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Low heel ultrasound parameters predict mortality in men: Results from the European Male Ageing Study (EMAS)

Pye, SR and Vanderschueren, D and Boonen, S and Gielen, E and Adams, JE and Ward, KA and Lee, DM and Bartfai, G and Casanueva, FF and Finn, JD and Forti, G and Giwercman, A and Han, TS and Huhtaniemi, IT and Kula, K and Lean, ME and Pendleton, N and Punab, M and Wu, FC and O'Neill, TW (2015) Low heel ultrasound parameters predict mortality in men: Results from the European Male Ageing Study (EMAS). Age and Ageing, 44 (5). pp. 801-807. ISSN 0002-0729

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Abstract

© The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. Background: low bone mineral density measured by dual-energy x-ray absorptiometry is associated with increased mortality. The relationship between other skeletal phenotypes and mortality is unclear. The aim of this study was to determine the relationship between quantitative heel ultrasound parameters and mortality in a cohort of European men. Methods: men aged 40-79 years were recruited for participation in a prospective study of male ageing: the European Male Ageing Study (EMAS). At baseline, subjects attended for quantitative ultrasound (QUS) of the heel (Hologic-SAHARA) and completed questionnaires on lifestyle factors and co-morbidities. Height and weight were measured. After a median of 4.3 years, subjects were invited to attend a follow-up assessment, and reasons for non-participation, including death, were recorded. The relationship between QUS parameters (broadband ultrasound attenuation [BUA] and speed of sound [SOS] ) and mortality was assessed using Cox proportional hazards model. Results: from a total of 3,244 men (mean age 59.8, standard deviation [SD] 10.8 years), 185 (5.7%) died during the follow-up period. After adjusting for age, centre, body mass index, physical activity, current smoking, number of co-morbidities and general health, each SD decrease in BUAwas associated with a 20% higher risk of mortality (hazard ratio [HR] per SD = 1.2; 95% confidence interval [CI] = 1.0-1.4). Compared with those in higher quintiles (2nd-5th), those in the lowest quintile of BUA and SOS had a greater mortality risk (BUA: HR = 1.6; 95% CI = 1.1-2.3 and SOS: HR = 1.6; 95% CI = 1.2-2.2). Conclusion: lower heel ultrasound parameters are associated with increased mortality in European men.

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