Association of white matter hyperintensities with BMD, incident fractures, and falls in the UK Biobank cohort

Osteoporosis is the most common metabolic bone disease globally, which increases the healthcare service burden. Recent studies have linked higher white matter hyperintensities (WMH) to reduced BMD, increasing the risk of fractures and falls in older adults. However, limited evidence exists regarding...

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Published in:Journal of bone and mineral research 2024-05, Vol.39 (4), p.408-416
Main Authors: Cai, Lishan, Lv, Xingyu, Li, Xiang, Wang, Xuan, Ma, Hao, Heianza, Yoriko, Qi, Lu, Zhou, Tao
Format: Article
Language:English
Subjects:
Accidental Falls
Aged
Biological Specimen Banks
Bone Density
Cohort Studies
Female
Fractures, Bone - diagnostic imaging
Fractures, Bone - epidemiology
Fractures, Bone - pathology
Humans
Incidence
Male
Middle Aged
UK Biobank
United Kingdom - epidemiology
White Matter - diagnostic imaging
White Matter - pathology
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Summary:Osteoporosis is the most common metabolic bone disease globally, which increases the healthcare service burden. Recent studies have linked higher white matter hyperintensities (WMH) to reduced BMD, increasing the risk of fractures and falls in older adults. However, limited evidence exists regarding the dose-response relationship between WMH and bone health in a larger and younger population. Our study aimed to examine the association of WMH volume with BMD, incident fractures and falls, focusing on dose-response relationship with varying levels of WMH volume. We included 26 410 participants from the UK Biobank. The association between WMH volume and BMD was analyzed using multiple linear regression. Cox regression models were used to estimate the hazard ratios of incident fractures and falls. Restricted cubic spline (RCS) fitted for linear and Cox regression models were employed to explore potential non-linearity. Over a mean follow-up time of 3.8 yr, we documented 59 hip fractures, 392 all fractures, and 375 fall incidents. When applying RCS, L-shaped relationships were identified between WMH volume and BMD across all 4 sites. Compared with those in the lowest fifth of WMH volume, individuals in the second to the highest fifths were associated with a reduction of 0.0102-0.0305 g/cm2 in femur neck BMD, 0.0075-0.0273 g/cm2 in femur troch BMD, 0.0173-0.0345 g/cm2 in LS BMD, and 0.0141-0.0339 g/cm2 in total body BMD. The association was more pronounced among women and younger participants under age 65 (Pinteraction 
ISSN:0884-0431
1523-4681
1523-4681
DOI:10.1093/jbmr/zjae031