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

Cai, Shaofang; Fan, Jiayao; Zhu, Lina; Ye, Jianhong; Rao, Xianming; Fan, Chunhong; Zhong, Yaohong; Li, Yingjun

Affiliations

¹Department of Science and Education, The Second Affiliated Hospital of Xiamen Medical College, Xiamen 361021, China

²School of Public Health, Hangzhou Medical College, Hangzhou 310053, China

Abstract and keywords

Objective: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Bone mineral density; Osteoporosis; Mortality; All-cause mortality; Cause-specific mortality

Links

DOI: 10.1016/j.bone.2020.115597

PubMed: 32814125

WoS: 000602327700009

History

Received: 2020-04-15

Revised: 2020-08-12

Accepted: 2020-08-12

Online: 2020-08-16

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Cited By (1)

Year	Entry
2022	Kuan-Kai Tung. Letter to the editor regarding, " bone mineral density and osteoporosis in relation to all-cause and cause-specific mortality in NHANES- a population-based cohort study "Bone. November 2022;164:116518.