Original articleBone changes in spouses having shared lifestyle for 40 years
Introduction
Common diseases result from the complex relationship between genetic and environmental factors. Indeed lifestyle is supposed to be an important determinant of bone health in adult men and women. Partners of people with specific diseases are at increased risk of the disease themselves – at least 70% increased risk for asthma, depression, and peptic ulcer disease. This implies shared environmental causes in some diseases in addition to any genetic [1].There is a high concordance in cardiovascular risk factors among couples. Hypertension, diabetes and cholesterol level are correlated among spousal pairs [2]. Spousal concordance for smoking is high. Seven studies reported a positive concordance for smoking, with an overall odds ratio of 3.25 (95% CI: 2.94–3.59) [3].
The same environmental factors have been shown to impact on fracture risk with the same weight in each gender [4]. For instance, high alcohol intake was associated with a significant increase in osteoporosis and hip fracture risk in each gender. Risk ratios were moderately but not significantly higher in men than in women, and there was no evidence for a different threshold for effect by gender [5]. Tobacco consumption was associated with a reduction in BMD at femoral neck and lumbar spine in both sexes (5–8%), and this effect was independent of calcium intake or body weight [6].
However, the prevalence of fractures and osteoporosis are not the same in men and women [7]. We asked if the impact of common environmental factors would be the same on bone changes in the two genders. Based on previous available data gained in other pathologies such as cardiovascular diseases, we made the hypothesis that lifestyle was shared among couples that had lived several decades together. Therefore, we studied longitudinally bone status, over a mean period of 5 years, among a population of 104 heterosexual couples that had lived together for 40 years in mean. This was an opportunity to assess whether the concordant environmental factors shared during several decades induced the same BMD changes in two persons of different gender.
Section snippets
Study subjects
A flow chart of the analysed population is presented in Fig. 1. The monocentric longitudinal French VIGGOS cohort included 621 women and 228 men healthy volunteers monitored to evaluate determinant factors for bone loss. All the women and men were at least 50 years old at inclusion. They were all white, and seen annually between 1992 and 2002. At each visit, they had an examination including densitometry, clinical measures as weight, height, and they answered a questionnaire collecting previous
Results
Mean baseline ages were 66 ± 5 years (range: 51–81) in men and 63 ± 5 years (range: 51–79) in women. The mean number of visits was 4 ± 2 (range: 2–8), and the mean number of years of follow-up was 5 ± 3 years in men and 6 ± 3 years in women. These couples had a mean common lifespan of 40 ± 8 years (range: 16–54).
Comparison between husbands and wives are described in Table 1. Men were significantly older than women, heavier, taller and had a subsequent more elevated BMI. The BMD at each site was significantly
Discussion
In this study, we have observed that several environmental factors and lifestyle were shared among couples who have lived for 40 years together. However, bone status was not correlated among couples and men didn’t loss bone. Environmental factors explained 37% of the bone loss in women. Concordance among spouses has been shown for several risk factors such as weight, tobacco consumption or alcohol intake that impact in coronary heart disease, hypertension or BMD [1], [2], [5], [13]. Spouses are
Conflict of interest statement
The authors have no conflicts of interest to declare.
Acknowledgments
We thank Professor Launay and his team from Biochemistry Laboratory of Lariboisière Hospital (Paris) who conducted biological dosages.
We thank all the members of the nutrition department of Lariboisière Hospital (Paris) whose staff conducted all the nutritional calculations from the food frequency questionnaires.
We thank Claire Parisot, an English teacher who accepted to read and correct the entire text.
Declaration of Sources of Funding: this work was supported by the Association “Rhumatismes
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