title: Osteoporosis as an independent risk factor for silent brain infarction and white matter changes in men and women: the PRESENT project.
abstract: CONCLUSIONS
  Previous studies have not demonstrated a relationship between osteoporosis and cerebral infarction in the community, especially in men. We found that osteoporosis may be an independent risk factor for brain white matter change/silent infarction in men, as well as in women.
  
  
  OBJECTIVE
  We aimed to study the relationship between low bone mineral density (BMD) and brain white matter changes and/or silent infarcts (WMC/SI).
  
  
  METHODS
  This was a community-based, cross-sectional study supported by the regional government. Bone mineral density measurements and brain computed tomography were performed in 646 stroke- and dementia-free subjects (aged 50-75 years).
  
  
  RESULTS
  After adjustment for age, hypertension, diabetes mellitus, dyslipidemia, and current smoking status, the odds ratio (OR) of risk for WMC and/or SI was 1.8 in the osteopenia group (95 % confidence interval [CI] 1.15-2.77; P = 0.01) and 2.2 in the osteoporosis group (95 % CI 1.42-3.55; P < 0.001). Among men, the OR was 1.8 (95 % CI 0.72-4.62; P = 0.21) and 3.8 (95 % CI 1.63-8.86; P = 0.002), and in women, the OR was 1.9 (95 % CI 1.15-2.78; P = 0.010) and 2.2 (95 % CI 1.42-3.55; P = 0.001), respectively.
  
  
  CONCLUSIONS
  Severe bone mass loss may be an independent risk factor for brain WMC/SI in men and women. Low BMD may cause brain WMC/SI in the step that leads to stroke. Although there are well-designed studies on the prevention of cerebral infarction in patients with brain WMC/SI, a specific prevention method, such as aspirin, should be used for patients with low BMD who have WMC/SI. Screening for low BMD as an independent vascular risk factor in healthy subjects may be required to prevent stroke.
authors.affiliation: Department of Neurology, Hallym University, Seoul, South Korea.
authors.forename: Y K
authors.initials: YK
authors.lastname: Minn
authors.forename: S H
authors.initials: SH
authors.lastname: Suk
authors.forename: S Y
authors.initials: SY
authors.lastname: Do
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000368:Aged; D015519:Bone Density / Q000502:physiology; D020520:Brain Infarction / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D056784:Leukoencephalopathies / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D014057:Tomography, X-Ray Computed