1533-9
references: 21901478
references: J Bone Miner Res. 2010 Dec;25(12):2777-85
references: 20641031
references: J Bone Miner Res. 2008 Jan;23(1):95-102
references: 17892380
references: J Bone Miner Res. 2005 Nov;20(11):1912-20
references: 16234963
references: Osteoporos Int. 2007 Oct;18(10):1355-62
references: 17492247
references: J Osteoporos. 2010;2010:748380
references: 20981152
references: Angiology. 2007 Dec-2008 Jan;58(6):725-33
references: 18071192
references: JAMA. 2009 Oct 21;302(15):1666-73
references: 19843901
references: Osteoporos Int. 2007 Jun;18(6):771-7
references: 17273893
references: J Bone Miner Res. 2008 Aug;23(8):1326-33
references: 18348697
references: Am J Med. 2011 May;124(5):418-25
references: 21531231
references: Kidney Int. 2002 Oct;62(4):1402-7
references: 12234312
references: Contemp Clin Trials. 2005 Oct;26(5):569-85
references: 16084776
references: J Bone Miner Res. 2007 Jul;22(7):1088-95
references: 17419681
references: J Intern Med. 2006 Jun;259(6):598-605
references: 16704561
references: J Bone Miner Res. 2006 Dec;21(12):1839-46
references: 17002567
references: Pacing Clin Electrophysiol. 2012 Aug;35(8):973-9
references: 22694347
references: J Clin Endocrinol Metab. 2004 Sep;89(9):4246-53
references: 15356016
references: Atherosclerosis. 1997 Jul 25;132(2):245-50
references: 9242971
references: Am J Epidemiol. 2009 Jan 15;169(2):186-94
references: 19064643