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Bone Mineral Density, Trabecular Bone Score and Fractures in Patients Hospitalized for Heart Failure
Lucian Batista de Oliveira1, Mariana Andrade de Figueiredo Martins Siqueira1, Rafael Buarque de Macedo Gadêlha2
1Division of Endocrinology and Diabetes, Agamenon Magalhães Hospital, University of Pernambuco (UPE), Faculty of Medical Sciences, Recife, Brazil.
Insights
Middle-aged heart failure patients show high rates of osteoporosis and poor bone health, linked to elevated parathyroid hormone (PTH) levels. These bone issues correlate with reduced muscle strength, highlighting a significant comorbidity in heart failure care.
Area of Science:
- Cardiology
- Endocrinology
- Bone Metabolism
Background:
- Heart failure (HF) is a complex condition with potential systemic effects.
- Bone health is often overlooked in HF patients, particularly in middle-aged populations.
- Investigating bone mineral density (BMD), trabecular bone score (TBS), and fracture history in HF is crucial.
Purpose of the Study:
- To evaluate BMD, TBS, and fracture history in middle-aged patients hospitalized for heart failure.
- To analyze the association between these bone parameters and cardiometabolic factors.
- To explore the relationship between bone health and muscle strength in this cohort.
Main Methods:
- A cross-sectional study involving 109 patients aged 40-64 hospitalized for HF.
- Dual-energy X-ray absorptiometry (DXA) used for BMD and TBS assessment.
- Evaluation of fracture history, handgrip strength (HGS), and cardiometabolic parameters.
Main Results:
- 15.6% of patients had osteoporosis, and 22.8% had low TBS.
- High serum parathyroid hormone (PTH) was significantly associated with osteoporosis (p=0.016).
- Serum PTH negatively correlated with TBS (p=0.038), and low TBS was linked to reduced HGS (p=0.009).
Conclusions:
- Middle-aged heart failure patients exhibit significant frequencies of osteoporosis and impaired bone microarchitecture.
- Elevated serum PTH levels are associated with osteoporosis and poorer bone quality in this population.
- Bone health degradation in HF patients may impact muscle strength, warranting further investigation.
Background:
This study aimed to evaluate the bone mineral density (BMD), trabecular bone score (TBS), and fracture history of middle-aged patients hospitalized for heart failure (HF), as well as analyze the association of these factors with cardiometabolic parameters and muscle strength.
Methods:
A cross-sectional study with patients aged 40 to 64 years hospitalized for HF was performed. Dual energy X-ray absorptiometry was performed to obtain BMD and TBS. Fracture history, handgrip strength (HGS), and clinical and laboratory cardiometabolic parameters of the patients were evaluated.
Results:
Altogether, 109 patients were evaluated (female 50.5%). Medians and interquartile ranges for age and length of hospital stay were 58.0 (53.0-61.0) years and 20.0 (11.0-32.0) days, respectively. Osteoporosis was observed in 15.6% of the patients, low TBS was observed in 22.8%, and 6 patients had a history of fragile fracture. No differences between the sexes regarding BMD (p=0.335) or TBS (p=0.736) classifications were observed. No association was observed between low BMD and HF classification (p>0.05) regarding the ejection fraction, ischemic etiology, or New York Heart Association Functional Classification. However, there was a significant association between high serum parathyroid hormone (PTH) and the presence of osteoporosis (62.5 [37.2-119.0] pg/mL vs. 34.2 [25.0-54.1] pg/mL; p=0.016). There was a negative correlation between serum PTH and TBS (r=-0.329, p=0.038) and a higher frequency of reduced HGS in patients with low TBS (92.3% vs. 50.0%; p=0.009).
Conclusions:
We found relevant frequencies of osteoporosis and bone microarchitecture degradation in middle-aged patients with HF, which were related to high serum PTH concentrations.
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