J I Barzilay1,2, P Bůžková3, H A Fink4, J A Cauley5, J A Robbins6, P S Garimella7, D I Jalal8, K J Mukamal9. 1. Kaiser Permanente of Georgia, Division of Endocrinology and the Division of Endocrinology, Emory University School of Medicine, Atlanta, GA, USA. joshua.barzilay@kp.org. 2. Kaiser Permanente of Georgia, 3650 Steve Reynolds Blvd, Duluth, GA, 30096, USA. joshua.barzilay@kp.org. 3. Department of Biostatistics, University of Washington, Seattle, WA, USA. 4. Geriatric Research Education and Clinical Center, VA Health Care System, Minneapolis, MN, USA. 5. Department of Epidemiology, Graduate School, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA. 6. Department of Medicine, University of California at Davis, Modesto, CA, USA. 7. Division of Nephrology, Tufts Medical Center, Boston, MA, USA. 8. Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Center, Aurora, CO, USA. 9. Department of Medicine, Beth Israel Deaconess Medical Center, Brookline, MA, USA.
Abstract
Here we report that abnormal brain white matter and, to a lesser extent, albuminuria are associated with reduced bone mineral density in the hip, spine, and total body in men and women. These findings may explain the increased hip fracture risk reported in some studies in association with microvascular disorders. INTRODUCTION: Markers of microvascular disease have been individually associated with increased risk of osteoporotic fractures in some studies. Here, we examine whether these markers are associated with reduced bone mineral density (BMD) individually and together. METHODS: BMD testing using dual x-ray absorptiometry of the hip, lumbar spine, and total body was performed in 1473 participants from the Cardiovascular Health Study (mean age ~ 78 years): 1215 were assessed for urinary albumin-creatinine ratio, 944 for abnormal white matter disease (AWMD) by brain MRI, and 541 for retinal vascular disease with fundus photographs. Linear regression models were used to evaluate the cross-sectional association of each marker with BMD accounting for potentially confounding factors. RESULTS: AWMD was associated with lower hip, spine, and total body BMD in women (β -3.08 to -4.53; p < 0.01 for all) and lower hip and total body BMD in men (β -2.90 to -4.24; p = 0.01-0.03). Albuminuria was associated with lower hip (β -3.37; p = .05) and total body (β -3.21; p = .02) BMD in men, but not in women. The associations of AWMD and albuminuria with BMD persisted with mutual adjustment and appeared to be additive to each other. Retinal vascular disease was not associated with BMD in men or women. CONCLUSION: AWMD and, to a lesser extent, albuminuria were independently associated with lower BMD, suggesting that microvascular disease may play a role in the pathogenesis of reduced BMD. These findings need to be confirmed by longitudinal studies.
Here we report that abnormal brain white matter and, to a lesser extent, albuminuria are associated with reduced bone mineral density in the hip, spine, and total body in men and women. These findings may explain the increased hip fracture risk reported in some studies in association with microvascular disorders. INTRODUCTION: Markers of microvascular disease have been individually associated with increased risk of osteoporotic fractures in some studies. Here, we examine whether these markers are associated with reduced bone mineral density (BMD) individually and together. METHODS:BMD testing using dual x-ray absorptiometry of the hip, lumbar spine, and total body was performed in 1473 participants from the Cardiovascular Health Study (mean age ~ 78 years): 1215 were assessed for urinary albumin-creatinine ratio, 944 for abnormal white matter disease (AWMD) by brain MRI, and 541 for retinal vascular disease with fundus photographs. Linear regression models were used to evaluate the cross-sectional association of each marker with BMD accounting for potentially confounding factors. RESULTS: AWMD was associated with lower hip, spine, and total body BMD in women (β -3.08 to -4.53; p < 0.01 for all) and lower hip and total body BMD in men (β -2.90 to -4.24; p = 0.01-0.03). Albuminuria was associated with lower hip (β -3.37; p = .05) and total body (β -3.21; p = .02) BMD in men, but not in women. The associations of AWMD and albuminuria with BMD persisted with mutual adjustment and appeared to be additive to each other. Retinal vascular disease was not associated with BMD in men or women. CONCLUSION: AWMD and, to a lesser extent, albuminuria were independently associated with lower BMD, suggesting that microvascular disease may play a role in the pathogenesis of reduced BMD. These findings need to be confirmed by longitudinal studies.
Entities:
Keywords:
Albuminuria; Bone mineral density; Brain white matter disease; Osteoporosis; Retinal vascular disease
Authors: Alejandro Santillan; Veronica Nacarino; Edward Greenberg; Howard A Riina; Y Pierre Gobin; Athos Patsalides Journal: J Neurointerv Surg Date: 2011-05-02 Impact factor: 5.836
Authors: J I Barzilay; P Bůžková; Z Chen; I H de Boer; L Carbone; N N Rassouli; H A Fink; J A Robbins Journal: Osteoporos Int Date: 2013-05-24 Impact factor: 4.507
Authors: R Burkhardt; G Kettner; W Böhm; M Schmidmeier; R Schlag; B Frisch; B Mallmann; W Eisenmenger; T Gilg Journal: Bone Date: 1987 Impact factor: 4.398
Authors: Michelle L Baker; Emily K Marino Larsen; Lewis H Kuller; Ronald Klein; Barbara E K Klein; David S Siscovick; Charles Bernick; Teri A Manolio; Tien Yin Wong Journal: Stroke Date: 2007-05-24 Impact factor: 7.914
Authors: Joshua I Barzilay; Peggy Gao; Catherine M Clase; Andrew Mente; Johannes F E Mann; Peter Sleight; Salim Yusuf; Koon K Teo Journal: Clin J Am Soc Nephrol Date: 2012-11-26 Impact factor: 8.237
Authors: Howard A Fink; Tien N Vo; Lisa Langsetmo; Joshua I Barzilay; Jane A Cauley; John T Schousboe; Eric S Orwoll; Muna T Canales; Areef Ishani; Nancy E Lane; Kristine E Ensrud Journal: J Bone Miner Res Date: 2017-02-21 Impact factor: 6.741
Authors: Joshua I Barzilay; Barry R Davis; Sara L Pressel; Alokananda Ghosh; Rachel Puttnam; Karen L Margolis; Paul K Whelton Journal: Curr Cardiol Rep Date: 2017-09 Impact factor: 2.931
Authors: Sang-Hwa Lee; So Young Park; Min Uk Jang; Yerim Kim; Jungyoup Lee; Chulho Kim; Yeo Jin Kim; Jong-Hee Sohn Journal: Medicina (Kaunas) Date: 2020-06-23 Impact factor: 2.430