ISSN 2052-1219 (online)

Bone Abstracts (2013) 1 PP382 | DOI: 10.1530/boneabs.1.PP382

The relationship between cardiovascular risk and bone mineral density: an important role for anthropometry

Renate de Jongh2, Karen Jameson1, Holly Syddall1, Avan Sayer1, Martin den Heijer2, Cyrus Cooper1 & Elaine Dennison1

1MRC Epidemiology Resource Centre, Southampton, UK; 2VU University Medical Centre, Amsterdam, The Netherlands.

Introduction: Cardiovascular disease and osteoporosis have often been reported to coexist in older people. However, the literature is conflicting regarding size and indeed direction of the association. The aim of the present study was therefore to assess associations between the Framingham general cardiovascular risk score and bone characteristics in a cohort of older adults.

Methods: We studied 374 men and 379 women, born 1931–1939, who participated in the Hertfordshire Cohort Study and were without cardiovascular disease at baseline (1998–2004). Data on demographic and lifestyle factors, anthropometry, blood pressure and blood lipid concentrations were collected and the Framingham general cardiovascular risk score (FRS) was calculated. DEXA scans were conducted. After an average of 4.5 years (± S.D. 0.9) DEXA (n=447) was repeated and peripheral quantitative computed tomography (pQCT) of the tibia and radius (n=499) was performed. All analyses were adjusted for gender and age.

Results: FRS (mean (range), 14.4 (5–26) points) was positively associated with BMD at the lumbar spine (β (95% CI), 0.058 (0.022 to 0.094) g/cm2 per 10 points change, P<0.01) and proximal femur (0.056 (0.028 to 0.083), P<0.01). These associations were unaltered by adjustment for additional cardiovascular risk factors except for anthropometry. This effect was strongest for weight (lumbar spine 0.014 (−0.020 to 0.049, P=0.42); proximal femur 0.016 (−0.010 to 0.042), P=0.23). No relationships were identified between FRS and bone loss rate over follow-up. Analysis of pQCT data demonstrated relationships between FRS and volumetric trabecular BMD (tibia 1.29 (0.15 to 2.43), P=0.03; radius 1.15 (−0.02 to 2.31, P=0.05), but not with volumetric cortical BMD, areal measurements or measurements of bone strength. Adjustment for anthropometric measurements attenuated the relationships between FRS and pQCT data.

Conclusion: General cardiovascular risk is positively associated with bone mineral density. Anthropometry, in particular weight, is an important contributor to this association.

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