Aims
Globorisk uses clinical information to predict the risk of heart attack or stroke over a 10-year period. Cardiovascular disease and osteoporosis have overlapping aetiology; thus, we aimed to investigate associations between Globorisk and bone mineral density (BMD) in adults.
Methods
Men (n=367) and women (n=579) from the Geelong Osteoporosis Study provided BMD at the hip and lumbar spine (L2-L4) using DXA (Lunar Prodigy). Globorisk was calculated using country of residence, age, sex, smoking status, diabetes status, blood pressure and serum cholesterol. Multivariable quantile (median) regression was used to assess the relationship between Globorisk and femoral neck and lumbar spine BMD T-scores. Models were stratified by sex and adjusted for anthropometry, lifestyle factors and medication use. A sensitivity analysis stratified by median age was also performed.
Results
Median age was 64.4yr (IQR 55.0-71.2) for men and 59.3yr (IQR 49.6-69.0) for women. For both sexes, Globorisk was negatively associated with femoral neck BMD, persisting after adjustment (Table). At the lumbar spine, Globorisk was negatively associated with BMD in women, but the inverse relationship was observed in men. In sensitivity analyses, Globorisk was negatively associated with femoral neck BMD in older women, but no other associations were observed.
Conclusion
Risk of heart attack and stroke as indicated by the Globorisk was associated with BMD at the hip and lumbar spine in both men and women. However, at the lumbar spine in men, a high risk score correlated with high BMD, which may be related to changes in abdominal aortic calcification or degenerative spine changes which can influence bone density measures at this site. Results may be driven by age, however associations persisted in older women at the femoral neck.
Table. Associations between Globorisk score and bone mineral density (BMD) T-scores at the femoral neck and lumbar spine in men and women.