Arterial stiffness and risk of new-onset fragility fracture in Chinese men and women: The Kailuan cohort study

Lu Guo; Nan Zhang; Yimeng Zhang; Lei Xing; Wenqi Xu; Wenjuan Li; Lisha Zhang; Xiaoli Hou; Shuohua Chen; Shouling Wu; Faming Tian

doi:10.1016/j.bone.2023.116991

Arterial stiffness and risk of new-onset fragility fracture in Chinese men and women: The Kailuan cohort study

Bone. 2024 Mar:180:116991. doi: 10.1016/j.bone.2023.116991. Epub 2023 Dec 21.

Authors

Lu Guo¹, Nan Zhang², Yimeng Zhang³, Lei Xing⁴, Wenqi Xu⁵, Wenjuan Li⁵, Lisha Zhang⁵, Xiaoli Hou¹, Shuohua Chen⁶, Shouling Wu⁶, Faming Tian⁷

Affiliations

¹ The School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China.
² Department of Orthopedics, Kailuan General Hospital, Tangshan, Hebei, China.
³ Medical Department, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
⁴ Department of General Practice, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, China.
⁵ The School of Clinical Medicine, North China University of Science and Technology, Tangshan, Hebei, China.
⁶ Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China.
⁷ The School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China. Electronic address: tianfaming@ncst.edu.cn.

PMID: 38141749
DOI: 10.1016/j.bone.2023.116991

Abstract

Background: Previous studies have shown an association between increased arterial stiffness and reduced bone mineral density. However, the relationship between arterial stiffness and fragility fracture remains unclear. In this study, we explored the impact of arterial stiffness on the risk of new-onset fragility fracture.

Methods: The study included 53,107 participants in the Kailuan Study in whom brachial-ankle pulse wave velocity (baPWV) measurements were obtained between 2010 and 2021. All participants were free of fragility fractures at baseline. A Cox proportional hazard regression model was used to estimate the hazard ratio (HR) and 95 % confidence interval (CI) for incident fragility fracture on the baseline baPWV groups: <1400 cm/s (reference), 1400 ≤ baPWV < 1800 cm/s, and ≥1800 cm/s.

Results: In total, 327 incident fragility fractures were recorded during an average follow-up of 4.99 ± 3.02 years. After adjustment for potential confounders, the HR for the risk of new-onset fragility fracture was 1.66 (95 % CI 1.14-2.42) for the arterial stiffness group in comparison with the normal baPWV group. The risk of fragility fracture was higher in men (HR 1.64, 95 % CI 1.05-2.57). There was a linear association between higher baPWV and fragility fracture.

Conclusions: Arterial stiffness as measured by baPWV was associated with the risk of fragility fracture.

Keywords: Arterial stiffness; Brachial-ankle pulse wave velocity; Cohort study; Fragility fracture.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Ankle Brachial Index*
China / epidemiology
Cohort Studies
Female
Humans
Male
Pulse Wave Analysis
Risk Factors
Vascular Stiffness*