Abdominal aortic calcification and the risk of bone fractures: a meta-analysis of prospective cohort studies

Abstract

The relationship between abdominal aortic calcification (AAC) and bone fracture has been examined by some observational studies, but the results remain discordant. Therefore, we aimed to assess the link between them by conducting a meta-analysis of prospective studies. Relevant studies were identified by searching PubMed and EMBASE databases until the end of December 2016. Summary relative risks (RRs) and 95% confidence intervals (CIs) for associations between AAC and fracture risk were estimated with fixed- or random- effects models. Seven prospective studies were included in the final analysis. The summarized RRs of any type of fractures for the highest compared with the lowest category of AAC were 1.64 (95% CI 1.30-2.07, P = 0.000) with mild heterogeneity (I = 30.1%, P = 0.188). Subgroup analysis showed that the association between AAC and fracture was not significantly modified by gender and follow-up length. Risks were similar when analyses were restricted to the studies with adjustment for bone mineral density (BMD) (RR = 1.76, 95% CI 1.31-2.38, P = 0.000, I = 49.1%). For the specific type of fracture, severe AAC was significantly related with hip fracture (RR = 1.64, 95% CI 1.22-2.20, P = 0.001, n = 5), but not with vertebral (RR = 1.45, 95% CI 0.81-2.58, P = 0.213, n = 3) or non-vertebral fracture (RR = 1.35, 95% CI 0.96-1.88, P = 0.081, n = 3). There was no evidence of publication bias. Our findings demonstrated that AAC was significantly and independently associated with a higher fracture risk, especially for hip fracture.

Brachial-Ankle Pulse Wave Velocity is Associated With the Risk of Osteoporosis: A Cross-Sectional Evidence From A Chinese Community-Based Cohort

“…In China, a prospective osteoporosis study followed 1,724 postmenopausal women for 5 years, they found the presence of aortic calci cations assessed using semiquantitative radiography at baseline was associated with a higher rate of vertebral fractures (12.2% vs. 4.5% in women with and without aortic calci cations, (P = 0.01) (28). This study was pooled in a further meta-analysis on the relationship of aortic calci cations to the risk of fracture, which demonstrated that aortic calci cations was signi cantly and independently associated with a higher fracture risk, recruiting 14,632 participants in total (27). For peripheral arterial disease (PAD), in a prospective study of 1,332 individuals, peripheral arterial disease (PAD) measured by ABI was not associated with the occurrence of fractures (29).…”

“…Correlations between arterial stiffness and BMD have been frequently reported in both retrospective and cross-sectional studies. A cross-sectional study involving around four thousand Chinese men and women aged 65-92 reported that ankle brachial index (ABI) as a measurement for peripheral arteriosclerosis was positively correlated with hip BMDs (27). Further, prospective studies have also reported ndings in evaluating whether low BMD predicts cardiovascular events.…”

Brachial-ankle pulse wave velocity is associated with the risk of osteoporosis: a cross-sectional evidence from a Chinese community-based cohort

“…Correlations between arterial stiffness and BMD have been frequently reported in both retrospective and cross-sectional studies. A cross-sectional study involving around four thousand Chinese men and women aged 65-92 reported that ankle-brachial index (ABI) as a measurement for peripheral arteriosclerosis was positively correlated with hip BMDs [38]. Further, prospective studies have also reported findings in evaluating whether low BMD predicts cardiovascular events.…”

Association between vertebral fractures and coronary artery calcification in current and former smokers in the ECLIPSE cohort

“…Although there was a significant univariate association between high Agatston score and 1-year incidence, and between high Agatston score and ≥ 2 incident VFs within 1 and 3 years, we did not find any significant multivariate associations between Agatston score and incident VFs after adjusting for age, sex, BA, and prevalent VFs. A recent meta-analysis examined data from prospective cohort studies of aortic calcification and fractures [41]. Although not all individual studies found significant results, it was reported that subjects in the high aortic calcification category had increased fracture risk compared to subjects in the zero category.…”