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Factors associated with the lumbar spine and proximal femur bone mineral density in older men

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Abstract

Bone mass is a major determinant of fracture, but there have been few comprehensive studies of the correlates of bone mineral density (BMD) in older men. The objective of the current cross-sectional analysis was to determine the factors associated with BMD of the lumbar spine and proximal femur in a large population-based sample of older men enrolled in The Osteoporotic Fractures in Men Study, “Mr.OS.” We enrolled 5,995 men 65 years of age or older, 89% Caucasian, in Mr.OS at six US clinical centers. Demographic, medical and family history and lifestyle information was obtained by interview and physical function and anthropometric data by examination. Spine and hip BMD was measured using dual-energy X-ray absorptimetry. The multivariable linear regression models predicted 19 and 10% of the overall variance in BMD of the femoral neck and spine, respectively. African-American men had 6 to 11% higher BMD than Caucasian men independent of multiple factors. Hip BMD declined with advancing age, while spine BMD increased. Body weight (per 10 kg) and self report of diabetes were each associated with 2 to 4% higher BMD, while history of a non-trauma fracture and current use of selective serotonin reuptake inhibitors, but not other antidepressants, were associated with at least 4% lower BMD. Both maternal and paternal histories of fracture were associated with 1.4–1.7% lower BMD. Osteoarthritis, physical activity, grip strength, alcohol intake, and dietary calcium were positively related to BMD, while a history of chronic lung disease, prostate cancer, and kidney stones was associated with lower BMD. Smoking, caffeine intake, and thiazide diuretics were not related to BMD in older men. A number of lifestyle and behavioral characteristics and medical conditions were associated with BMD in older men. Identification of these correlates could improve methods to identify men at risk for fracture and improve our understanding of fracture etiology.

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Acknowledgement

Investigators in the Osteoporotic Fractures in Men (MrOS) Research Group: Coordinating center (University of California, San Francisco and California Pacific Medical Center Research Institute): S.R. Cummings (principal investigator), M.C. Nevitt (co-investigator), D.C. Bauer (co-investigator), K.L. Stone (co-investigator), D.M. Black (co-investigator), P.M. Cawthon (project director), R. Fullman (research associate), R. Benard, T. Blackwell, J. Diehl, S. Ewing, C.Fox, M. Jaime-Chavez, E. Kwan, S.Litwack, L.Y.Lui, A. Mills, L. Palermo, J. Schneider, R.Scott, D. Tanaka, C. Yeung; Administrative Center (Oregon Health and Sciences University): E. Orwoll (principal Investigator), L. Marshall (co-investigator), J. Babich Blank (project director), L. Lambert, B. Chan, D. Neevel, J. Mougey, L. Press; University of Alabama, Birmingham: C.E. Lewis (principal investigator), J. Shikany (co-investigator), P. Johnson (project director), E. Clavino, C. Oden, N. Webb, K. Hardy, S. Felder, P. Grayson, J. Wilkoff, J. King, T. Johnsey, J. Thompson; University of Minnesota: K. Ensrud (principal investigator), H. Fink (co-investigator), D. King (program manager), N. Michaels (asst. program manager), N. Nelson (clinic coordinator), C. Bird, D. Blanks, F. Imker-Witte, K. Moen, M. Paudel, M. Slindee; Stanford University: M. Stefanick (principal investigator), A. Hoffman (co-investigator), E. Moore (project director), K. Kent, B. Malig, S. Wong; University of Pittsburgh: J. Cauley (principal investigator), J. Zmuda (co-investigator), M.Danielson, L. Harper (project director), L. Buck (clinic coordinator), M. Nasim, D. Cusick, D. Moore, M. Gorecki, D. Lee, N. Watson, C. Bashada, C. Newman, G. Engleka; Univestiry of California, San Deigo: E. Barrett-Connor (principal investigator), T. Dam (co-investigator), M.L. Carrion-Petersen (project director), P. Miller, N. Kamantigue, S. Szerdi, G. Reno.

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Authors and Affiliations

  1. Department of Epidemiology, University of Pittsburgh, 130 DeSoto Street, Crabtree Hall A524, Pittsburgh, PA, 15261, USA

    Jane A. Cauley & Joseph M. Zmuda

  2. California Pacific Medical Center Research Institute, San Francisco, CA, 94105, USA

    Robin L. Fullman

  3. Department of Medicine, University of California, San Francisco, CA, 94143, USA

    Katie L. Stone & Douglas C. Bauer

  4. University of California, San Diego, CA, 92093, USA

    Elizabeth Barrett-Connor

  5. Department of Medicine and Epidemiology, VA Medical Center and University of Minnesota, Minneapolis, MN, 55415, USA

    Kristine Ensrud

  6. Department of Community and Family Medicine, Chinese University of Hong Kong, Shatin N.T., Hong Kong, New Territories

    Edith M. C. Lau

  7. Oregon Health and Sciences University, Portland, OR, 97239-3098, USA

    Eric S. Orwoll

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  1. Jane A. Cauley
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  2. Robin L. Fullman
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  3. Katie L. Stone
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  4. Joseph M. Zmuda
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  5. Douglas C. Bauer
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  6. Elizabeth Barrett-Connor
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  7. Kristine Ensrud
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  8. Edith M. C. Lau
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  9. Eric S. Orwoll
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For the Mr. OS Research Group

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Correspondence to Jane A. Cauley.

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The authors represent the Osteoporotic Fractures in Men (Mr.OS) Research Group. The Osteoporotic Fractures in Men (MrOS) Study is supported by National Institutes of Health funding. The following institutes provided support: the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Institute on Aging (NIA), and the National Cancer Institute (NCI), under the following grant numbers: UO1 AG18197-02, UO1 AR45580-02, UO1 AR45614, UO1 AR45632, UO1 AR45647, UO1 AR45654, UO1 AR45583, and M01 RR00334.

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Cauley, J.A., Fullman, R.L., Stone, K.L. et al. Factors associated with the lumbar spine and proximal femur bone mineral density in older men. Osteoporos Int 16, 1525–1537 (2005). https://doi.org/10.1007/s00198-005-1866-8

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