Document Type

Journal Article

Publication Title

Journal of Gerontology Series A: Biological Sciences and Medical Sciences

Publisher

Oxford Academic

School

Nutrition and Health Innovation Research Institute / School of Medical and Health Sciences

RAS ID

45466

Funders

National Health and Medical Research Council Australia / National Heart Foundation of Australia Future Leader Fellowship (ID: 102817 for J.R.L.) / Medical Research Foundation (R.L.C.) / National Institute for Arthritis and Musculoskeletal and Skin Diseases (R01 AR 041398 for D.P.L.)

Grant Number

NHMRC Numbers : GNT1174886, GNT1197958

Comments

This is a pre-copyedited, author-produced version of an article accepted for publication in The Journals of Gerontology: Series A following peer review. The version of record Gebre, A. K., Lewis, J. R., Leow, K., Szulc, P., Scott, D., Ebeling, P. R., . . . Rodríguez, A. J. (2022). Abdominal aortic calcification, bone mineral density and fractures: A systematic review and meta-analysis of observational studies. The Journals of Gerontology: Series A. 78(7), 1147–1154. is available online at: https://doi.org/10.1093/gerona/glac171

Gebre, A. K., Lewis, J. R., Leow, K., Szulc, P., Scott, D., Ebeling, P. R., . . . Rodríguez, A. J. (2023). Abdominal aortic calcification, bone mineral density and fractures: A systematic review and meta-analysis of observational studies. The Journals of Gerontology: Series A, 78(7), 1147–1154. https://doi.org/10.1093/gerona/glac171

Abstract

Background: Abdominal aortic calcification (AAC) has been inconsistently associated with skeletal health. We aimed to investigate the association of AAC with bone mineral density (BMD) and fracture risk by pooling the findings of observational studies. Methods: MEDLINE, EMBASE, Web of Science, and Google Scholar were searched (August 2021). All clinical studies that assessed the association between AAC and BMD or fracture were included. AAC was categorized into any/advanced (all higher reported groups) versus no/less advanced (lowest reported group). Pooled standardized mean differences (SMDs) and risk ratios (RRs) with 95% confidence intervals (CI) were determined for BMD and fracture, respectively, using random-effects models. Results: Of 2 192 articles screened, 86 (61 553 participants) were included in the review, while 42 provided data for meta-analysis. AAC was associated with lower BMD at the total hip (SMD = −1.05 [95%CI: −1.47 to −0.63]; 16 studies), femoral neck (−0.25 [−0.46 to−0.04]; 10), and lumbar spine (−0.67 [−1.21 to −0.12]; 20). AAC was associated with a greater risk of any fracture (RR = 1.73 [95%CI: 1.48–2.02]; 27). AAC was also associated with vertebral, non-vertebral, and hip fractures. In dose–response analysis, the highest AAC group had greater risks of any, vertebral and non-vertebral fractures. Conclusions: AAC is associated with lower BMD and increased fracture risk at multiple sites, underscoring the potential importance of vascular disease on skeletal health. Detection of AAC at the time of BMD testing may provide clinicians with prognostic information about bone health to enhance osteoporosis screening programs and fracture risk prediction.

DOI

10.1093/gerona/glac171

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