Bone mineral density and risk of cardiovascular disease in men and women: the HUNT study
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Published on: January 29, 2018
Laxmi Bhatta1, Aivaras Cepelis2, Sigrid A Vikjord2
1K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway. laxmi.bhatta@ntnu.no.
Insights
This study found no link between lower bone mineral density (BMD) in the forearm and increased risk of cardiovascular disease (CVD), including atrial fibrillation, heart attack, stroke, or heart failure in men and women.
Area of Science:
- Cardiology
- Endocrinology
- Epidemiology
Background:
- The relationship between bone mineral density (BMD) and cardiovascular disease (CVD) requires further investigation.
- Understanding this association is crucial for comprehensive risk assessment.
Purpose of the Study:
- To evaluate distal forearm bone mineral density (BMD) as a predictor for cardiovascular disease (CVD).
- Specifically investigate the association between BMD and atrial fibrillation (AF), acute myocardial infarction (AMI), ischemic stroke (IS), hemorrhagic stroke (HS), and heart failure (HF) in men and women.
Main Methods:
- Prospective population cohort study using data from the HUNT Study in Norway (n=22,857).
- BMD measured via X-ray absorptiometry; T-score calculated.
- Adjusted Cox proportional hazards models used for sex-stratified analyses with a mean follow-up of 13.6 years.
Main Results:
- No significant association was found between lower distal forearm BMD and the risk of developing any CVD.
- Hazard ratios for CVD outcomes, including AF, AMI, IS, HS, and HF, did not show a consistent or significant link with BMD.
- Point estimates for specific cardiovascular outcomes showed no clear trend, ranging from slightly protective to slightly deleterious, but lacked statistical significance.
Conclusions:
- Distal forearm bone mineral density (BMD) does not appear to be a significant risk factor for major cardiovascular diseases (CVD) in this Norwegian population.
- Further research may be needed to explore other skeletal sites or different populations to fully elucidate the bone-heart axis.
Abstract:
The association between bone mineral density (BMD) and cardiovascular disease (CVD) is not fully understood. We evaluated BMD as a risk factor for cardiovascular disease and specifically atrial fibrillation (AF), acute myocardial infarction (AMI), ischemic (IS) and hemorrhagic stroke (HS) and heart failure (HF) in men and women. This prospective population cohort utilized data on 22 857 adults from the second and third surveys of the HUNT Study in Norway free from CVD at baseline. BMD was measured using single and dual-energy X-ray absorptiometry in the non-dominant distal forearm and T-score was calculated. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated from adjusted cox proportional hazards models. The analyses were sex-stratified, and models were adjusted for age, age-squared, BMI, physical activity, smoking status, alcohol use, and education level. Additionally, in women, we adjusted for estrogen use and postmenopause. During a mean follow-up of 13.6 ± 5.7 years, 2 928 individuals (12.8%) developed fatal or non-fatal CVD, 1 020 AF (4.5%), 1 172 AMI (5.1%), 1 389 IS (6.1%), 264 HS (1.1%), and 464 HF (2.0%). For every 1 unit decrease in BMD T-score the HR for any CVD was 1.01 (95% CI 0.98 to 1.04) in women and 0.99 (95% CI 0.94 to 1.03) in men. Point estimates for the four cardiovascular outcomes ranged from slightly protective (HR 0.95 for AF in men) to slightly deleterious (HR 1.12 for HS in men). We found no evidence of association of lower distal forearm BMD with CVD, AF, AMI, IS, HS, and HF.
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