Bone mineral density and osteoporosis in relation to all-cause and cause-specific mortality in NHANES: A population-based cohort study

骨矿物 医学 全国健康与营养检查调查 危险系数 骨质疏松症 转子 比例危险模型 队列 人口 股骨 置信区间 股骨颈 死亡率 髋部骨折 队列研究 内科学 外科 环境卫生
作者
Shaofang Cai,Jiayao Fan,Li Zhu,Jianhong Ye,Xianming Rao,Chunhong Fan,Yaohong Zhong,Yingjun Li
出处
期刊:Bone [Elsevier]
卷期号:141: 115597-115597 被引量:44
标识
DOI:10.1016/j.bone.2020.115597
摘要

The majority of the published studies ascertaining the relationships between low bone mineral density (BMD) and mortality highlighted the elderly population with limited sample size. Our study aimed to ascertain the relationships in general population. This study ascertained the relationships between BMD levels in femur and lumbar spine with all-cause and cause-specific mortality in the National Health and Nutrition Examination Survey (NHANES) (n = 15,076, mean age 48.6 years). Cox proportional hazards models were adopted to calculate the hazard ratios (HR) and the corresponding 95% confidence intervals (CIs) for mortality. During a 6.8-year median follow-up, 1216 men and women in the cohort died. There was a higher risk of all-cause mortality among participants with osteoporosis compared with normal in the regions of total femur (HR = 1.36, 95% CI = 1.07–1.73), femur neck (HR = 1.41, 95% CI = 1.11–1.78), intertrochanter (HR = 1.34, 95% CI = 1.05–1.72), as well as overall (HR = 1.36, 95% CI = 1.09–1.69). Non-linear dose-response analyses showed a statistically significant L-shaped association for all-cause mortality with BMD increment in the regions of total femur, femur neck, trochanter, and intertrochanter. The protective role of higher BMD level in femur for decreased risk of cancer mortality and heart diseases mortality was more evident in male participants and female participants, respectively. In summary, our results revealed that maintaining normal BMD is critical to lower the risk of mortality. The association between higher BMD level in femur and decreased risk of cancer as well as heart diseases mortality varies by gender.
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