title: Association of severe disc degeneration with all-cause mortality and abdominal aortic calcification assessed prospectively in older men: findings of a single-center prospective study of osteoporosis in men.
abstract: OBJECTIVE
  To assess the association of disc degeneration with all-cause mortality and with the severity and rate of progression of abdominal aortic calcification (AAC) in older men.
  
  
  METHODS
  Men >50 years of age (n = 766) underwent lateral spine radiography and blood collection and were monitored prospectively. We assessed the association of disc degeneration with all-cause mortality (at 10 years), AAC severity (at baseline), and AAC progression (at 7.5 years).
  
  
  RESULTS
  After adjustment for confounders, including AAC, the total overall grade score for AAC predicted all-cause mortality (hazard ratio [HR] 1.20 per SD increase [95% confidence interval (95% CI) 1.01-1.43]). The highest tertile of the total overall grade score was associated with higher mortality rates (39.3/1,000 person-years for a score of >8 versus 20.9/1,000 person-years for a score of 0-8; adjusted HR 1.47 [95% CI 1.05-2.06]). The odds of severe AAC (score of >5) increased with the total disc space narrowing score (adjusted HR 1.44 per SD [95% CI 1.11-1.87]). The highest tertile of the total disc space narrowing score was associated with higher odds of severe AAC (adjusted HR 2.42 versus the lowest tertile [95% CI 1.24-4.73]). The probability of long-term AAC stability decreased with an increasing total osteophyte score (adjusted HR 0.66 per SD [95% CI 0.49-0.88]). The highest tertile of the total osteophyte score was associated with a lower probability of AAC stability (adjusted HR 0.35 versus the lowest tertile [95% CI 0.18-0.71]).
  
  
  CONCLUSIONS
  Older men with severe disc degeneration have greater AAC severity, faster AAC progression, and higher all-cause mortality rates.
authors.affiliation: INSERM UMR 1033, Université de Lyon, and Hôpital Edouard Herriot, Lyon, France.
authors.forename: Charline
authors.initials: C
authors.lastname: Estublier
authors.forename: Roland
authors.initials: R
authors.lastname: Chapurlat
authors.forename: Pawel
authors.initials: P
authors.lastname: Szulc
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D018450:Disease Progression; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010024:Osteoporosis; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors; D012720:Severity of Illness Index; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000453:epidemiology*