Sanchita Agarwal1, Carmen Germosen1, Nayoung Kil1, Mariana Bucovsky1, Ivelisse Colon1, John Williams1, Natalie Cusano2, Marcella Walker3. 1. Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA. 2. Division of Endocrinology, Department of Medicine, Lenox Hill Hospital, New York, NY, USA. 3. Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA. Electronic address: mad2037@columbia.edu.
Abstract
BACKGROUND: Smoking is a risk factor for fracture, but the mechanism by which smoking increases fracture risk is unclear. METHODS: Musculoskeletal health was compared with dual energy X-ray absorptiometry (DXA), high resolution peripheral quantitative computed tomography (HR-pQCT), trabecular bone score, and vertebral fracture assessment in current and past smokers and nonsmokers from a multiethnic study of adults ≥ age 65. Skeletal indices were adjusted for age and weight. RESULTS: Participants (n = 311) were mean age (±SD) 76.1 ± 6.5 years, mostly female (66.0%) and non-white (32.7% black/39.4% mixed race/26.3% white). Mean pack-years was 34.6 ± 20.4. In men (n = 106), weight and BMI were lower (both p < 0.05) in current vs past smokers. Male smokers consumed half the calcium of never and past smokers. BMD by DXA did not differ by smoking status at any skeletal site in either sex. Current male smokers had 13.5%-15.3% lower trabecular bone score vs never and past smokers (both p < 0.05). By HR-pQCT, trabecular volumetric BMD was 26.6%-30.3% lower and trabeculae were fewer, thinner and more widely spaced in male current vs past and never smokers at the radius (all p < 0.05). Cortical indices did not differ. Tibial results were similar, but stiffness was also 17.5%-22.2% lower in male current vs past and never smokers (both p< 0.05). In women, HR-pQCT trabecular indices did not differ, but cortical porosity was almost twice as high in current vs never smokers at the radius and 50% higher at the tibia (both p < 0.05). CONCLUSIONS: In summary, current smoking is associated with trabecular deterioration at the spine and peripheral skeleton in men, while women have cortical deficits. Smoking may have sex-specific skeletal effects. The consistent association with current, but not past smoking, suggests the effects of tobacco use may be reversible with smoking cessation.
BACKGROUND: Smoking is a risk factor for fracture, but the mechanism by which smoking increases fracture risk is unclear. METHODS: Musculoskeletal health was compared with dual energy X-ray absorptiometry (DXA), high resolution peripheral quantitative computed tomography (HR-pQCT), trabecular bone score, and vertebral fracture assessment in current and past smokers and nonsmokers from a multiethnic study of adults ≥ age 65. Skeletal indices were adjusted for age and weight. RESULTS: Participants (n = 311) were mean age (±SD) 76.1 ± 6.5 years, mostly female (66.0%) and non-white (32.7% black/39.4% mixed race/26.3% white). Mean pack-years was 34.6 ± 20.4. In men (n = 106), weight and BMI were lower (both p < 0.05) in current vs past smokers. Male smokers consumed half the calcium of never and past smokers. BMD by DXA did not differ by smoking status at any skeletal site in either sex. Current male smokers had 13.5%-15.3% lower trabecular bone score vs never and past smokers (both p < 0.05). By HR-pQCT, trabecular volumetric BMD was 26.6%-30.3% lower and trabeculae were fewer, thinner and more widely spaced in male current vs past and never smokers at the radius (all p < 0.05). Cortical indices did not differ. Tibial results were similar, but stiffness was also 17.5%-22.2% lower in male current vs past and never smokers (both p< 0.05). In women, HR-pQCT trabecular indices did not differ, but cortical porosity was almost twice as high in current vs never smokers at the radius and 50% higher at the tibia (both p < 0.05). CONCLUSIONS: In summary, current smoking is associated with trabecular deterioration at the spine and peripheral skeleton in men, while women have cortical deficits. Smoking may have sex-specific skeletal effects. The consistent association with current, but not past smoking, suggests the effects of tobacco use may be reversible with smoking cessation.
Authors: Robert Rudäng; Anna Darelid; Martin Nilsson; Staffan Nilsson; Dan Mellström; Claes Ohlsson; Mattias Lorentzon Journal: J Bone Miner Res Date: 2012-10 Impact factor: 6.741
Authors: Daniel Sundh; Dan Mellström; Martin Nilsson; Magnus Karlsson; Claes Ohlsson; Mattias Lorentzon Journal: J Bone Miner Res Date: 2015-05-21 Impact factor: 6.741
Authors: Melissa S Putman; Elaine W Yu; Hang Lee; Robert M Neer; Elizabeth Schindler; Alexander P Taylor; Emily Cheston; Mary L Bouxsein; Joel S Finkelstein Journal: J Bone Miner Res Date: 2013-10 Impact factor: 6.741