Abstract
The objective of the present study was to investigate the association of low bone mass with the risk of stroke and death in community residents of China. This study was based on the follow-up data acquired from 5,136 postmenopausal women aged 50 years or older between July 2006 and June 2011. Baseline and the follow-up bone mineral density (BMD) in these patients were measured by dual energy X-ray absorptiometry scanning. The association of BMD and risk of stroke and death was further evaluated by Cox proportional hazard analysis. During the follow-up, 148 subjects (2.9 %) sustained prospective stroke, and 261 subjects (5.1 %) died. After adjustments for age and BMI, our results indicated that neck BMD and osteoporosis were independent predictors of stroke (HR for neck BMD = 1.35, 95 % CI = 1.21–1.62; HR for osteoporosis = 2.24, 95 % CI = 1.47–3.58) and were also associated with increased risk of death (HR for neck BMD = 1.39, 95 % CI = 1.24–1.71; HR for osteoporosis = 1.97, 95 % CI = 1.21–2.97). Our results also suggest that low neck BMD and osteoporosis are associated with significantly elevated risk of stroke and death in Chinese postmenopausal women.
Similar content being viewed by others
References
Rachner, T. D., Khosla, S., & Hofbauer, L. C. (2011). Osteoporosis: now and the future. Lancet, 377, 1276–1287.
Cummings, S. R., Nevitt, M. C., Browner, W. S., Stone, K., Fox, K. M., Ensrud, K. E., et al. (1995). Risk factors for hip fracture in white women. Study of osteoporotic fractures research group. New England Journal of Medicine, 332, 767–773.
Dobkin, B. H. (2005). Clinical practice rehabilitation after stroke. New England Journal of Medicine, 352, 1677–1684.
Wang, Y., Tao, Y., Hyman, M. E., Li, J., & Chen, Y. (2009). Osteoporosis in china. Osteoporosis International, 20, 1651–1662.
Zhao, D., Liu, J., Wang, W., Zeng, Z., Cheng, J., Liu, J., et al. (2008). Epidemiological transition of stroke in China: twenty-one-year observational study from the Sino-MONICA-Beijing Project. Stroke, 39, 1668–1674.
Xingye, L., & Zengdong, M. (2011). Relationship between quantity of illumination and human vitamin D concentration and bone mineral density in different region. Chin J Osteoporos, 18, 183–187.
Aronow, W. S. (2011). Osteoporosis, osteopenia, and atherosclerotic vascular disease. Arch Med Sci, 7, 21–26.
Tanko, L. B., Christiansen, C., Cox, D. A., Geiger, M. J., McNabb, M. A., & Cummings, S. R. (2005). Relationship between osteoporosis and cardiovascular disease in postmenopausal women. Journal of Bone and Mineral Research, 20, 1912–1920.
Szulc, P., Samelson, E. J., Kiel, D. P., & Delmas, P. D. (2009). Increased bone resorption is associated with increased risk of cardiovascular events in men: the MINOS study. Journal of Bone and Mineral Research, 24, 2023–2031.
Tamaki, J., Iki, M., Hirano, Y., Sato, Y., & Kajita, E. (2009). Low bone mass is associated with carotid atherosclerosis in postmenopausal women: the Japanese Population-based Osteoporosis (JPOS) Cohort Study. Osteoporosis International, 20, 53–60.
Mussolino, M. E., & Armenian, H. K. (2007). Low bone mineral density, coronary heart disease, and stroke mortality in men and women: the Third National Health and Nutrition Examination Survey. Annals of Epidemiology, 17, 841–846.
Suzuki, T., & Yoshida, H. (2010). Low bone mineral density at femoral neck is a predictor of increased mortality in elderly Japanese women. Osteoporosis International, 21, 71–79.
Shiraki, M., Kuroda, T., & Tanaka, S. (2011). Established osteoporosis associated with high mortality after adjustment for age and co-mobidities in postmenopausal Japanese women. Internal Medicine, 50, 397–404.
Kauppila, L. I., Polak, J. F., & Cupples, L. A. (1998). Guidelines for preclinical evaluation and clinical trials in osteoporosis. Geneva: World Health Organization.
Uyama, O., Yoshimoto, Y., Yamamoto, Y., & Kawai, A. (1997). Bone changes and carotid atherosclerosis in postmenopausal women. Stroke, 28, 1730–1732.
Barengolts, E. I., Berman, M., Kukreja, S. C., Kouznetsova, T., Lin, C., & Chomka, E. V. (1998). Osteoporosis and coronary atherosclerosis in asymptomatic postmenopausal women. Calcified Tissue International, 62, 209–213.
Kiel, D. P., Kauppila, L. I., Cupples, L. A., Hannan, M. T., O’Donnell, C. J., & Wilson, P. W. (2001). Bone loss and the progression of abdominal aortic calcification over a 25 year period: the Framingham Heart Study. Calcified Tissue International, 68, 271–276.
Nordstrom, A., Eriksson, M., Stegmayr, B., Gustafson, Y., & Nordstrom, P. (2010). Low bone mineral density is an independent risk factor for stroke and death. Cerebrovascular Diseases, 29, 130–136.
Jorgensen, L., Engstad, T., & Jacobsen, B. K. (2001). Bone mineral density in acute stroke patients: low bone mineral density may predict first stroke in women. Stroke, 32, 47–51.
Lee, S. B., Cho, A. H., Butcher, K. S., Kim, T. W., Ryu, S. Y., & Kim, Y. I. (2013). Low bone mineral density is associated with poor clinical outcome in acute ischemic stroke. International Journal of Stroke, 8, 68–72.
Browner, W. S., Pressman, A. R., Nevitt, M. C., Cauley, J. A., & Cummings, S. R. (1993). Association between low bone density and stroke in elderly women. The study of osteoporotic fractures. Stroke, 24, 940–946.
Trivedi, D. P., & Khaw, K. T. (2001). Bone mineral density at the hip predicts mortality in elderly men. Osteoporosis International, 12, 259–265.
Van Der Klift, M., Pols, H. A., Geleijnse, J. M., Van Der Kuip, D. A., Hofman, A., & De Laet, C. E. (2002). Bone mineral density and mortality in elderly men and women: the Rotterdam Study. Bone, 30, 643–648.
Mussolino, M. E., Madans, J. H., & Gillum, R. F. (2003). Bone mineral density and stroke. Stroke, 34, e20–e22.
Simonet, W. S., Lacey, D. L., Dunstan, C. R., Kelley, M., Chang, M. S., Lüthy, R., et al. (1997). Osteoprotegerin: a novel secreted protein involved in the regulation of bone density. Cell, 89, 309–319.
Ross, R. (1993). The pathogenesis of atherosclerosis: a perspective for the 1990s. Nature, 362, 801–809.
Acknowledgments
This study was supported by funding from Chongqing Educational Commission (KJTD201337).
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zhou, R., Liu, D., Li, R. et al. Low Bone Mass is Associated with Stroke in Chinese Postmenopausal Women: The Chongqing Osteoporosis Study. Cell Biochem Biophys 71, 1695–1701 (2015). https://doi.org/10.1007/s12013-014-0392-8
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12013-014-0392-8