Poor Bone Quality is Associated With Greater Arterial Stiffness: Insights From the UK Biobank.
Zahra Raisi-EstabraghLuca BiasiolliJackie CooperNay AungKenneth FungJosé M PaivaMihir M SanghviRoss J ThomsonElizabeth CurtisJulien PaccouJennifer J RaynerKonrad WerysHenrike PuchtaKatharine E ThomasAaron M LeeStefan K PiechnikStefan NeubauerPatricia B MunroeCyrus CooperSteffen E PetersenNicholas C W HarveyPublished in: Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research (2020)
Osteoporosis and ischemic heart disease (IHD) represent important public health problems. Existing research suggests an association between the two conditions beyond that attributable to shared risk factors, with a potentially causal relationship. In this study, we tested the association of bone speed of sound (SOS) from quantitative heel ultrasound with (i) measures of arterial compliance from cardiovascular magnetic resonance (aortic distensibility [AD]); (ii) finger photoplethysmography (arterial stiffness index [ASI]); and (iii) incident myocardial infarction and IHD mortality in the UK Biobank cohort. We considered the potential mediating effect of a range of blood biomarkers and cardiometabolic morbidities and evaluated differential relationships by sex, menopause status, smoking, diabetes, and obesity. Furthermore, we considered whether associations with arterial compliance explained association of SOS with ischemic cardiovascular outcomes. Higher SOS was associated with lower arterial compliance by both ASI and AD for both men and women. The relationship was most consistent with ASI, likely relating to larger sample size available for this variable (n = 159,542 versus n = 18,229). There was no clear evidence of differential relationship by menopause, smoking, diabetes, or body mass index (BMI). Blood biomarkers appeared important in mediating the association for both men and women, but with different directions of effect and did not fully explain the observed effects. In fully adjusted models, higher SOS was associated with significantly lower IHD mortality in men, but less robustly in women. The association of SOS with ASI did not explain this observation. In conclusion, our findings support a positive association between bone and vascular health with consistent patterns of association in men and women. The underlying mechanisms are complex and appear to vary by sex. © 2020 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Keyphrases
- bone mineral density
- public health
- body mass index
- risk factors
- magnetic resonance
- type diabetes
- postmenopausal women
- cardiovascular disease
- blood pressure
- healthcare
- mental health
- heart failure
- magnetic resonance imaging
- soft tissue
- bone loss
- weight gain
- left ventricular
- cardiovascular events
- randomized controlled trial
- smoking cessation
- metabolic syndrome
- pregnant women
- body composition
- atrial fibrillation
- insulin resistance
- systematic review
- oxidative stress
- pulmonary artery
- skeletal muscle
- risk assessment
- pulmonary hypertension
- ultrasound guided
- polycystic ovary syndrome
- climate change
- coronary artery
- social media
- subarachnoid hemorrhage
- pregnancy outcomes
- heart rate