Table 1

Prospective studies investigating relationship CV disease and low BMD

Study

Study population (years follow-up)

Number of cases (% women)

Postmenopausal women

CV disease excluded

Mean age

Outcome CV disease

Outcome bone mass

Results #

Quality


Sennerby, 2009 [13]

Population-based

(20)

31,936

(NA)

NA

Yes

67.9 to 74.4

CV disease by National patient registry, ICD 9 codes

Incident hip fracture by National patient registry, ICD 9 codes

Women:

HR: 4.42 (95% CI 3.49 to 5.61)

Men:

HR: 6.65 (95% CI 4.82 to 9.19)

3

Szulc, 2008 [14]

Population-based

(10)

781

(0%)

No

No

65

AC by X-spine

Incident fracture by hospital records or X-ray

OR: 2.54 to 3.04 (P < 0.005 to 0.001)

3

Naves, 2008 [4]

Population-based

(4)

624

(51%)

NA

No

65

AC by X-spine

BMD lumbar spine and femur by DXA

Incident fracture by hospital record or X-ray

Change BMD spine in progression AC vs no progression AC:

-1.48% vs 1.43% (P <.0001)

Change BMD hip in progression AC and no progression AC:

-0.48% vs 0.23% (P = 0.315)

Incident fracture:

OR: 2.13 (95% CI 0.85 to 5.31)

3

Von Muhlen, 2009 [15]

Population-based

(4)

1,332

(60%)

NA

No

73.8

PAD by ABI

BMD lumbar spine and hip by DXA and incident fracture by X-ray

Women:

Change BMD in PAD vs no PAD:

59.2% vs 43.5% (P < 0.05)

Incident non-vert fracture:

OR: 0.84 (95% CI 0.31 to 2.26)

Men :

Change BMD in PAD vs no PAD :

43.5% vs 35.5% (P = 0.20)

Incident non-vert fracture:

OR: 1.52 (95% CI 0.30 to 7.45)

3

Collins, 2009 [2]

Population-based

(5.4)

4,302

(0%)

NA

No

73.5

PAD by ABI

BMD hip by DXA

Incident fractures by x-ray and hospital records

Change BMD in PAD vs no PAD:

-0.60% vs -0.32% (P < 0.001

PAD and non-vert fracture risk: HR = 1.47 (95% CI 1.07 to 2.04)

3

Hak, 2000 [3]

Population-based

(9)

236

(100%)

No (100%)

No

49

AC by X-spine

MCA by radiogrammetry

MCA in patients with AC progression vs no AC progression

-3.5 mm vs -2.0 mm (P < 0.01)

3

Samelson, 2007 [12]

Population-based

(21)

2,499

(58%)

No

61

AC by X-spine

Incident hip fracture by hospital records and death certificates

Women:

HR: 1.4 (0.8 to 2.3)

Men:

HR: 1.2 (0.2 to 5.7)

4

Bagger, 2006 [1]

Population-based

(7.5)

2,262

(100%)

Yes (100%)

No

65

AC by X-spine

BMD lumbar spine and hip and incident fractures by hospital records or X-ray

Change hip BMD AC score ≥3 vs <3:

-0.38% vs -0.25% (P < 0.001)

AC and hip fracture:

OR: 2.3 (95% CI 1.1 to 4.8)

AC and vert fracture:

OR: 1.2 (95% CI 1.0 to 1.5)

4

Schulz, 2004 [17]

Clinic-based

(8)

228

(100%)

Yes

No

65.2

AC by CT-scan of spine

BMD spine by CT-scan

Change BMD AC vs no AC:

-5.3% vs -1.3% (P < 0.001)

6


#adjusted for confounders; NA, not available; AC, aortic calcification; BMD, bone mineral density; DXA, dual-energy x-ray absorptiometry; PAD, peripheral arterial disease; ABI, ankle brachial index; MCA, metacarpal cortical area.

den Uyl et al. Arthritis Research & Therapy 2011 13:R5   doi:10.1186/ar3224

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