Data concerning the link between severity of abdominal aortic calcification (AAC) and fracture risk in postmenopausal women are discordant. This association may vary by skeletal site and duration of follow-up. Our aim was to assess the association between the AAC severity and fracture risk in older women over the short- and long term. This is a case-cohort study nested in a large multicenter prospective cohort study. The association between AAC and fracture was assessed using Odds Ratios (OR) and 95% confidence intervals (95%CI) for vertebral fractures and using Hazard Risks (HR) and 95%CI for non-vertebral and hip fractures. AAC severity was evaluated from lateral spine radiographs using Kauppila's semiquantitative score. Severe AAC (AAC score 5. +) was associated with higher risk of vertebral fracture during 4. years of follow-up, after adjustment for confounders (age, BMI, walking, smoking, hip bone mineral density, prevalent vertebral fracture, systolic blood pressure, hormone replacement therapy) (OR = 2.31, 95%CI: 1.24-4.30, p < 0.01). In a similar model, severe AAC was associated with an increase in the hip fracture risk (HR = 2.88, 95%CI: 1.00-8.36, p = 0.05). AAC was not associated with the risk of any non-vertebral fracture. AAC was not associated with the fracture risk after 15. years of follow-up. In elderly women, severe AAC is associated with higher short-term risk of vertebral and hip fractures, but not with the long-term risk of these fractures. There is no association between AAC and risk of non-vertebral-non-hip fracture in older women. Our findings lend further support to the hypothesis that AAC and skeletal fragility are related.
Bibliographical noteFunding Information:
The Study of Osteoporotic Fractures (SOF) is supported by National Institutes of Health funding. The National Institute on Aging (NIA) provides support under the following grant numbers: R01 AG005407 , R01 AR35582 , R01 AR35583 , R01AR35584 , R01 AG005394 , R01 AG027574 , R01 AG027576 , and R01 AR41398 .
- Abdominal aortic calcification
- Bone mineral density
- Elderly women
- Fragility fracture