title: Abdominal aortic calcification and risk of fracture among older women - The SOF study.
abstract: Data concerning the link between severity of abdominal aortic calcification (AAC) and fracture risk in postmenopausal women are discordant. This association may vary by skeletal site and duration of follow-up. Our aim was to assess the association between the AAC severity and fracture risk in older women over the short- and long term. This is a case-cohort study nested in a large multicenter prospective cohort study. The association between AAC and fracture was assessed using Odds Ratios (OR) and 95% confidence intervals (95%CI) for vertebral fractures and using Hazard Risks (HR) and 95%CI for non-vertebral and hip fractures. AAC severity was evaluated from lateral spine radiographs using Kauppila's semiquantitative score. Severe AAC (AAC score 5+) was associated with higher risk of vertebral fracture during 4 years of follow-up, after adjustment for confounders (age, BMI, walking, smoking, hip bone mineral density, prevalent vertebral fracture, systolic blood pressure, hormone replacement therapy) (OR=2.31, 95%CI: 1.24-4.30, p<0.01). In a similar model, severe AAC was associated with an increase in the hip fracture risk (HR=2.88, 95%CI: 1.00-8.36, p=0.05). AAC was not associated with the risk of any non-vertebral fracture. AAC was not associated with the fracture risk after 15 years of follow-up. In elderly women, severe AAC is associated with higher short-term risk of vertebral and hip fractures, but not with the long-term risk of these fractures. There is no association between AAC and risk of non-vertebral-non-hip fracture in older women. Our findings lend further support to the hypothesis that AAC and skeletal fragility are related.
authors.affiliation: INSERM UMR 1033, University of Lyon, Lyon, France. Electronic address: pawel.szulc@inserm.fr.
authors.forename: Pawel
authors.initials: P
authors.lastname: Szulc
authors.affiliation: California Pacific Medical Center Research Institute, San Francisco, CA, USA.
authors.forename: Terri
authors.initials: T
authors.lastname: Blackwell
authors.affiliation: Institute for Aging Research, Hebrew SeniorLife, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
authors.forename: Douglas P
authors.initials: DP
authors.lastname: Kiel
authors.affiliation: Park Nicollet Institute, Minneapolis, MN, USA; Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA.
authors.forename: John T
authors.initials: JT
authors.lastname: Schousboe
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Jane
authors.initials: J
authors.lastname: Cauley
authors.affiliation: Center for Health Research, Kaiser Permanente Hawaii, Honolulu, HI, USA; Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA.
authors.forename: Teresa
authors.initials: T
authors.lastname: Hillier
authors.affiliation: Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; Department Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Hochberg
authors.affiliation: Department of General Internal Medicine, University Hospital of Bern, Bern, Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Rodondi
authors.affiliation: Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA; Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, MN, USA.
authors.forename: Brent C
authors.initials: BC
authors.lastname: Taylor
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
authors.forename: Dennis
authors.initials: D
authors.lastname: Black
authors.affiliation: California Pacific Medical Center Research Institute, San Francisco, CA, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Cummings
authors.affiliation: Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA; Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, MN, USA.
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Ensrud
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000473:pathology*; D015519:Bone Density / Q000502:physiology; D002114:Calcinosis / Q000150:complications*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D015663:Osteoporosis, Postmenopausal / Q000150:complications*; D058866:Osteoporotic Fractures / Q000150:complications / Q000453:epidemiology*; D012307:Risk Factors
keywords: Abdominal aortic calcification; Bone mineral density; Elderly women; Fragility fracture