Table 2 |
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|
Prospective studies investigating relationship low BMD and CV disease |
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|
Study |
Study population (years follow-up) |
Number of cases (% women) |
Postmenopausal women |
CV disease excluded |
Mean age (years) |
Race |
Outcome osteoporosis |
Outcome CV disease |
Results # |
Quality (x nee) |
|
|
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|
Mussolino, 2007 [69] |
Population-based (9) |
5,272 (NA) |
NA |
Yes |
60.9 to 69.4 |
Caucasian (NA%), black and Mexican-American |
BMD proximal femur by DXA |
CV and stroke mortality by death certificates |
Women: BMD and CV mortality RR: 1.26 (95% CI 0.88 to 1.80) BMD and stroke mortality: RR: 1.34 (95% CI 0.86 to 2.07) Men: BMD and CV mortality: RR: 1.05 (95% CI 0.79 to 1.39) BMD and stroke mortality: RR; 0.73 (95% CI 0.43 to 1.23) |
3 |
|
Farhat, 2007 [6] |
Population-based (5.4) |
2,310 (55%) |
Yes |
Yes |
73.5 |
Caucasian (58%) and black |
BMD total hip, femoral neck and trochanter by DXA BMD spine by CT-scans |
Incident CV disease by hospital records and death certificates |
Women: BMD fem neck and incident CV disease: HR: 1.24 (95% CI 1.02 to 1.52) Men: BMD fem neck and incident CV disease: HR: 1.04 (95% CI 0.89 to 1.21) |
3 |
|
Tamaki, 2009 [75] |
Population-based (10) |
609 (100%) |
Yes (60%) |
No |
55.9 |
Japanese |
BMD lumbar spine and total hip by DXA |
IMT values |
<10 YSM: IMT OP vs normal bone mass: 1.55 vs 1.19 (P < 0.05) ≥YSM: IMT OP vs normal bone mass: 1.53 vs 1.28 (P < 0.05) |
3 |
|
Browner, 1991 [5] |
Population-based (2.8) |
9,704 (100%) |
Yes |
No |
NA |
Caucasian (99%) and Asian |
BMD distal radius, prox radius and calcaneus by single photon absorptiometry |
Overall mortality and CV mortality by death certificates |
BMD and risk overall mortality: RR: 1.22 (95% CI 1.01 to 1.47) BMD and stroke mortality: RR: 1.75 (95% CI 1.15 to 2.65) BMD and CV mortality: RR: 1.17 (95% CI 0.92 to 1.51) |
3 |
|
Trone, 2007 [68] |
Population-based (7.6) |
1,580 (60%) |
Yes (NA %) |
No |
71.9 |
Caucasian |
Prevalence vertebral fracture by lateral spine radiographs |
Overall mortality by death certificates |
Women: prevalent vertebral fracture and overall mortality: HR: 1.15 (95% CI 0.83 to 1.59) Men: prevalent vertebral fracture and overall mortality: HR: 0.98 (95% CI 0.55 to 1.46) |
3 |
|
Kado, 2000 [64] |
Population-based (3.5) |
6,018 (100%) |
Yes |
No |
76.5 |
Caucasian |
BMD total hip by DXA |
Overall and CV mortality by death certificates |
BMD and overall mortality: RH: 1.3 (95% CI 1.1 to 1.4) BMD and CV mortality: RH: 1.3 (95% CI 1.0 to 1.9) |
4 |
|
Trivedi, 2001 [67] |
Population-based (6.7) |
1,002 (0%) |
No women included |
No |
69.7 |
NA |
BMD total hip by DXA |
Overall and CV mortality by death certificates |
BMD and overall mortality: RR: 0.79 (95% CI 0.65 to 0.97) BMD and CV mortality: RR: 0.72 (95% CI 0.56 to 0.93) |
4 |
|
Tanko, 2005 [76] |
Clinic-based (4) |
2,576 (100%) |
Yes |
No |
66.5 |
NA |
BMD lumbar spine and femoral neck by DXA |
Incidence CV events self-reported and confirmed by primary documents |
HR: 3.9 (95% CI 2.0 to 7.7) |
4 |
|
Pinheiro, 2006 [66] |
Population-based (5) |
208 (100%) |
Yes |
No |
75.1 |
Caucasian |
BMD lumbar spine, femoral neck and trochanter by DXA |
Overall and CV mortality by death certificates |
BMD and overall mortality: HR: 1.44 (95% CI 1.06 to 2.21) BMD and CV mortality: HR: 1.28 (95% CI 1.08 to 2.26) |
4 |
|
Johansson, 1998 [7] |
Population-based (7) |
1,468 (56%) |
Yes |
No |
74.0 |
Caucasian |
BMD calcaneus by DPA |
Overall mortality by death certificates |
Women: RR: 1.19 (95% CI 1.02 to 1.39) Men: RR: 1.23 (95% CI 1.10 to 1.41) |
4 |
|
Mussolino, 2003 [65] |
Population-based (18.5) |
3,402 (NA) |
NA |
Yes |
NA |
Caucasian (87%) and black |
BMD phalangeal by single photon absorption |
Stroke mortality by death certificates |
Women: RR: 1.01 (95% CI 0.86 to 1.19) Men: RR: 1.13 (95% CI 0.93 to 1.38) Blacks: RR : 0.93 (95% CI 0.72 to 1.21) |
4 |
|
Samelson, 2004 [70] |
Population-based (30) |
2,059 (60%) |
Yes (85,3-94%) |
Yes |
60.2 |
NA |
Second MCA by radiogrammatry |
Incidence coronary heart disease by hospital records and death certificates |
Women: HR: 0.73 (95% CI 0.53 to 1.00) Men: HR: 1.14 (95% CI 0.84 to 1.56) |
4 |
|
Kiel, 2001 [77] |
Population-based (25) |
554 (66%) |
NA |
No |
54.4 |
NA |
Second MCA by radiogrammetry |
AC by radiograph of the lumbar spine |
Women: Sign association % change in MCA and change AC index (P = 0.01) Men: No association % change MCA and change AC index (P = 0.50) |
4 |
|
Browner, 1993 [62] |
Population-based (1.98) |
4,024 (100%) |
Yes |
Yes |
NA |
Caucasian |
BMD distal radius and calcaneus by single photon absorptiometry |
Incident strokes by hospital records and death certificates |
HR: 1.31 (95% CI 1.03 to 1.67) |
5 |
|
Von der Recke, 1999 [8] |
Clinic-based (17) |
1,063 (100%) |
Yes |
Yes |
50 and 70 |
NA |
BMD distal forearm by single photon absorptiometry with 125I source |
CV mortality by death certificates, hospital records and autopsy reports |
Early menopause: RR: 2.3 (95% CI 1.0 to 5.3) Late menopause: RR: 1.3 (95% CI 0.9 to 1.8) |
5 |
|
Silverman, 2004 [71] |
Clinic-based (3) |
2,565 (100%) |
Yes |
No |
67 |
Caucasian (95.8%) |
Prevalence vertebral fracture by lateral spine radiographs |
Incident CV event self-reported and confirmed by primary documents |
CV event rate women with prevalent vertebral fracture vs no vertebral fracture: 15.1 vs 8.3 (P = 0.55) |
5 |
|
Varosy, 2003 [73] |
Clinic-based (4.1) |
2,763 (100%) |
Yes |
Yes |
NA |
NA |
Prevalent and incident skeletal fracture self-reported. Incident fractures were confirmed by radiological reports |
Incident coronay event by hospital records |
HR: 0.75 (95% CI 0.57 to 0.98) |
5 |
|
Gonzales-Macias, 2009 [63] |
Clinic-based (3) |
5,201 (100%) |
Yes |
No |
72.3 |
Caucasian |
eBMD calcaneus by QUS |
Overall and CV mortality by medical records |
eBMD and overall mortality: HR: 1.19 (95% CI 0.97 to 1.45) eBMD and CV mortality: HR: 1.39 (95% CI 1.15 to 1.66) |
6 |
|
|
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|
#adjusted for age; AC, aortic calcification; BMD, bone mineral density; DPA, dual photon absorptiometry; DXA, dual-energy x-ray absorptiometry; IMT, intima media thickness; MCA, metacarpal relative cortical area; NA, not available; QUS, quantitative ultrasonography; YSM, years since menopause. |
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den Uyl et al. Arthritis Research & Therapy 2011 13:R5 doi:10.1186/ar3224 |
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