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01.02.2009 | Original Article

Relationship between bone quantitative ultrasound and mortality: a prospective study

verfasst von: J. González-Macías, F. Marín, J. Vila, E. Carrasco, P. Benavides, M. V. Castell, J. E. Magaña, F. Chavida, A. Díez-Pérez, for the ECOSAP investigators

Erschienen in: Osteoporosis International | Ausgabe 2/2009

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Abstract

Summary

In a cohort of 5,201 women [72.3 ± 5.3 years] from 58 primary care centers in Spain, followed for three years, no relationship between heel QUS parameters and overall mortality was found. However, a significant relationship between a low speed of sound (SOS) and vascular mortality was observed.

Introduction

An inverse relationship between mortality and bone mineral density measured by dual-energy absorption densitometry or quantitative bone ultrasound (QUS) has been described. The aim of the present study was to test this relationship in the ECOSAP cohort, a 3-year prospective study designed to assess the ability of heel QUS and clinical risk factors to predict non-vertebral fracture risk in women over 64.

Methods

A cohort of 5,201 women [72.3 ± 5.3 years] was studied. QUS was assessed with the Sahara® bone sonometer. Women attended follow-up visits every 6 months. Physicians recorded if the patient died and cause of death. Hazard rates (HR) of all-cause and vascular mortality per one standard deviation reduction in QUS parameters were determined.

Results

One hundred (1.9%) women died during a median of 36.1 months follow-up, for a total of 14,999 patient-years, 42 because of vascular events (both cardiovascular and cerebrovascular). After adjusting for age, none of the QUS variables showed statistically significant differences between the patients who died and the survivors. In the final multivariate model, adjusted for age, current thyroxine and hypoglycaemic drug use, chronic obstructive pulmonary disease and decreased visual acuity, SOS was marginally non-significant: (HR: 1.19; 0.97–1.45). However, each 1 SD reduction in SOS was associated with a 39% increase in vascular mortality (HR: 1.39; 1.15–1.66).

Conclusions

In our cohort, SOS was related with vascular mortality, but not overall mortality.

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Cooper C, Atkinson EJ, Jacobsen SJ, O'Fallon WM, Melton LJ 3rd (1993) Population-based study of survival after osteoporotic fractures. Am J Epidemiol 137:1001–1005PubMed

Kado DM, Browner WS, Palermo L, Nevitt MC, Genant HK, Cummings SR, Osteoporotic Fractures Research Group (1999) Vertebral fractures and mortality in older women: a prospective study. Arch Inter Med 159:1215–1220CrossRef

Jalava T, Sarna S, Pylkkanen L, Mawer B, Kanis JA, Selby P, Davies M, Adams J, Francis RM, Robinson J, McCloskey E (2003) Association between vertebral fracture and increased mortality in osteoporotic patients. J Bone Miner Res 18:1254–1260PubMedCrossRef

Johnell O, Kanis JA, Oden A, Sernbo I, Redlund-Johnell I, Petterson C, De Laet C, Jonsson B (2004) Mortality after osteoporotic fractures. Osteoporos Int 15:38–42PubMedCrossRef

Empana JP, Dargent-Molina P, Bracart G, EPIDOS Group (2004) Effect of hip fracture on mortality in elderly women: the EPIDOS prospective study. J Am Geriatr Soc 52:685–690PubMedCrossRef

Hasserius R, Karlsson MK, Jonsson B et al (2005) Long-term morbidity and mortality after a clinically diagnosed vertebral fracture in the elderly: a 12- and 22-year follow-up of 257 patients. Calcif Tissue Int 76:235–242PubMedCrossRef

Browner WS, Seeley DG, Vogt TM et al (1991) Non-trauma mortality in elderly women with low bone mineral density. Study of Osteoporotic Fractures Research Group. Lancet 338:355–358PubMedCrossRef

Johansson C, Black D, Johnell O et al (1998) Bone mineral density is a predictor of survival. Calcif Tissue Int 63:190–196PubMedCrossRef

Kado DM, Browner WS, Blackwell T et al (2000) Rate of bone loss is associated with mortality in older women: a prospective study. J Bone Miner Res 15:1974–1980PubMedCrossRef

10.

Trivedi DP, Khaw KT (2001) Bone mineral density at the hip predicts mortality in elderly men. Osteoporos Int 12:259–265PubMedCrossRef

11.

Marín F, González-Macías J, Díez-Pérez A et al (2006) Relationship between bone quantitative ultrasound and fractures: a meta-analysis. J Bone Miner Res 21:1126–1135PubMedCrossRef

12.

Turner CH, Peacock M, Timmerman L et al (1995) Calcaneal ultrasonic measurements discriminate hip fracture independently of bone mass. Osteoporos Int 5:130–135PubMedCrossRef

13.

Schott AM, Weill-Engerer S, Hans D et al (1995) Ultrasound discriminates patients with hip fracture equally well as dual energy X-ray absorptiometry and independently of bone mineral density. J Bone Miner Res 10:243–249PubMedCrossRef

14.

Bouxsein ML, Radloff SE (1997) Quantitative ultrasound of the calcaneus reflects the mechanical properties of calcaneal trabecular bone. J Bone Miner Res 12:839–846PubMedCrossRef

15.

Bauer DC, Palermo L, Black D et al (2002) Quantitative ultrasound and mortality: a prospective study. Osteoporos Int 13:606–612PubMedCrossRef

16.

Pinhero MM, Castro CM, Szejnfeld VL (2006) Low femoral bone mineral density and quantitative ultrasound are risk factors for new osteoporotic fracture and total and cardiovascular mortality: a 5-year population-based study of Brazilian elderly women. J Gerontol A Biol Sci Med Sci 61:196–203

17.

Díez-Pérez A, González-Macías J, Marín F et al (2007) Prediction of absolute risk of non-spinal fractures using clinical risk factors and heel quantitative ultrasound. Osteoporos Int 18:629–639PubMedCrossRef

18.

Hernández JL, Marín F, González-Macías J et al (2004) Discriminative capacity of calcaneal quantitative ultrasound and fracture risk factors in postmenopausal women with osteoporotic fractures. Calcif Tissue Int 74:357–365PubMedCrossRef

19.

von Stetten E, Ouellet H, Wilson KE et al (1998) European caucasian female reference data values for the Sahara clinical bone sonometer. Bone 23(Suppl 5):S637 Abstract

20.

Marín F, Vila J, González-Macías J, on behalf the ECOSAP project investigators (2003) Quantitative bone ultrasound: impact of the application of two different reference databases to a population of 5195 postmenopausal women. Med Clin (Barc) 121:250–252CrossRef

21.

Sosa M, Saavedra P, Muñoz-Torres M et al (2002) Quantitative ultrasound calcaneous measurements: normative data and precision in the spanish population. Osteoporos Int 13:487–492PubMedCrossRef

22.

Lin J, Zhang D, Davidian M (2006) Smoothing Spline-based score tests for proportional hazards models. Biometrics 62:803–812PubMedCrossRef

23.

R Development Core Team (2006) R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. Available at: http://www.R-project.org, accessed: 29 December, 2007

24.

von der Recke P, Hansen MA, Hassager C (1999) The association between low bone mass at the menopause and cardiovascular mortality. Am J Med 106:273–278CrossRef

25.

Mussolino ME, Madans JH, Gillum RF (2003) Bone mineral density and mortality in women and men: the NHANES I epidemiologic follow-up study. Ann Epidemiol 13:692–697PubMedCrossRef

26.

van der Klift M, Pols HAP, Geleijnse JM et al (2002) Bone mineral density and mortality in elderly men and women: the Rotterdam study. Bone 30:643–648CrossRef

27.

Browner WS, Pressman AR, Nevitt MC et al (1993) Association between low bone density and stroke in elderly women. The study of osteoporotic fractures. Stroke 24:940–946PubMed

28.

Uyama O, Yoshimoto Y, Yamamoto Y et al (1997) Bone changes and carotid atherosclerosis in postmenopausal women. Stroke 28:1730–1732PubMed

29.

Jorgensen L, Engstad T, Jacobsen BK (2001) Bone mineral density in acute stroke patients: low bone mineral density may predict first stroke in women. Stroke 32:47–51PubMed

30.

Tanko LB, Bagger YZ, Christiansen C (2003) Low bone mineral density in the hip as a marker of advanced atherosclerosis in elderly women. Calcif Tissue Int 73:15–20PubMedCrossRef

31.

Tanko LB, Christiansen C, Cox DA et al (2005) Relationship between osteoporosis and cardiovascular disease in postmenopausal women. J Bone Miner Res 20:1912–1920PubMedCrossRef

32.

Johnell O, Kanis JA, Oden A et al (2005) Predictive value of BMD for hip and other fractures. J Bone Miner Res 20:1185–1194PubMedCrossRef

33.

Stewart A, Kumar V, Reid DM (2006) Long-term fracture prediction by DXA and QUS: a 10-year prospective study. J Bone Miner Res 21:413–418PubMedCrossRef

34.

World Health Organization. http://www.who.int/countries. Accessed: 18 January 2008

35.

Bauer DC, Rodondi N, Stone KL et al (2007) Thyroid hormone use, hyperthyroidism and mortality in older women. Am J Med 120:343–349PubMedCrossRef

Titel: Relationship between bone quantitative ultrasound and mortality: a prospective study
verfasst von: J. González-Macías
F. Marín
J. Vila
E. Carrasco
P. Benavides
M. V. Castell
J. E. Magaña
F. Chavida
A. Díez-Pérez
for the ECOSAP investigators
Publikationsdatum: 01.02.2009
Verlag: Springer-Verlag
Erschienen in: Osteoporosis International / Ausgabe 2/2009
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-008-0645-8

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Abstract

Summary

Introduction

Methods

Results

Conclusions

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