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Association between passive smoking in adulthood and phalangeal bone mineral density: results from the KRAM study—the Danish Health Examination Survey 2007–2008

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Abstract

Summary

The study investigates an association between phalangeal bone mineral density (BMD) and self-reported passive smoking using data on 15,038 persons (aged 18–95 years), who underwent a BMD scan in the Danish KRAM study. BMD was significantly lower in persons exposed to long-term passive smoking in their home during adulthood.

Introduction

Smoking is associated with decreased bone mineral density (BMD) and increased risk of osteoporotic fractures. This study aimed to investigate a possible association between BMD at the phalangeal bones and self-reported passive smoking.

Methods

The study included a cohort of 15,544 men and women aged 18–95 years, who underwent a BMD scan in the Danish KRAM study. BMD scans of the middle phalanges of the second, third and fourth digits of the non-dominant hand were performed with a compact radiographic absorptiometry system (Alara MetriScan®). Also, height, weight and body fat percentage were measured and 96.7% (n = 15,038) of the participants answered a self-reported questionnaire with information on passive smoking, other lifestyle factors, education, etc. The association between passive smoking and BMD was examined using multiple linear regression analysis.

Results

A total of 39.1% (n = 5,829) of the participants had been exposed to passive smoking in adulthood at home. BMD was significantly lower in subjects exposed to passive smoking, 0.343 vs. 0.331 g/cm2; p < 0.01 (unadjusted) and 0.339 vs. 0.337 g/cm2; p < 0.05 (adjusted for age, gender, height and weight, and smoking). Multiple linear regression analysis showed that exposure to passive smoking for more than 20 years in adulthood at home was significantly related to BMD when adjusted for potential confounders (men, β = −4.4 × 10−3; r = −0.05; p < 0.01 and women, β = −2.3 × 10 −3; r = −0.03; p < 0.05). This relationship was also seen in the group of never smokers (β = −3.3 × 10−3; r = −0.03; p = 0.01).

Conclusion

Our study supports a potential negative effect of long-term passive smoking in adulthood at home on phalangeal BMD.

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Acknowledgements

The KRAM study—the Danish Health Examination Survey 2007–2008 was funded by the Ministry of Health and Prevention and the TrygFoundation, Denmark. Thanks to the 13 participating municipalities and to all the participants who took part in the study by completing questionnaires and participating in health examinations. Finally, the data collection would not have been possible without the immense effort from all the masters and students from the National Institute of Public Health and local nurses and students from the 13 municipalities. The execution of this manuscript was funded by the Region of Southern Denmark.

Conflicts of interest

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Authors and Affiliations

  1. National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2, 1353, Copenhagen K, Denmark

    T. Holmberg, T. Curtis, K. Juel & M. Grønbæk

  2. The Research unit of Health Economics, University of Southern Denmark, Odense, Denmark

    M. Bech

  3. Institute of Clinical Research, University of Southern Denmark, Odense, Denmark

    K. Brixen

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  1. T. Holmberg
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Correspondence to T. Holmberg.

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Holmberg, T., Bech, M., Curtis, T. et al. Association between passive smoking in adulthood and phalangeal bone mineral density: results from the KRAM study—the Danish Health Examination Survey 2007–2008. Osteoporos Int 22, 2989–2999 (2011). https://doi.org/10.1007/s00198-010-1506-9

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