Predictive value of brachial-ankle pulse wave velocity>1 400 cm/s in fragility fracture in middle-aged and elderly population / 中华内分泌代谢杂志

ABSTRACT

Objective:To explore the predictive value of brachial-ankle pulse wave velocity (baPWV)>1 400 cm/s in fragility fracture in middle-aged and elderly population.Methods:From May to October 2011, questionnaire survey was conducted on a total of 3 265 males over 50 years old and postmenopausal females in Yunyan District, Guiyang City, and physical examination was carried out to measure their metabolic related indicators such as blood lipids, QUS calcaneus bone densities, and brachial-ankle pulse wave velocities. According to their baPWV, the enrolled subjects were divided into a normal baPWV group and an elevated baPWV group. Follow-up was performed for 38 months, and the incidence of fractures was tracked. Finally, 2 637 subjects with complete baseline and follow-up data were enrolled in this research for analysis.Results:The 3-year total incidence of fragility fracture was 5.08%. In particular, the rate of fragility fractures among males in the normal baPWV group was 1.6%, and that in the elevated baPWV group was 2.0%. There was no statistically significant difference between the two groups ( P>0.05). The rate of fragility fracture events among postmenopausal females in the normal baPWV group was 4.4%, and that in the elevated baPWV group was 7.1%. There was statistically significant difference between the two groups ( P<0.05). Further multivariate COX regression (or proportional hazards regression) analysis showed that the bone density T value ( HR 0.839, 95% CI 0.741-0.952, P=0.006) and baPWV ( HR 1.700, 95% CI 1.046-2.763, P=0.042) were related with risk of fragility fractures in postmenopausal women. Conclusion:A baPWV greater than 1 400 cm/s could be independently associated with the risk of fragility fractures in postmenopausal females and might be an independent risk factor for predicting fragility fractures. However, such differences were not as evident in middle-aged and elderly male patients.