Low Bone Mineral Density Is Associated with Higher Venous Thromboembolism Risk Scores in Postmenopausal Women

Venous thromboembolism (VTE) and osteoporosis are both prevalent and clinically significant conditions in postmenopausal women. These disorders share common risk factors, including estrogen deficiency and age-related physiological changes. Although emerging evidence suggests a link between reduced bone mineral density (BMD) and thrombotic events, current VTE risk assessment models do not incorporate BMD. This study aimed to investigate the association between BMD and VTE risk in postmenopausal women.

A total of 511 postmenopausal women hospitalized at the First Affiliated Hospital of Nanjing Medical University between January and December 2024 were enrolled. BMD was measured using dual-energy X-ray absorptiometry (DXA) and classified according to World Health Organization criteria. VTE risk was assessed using the Caprini Risk Assessment Score.

Patients with osteoporosis had significantly higher Caprini scores compared to those with normal BMD (6.20 ± 3.20 vs 5.40 ± 2.60; p = 0.019). Additionally, levels of D-dimer 2 (DD2) and fibrinogen (FIB) increased as BMD decreased. Multivariate analysis identified the lowest BMD value as an independent predictor of elevated VTE risk (odds ratio = 0.02; 95% CI: 0.003-0.164; p < 0.01). A negative correlation was observed between BMD and Caprini score (r = -0.241; p < 0.01).

Lower BMD is independently associated with increased VTE risk in postmenopausal women. These findings suggest that BMD may serve as a novel biomarker for VTE risk. Incorporating BMD into existing risk assessment models and considering thromboprophylaxis for individuals with low BMD are recommended.