Oral Presentation 30th Australian and New Zealand Bone and Mineral Society Annual Scientific Meeting 2020

Heel bone structure is associated with all cause and cardiovascular disease mortality independent of hip bone mineral density (#48)

Abadi Kahsu Gebre 1 2 , Richard L Prince 3 4 , John T Schousboe 5 6 , Douglas P Kiel 7 , Peter L Thompson 3 8 , Kun Zhu 3 4 , Wai H Lim 3 9 , Marc Sim 1 3 , Joshua R Lewis 1 3 10
  1. Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences , Edith Cowan University, Joondalup, Western Australia, Australia
  2. School of Pharmacy , Mekelle University, Mekelle , Tigray , Ethiopia
  3. Medical School , The University of Western Australia, Perth, Western Australia, Australia
  4. Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
  5. Park Nicollet Osteoporosis Centre and HealthPartners Institute, HealthPartners, Minneapolis, Minnesota, USA
  6. Division of Health Policy and Management, University of Minnesota, Minneapolis, Minnesota, USA
  7. Marcus Institute for Aging Research, Hebrew SeniorLife, Department of Medicine, Beth Israel Deaconess Medical Centre, Boston, Commonwealth of Massachusetts, USA
  8. Department of Cardiology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
  9. Renal department, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
  10. Centre for Kidney Research, Children's Hospital at Westmead School of Public Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia

Osteoporosis is a prominent cause of disability and poor quality of life which has been linked to increased risk of cardiovascular disease (CVD) and mortality. We investigated the association between calcaneal quantitative ultrasound (QUS) measurements and 15-year mortality in 1,404 older women [mean age 75.2±2.7 years]. Calcaneal QUS bone ultrasound attenuation (BUA) and speed of sound (SOS) were obtained using a Lunar Achilles Ultrasound machine at baseline, while hip BMD was obtained by dual-energy X-ray absorptiometry (Hologic Acclaim 4500A) at either baseline or year 1. Mortality records including cause of death were obtained from linked health records. Cox proportional hazard models were used to investigate the relationship between QUS measures, all cause, CVD, cancer and ‘other’ causes of mortality, with no violations of the proportional hazards assumptions being detected. Over the 15-years of follow-up (17,955 person years), 584 (42%) died from any cause. This included 223 (16%), 158 (12%) and 203 (14%) deaths from CVD, cancer and ‘other’ causes, respectively. Consistent and robust associations were observed for BUA with all-cause and CVD mortality but not SOS (Table 1).  For every standard deviation (SD) reduction in BUA in minimally and multivariable-adjusted models, there was a 15% and 20% increase in the relative hazards of all-cause mortality and CVD mortality, respectively. These relationships persisted in multivariable adjustment models after the inclusion of hip BMD (Table 1). No consistent associations were seen for SOS or BUA measures with cancer or “other” mortality.  In conclusion, the association between calcaneal BUA, a measure of osteoporosis, with all-cause and CVD mortality in older women suggests a link between bone disease and other disorders, particularly CVD. However, due to the observational nature of this work, further intervention studies are needed to demonstrate causality.

 5f37839a187c6-Graphic+ANZBMS+2020+Abadi+Gebre+.jpg