Links between arterial stiffness and bone mineral density in middle-aged and elderly Chinese individuals: a cross-sectional study

OBJECTIVES: To explore whether bone mineral density (BMD) is associated with arterial stiffness in middle-aged and elderly people with an advanced arterial stiffness index as indicated by the cardio-ankle vascular index (CAVI). DESIGN: A cross-sectional study. SETTING: This study was conducted from September 2015 to May 2017 at the geriatrics department of a provincial medical centre in China. PARTICIPANTS: A total of 580 patients aged 50 and over were enrolled in the study. The mean age of the group was 64.82±11.4 years, and 63.1% were male. PRIMARY OUTCOME MEASURES: Associations of age with CAVI values and BMD. Associations between BMD and CAVI values. RESULTS: With increasing age, CAVI values gradually increased (p<0.001) and the femoral neck (FN) and total hip (TH) BMD gradually decreased (p<0.001, all). In the bivariate correlation analyses between the covariates and CAVI values, age and CAVI values showed the greatest positive correlation (r=0.631, p<0.001), and CAVI values were negatively correlated with FN BMD (r=−0.229, p<0.001) and TH BMD (r=−0.218, p<0.001). In the linear regression analyses, TH BMD (B=−1.812 (95% CI −2.475 to −1.149), p<0.001) and FN BMD (B=−1.968 (95% CI −2.651 to −1.284), p<0.001) were negatively correlated with CAVI values. After adjusting for age, gender, body mass index, smoking, history of cardiovascular or cerebrovascular disease, history of diabetes mellitus, systolic blood pressure, high-density lipoprotein cholesterol, blood uric acid, fibrinogen and estimated glomerular filtration rate, only TH BMD was still negatively correlated with CAVI values (B=−0.843 (95%CI −1.454 to −0.232), p=0.007). However, there was no consistent and significant correlation between lumbar spine BMD and CAVI values. CONCLUSION: In this cross-sectional study, a significant correlation between TH BMD and CAVI values was observed in middle-aged and elderly Chinese inpatients. However, our cohort was a small sample of inpatients, and prospective studies from more centres are expected.