Skip to main content
Top
Published in: Clinical Rheumatology 2/2009

01-02-2009 | Original Article

Haemoglobin levels are associated with bone mineral density in the elderly: a population-based study

Authors: Alice Laudisio, Emanuele Marzetti, Francesco Pagano, Roberto Bernabei, Giuseppe Zuccalà

Published in: Clinical Rheumatology | Issue 2/2009

Login to get access

Abstract

Hypoxemia has been associated with low bone mineral density (BMD) in animal and human models. We assessed the association of haemoglobin levels with ultrasound-derived (UD) T score, Z score and the stiffness index in all 358 subjects aged 75+ living in Tuscania (Italy). Also, we searched for the haemoglobin cutoff levels that might best identify participants with osteoporosis. In the multivariable linear regression analysis, haemoglobin levels were associated among participants with the UD T score [β = 0.13; 95% confidence interval (CI) = 0.01–0.25; p = 0.030], Z score (β = 0.11; 95% CI = 0.01–0.22; p = 0.045) and stiffness index (β = 1.87; 95% CI = 0.51–3.21; p = 0.007) after adjusting for potential confounders. Haemoglobin levels <140 g/L in men and <130 g/L in women best predicted osteoporosis in linear discriminant analysis. Haemoglobin is independently associated with all UD-BMD parameters. Haemoglobin levels <140 g/L in men and 130 g/L in women might be adopted in clinical practice to identify older subjects in whom screening for osteoporosis might yield higher effectiveness.
Literature
1.
go back to reference Johnell O, Kanis JA (2004) An estimate of the worldwide prevalence, mortality and disability associated with hip fracture. Osteoporos Int 15:897–902PubMedCrossRef Johnell O, Kanis JA (2004) An estimate of the worldwide prevalence, mortality and disability associated with hip fracture. Osteoporos Int 15:897–902PubMedCrossRef
2.
go back to reference Kannus P, Niemi S, Parkkari J, Palvanen M, Vuori I, Jarvinen M (1999) Hip fractures in Finland between 1970 and 1997 and predictions for the future. Lancet 353:802–805PubMedCrossRef Kannus P, Niemi S, Parkkari J, Palvanen M, Vuori I, Jarvinen M (1999) Hip fractures in Finland between 1970 and 1997 and predictions for the future. Lancet 353:802–805PubMedCrossRef
3.
go back to reference Braithwaite RS, Col NF, Wong JB (2003) Estimating hip fracture morbidity, mortality and costs. J Am Geriatr Soc 51:364–70PubMedCrossRef Braithwaite RS, Col NF, Wong JB (2003) Estimating hip fracture morbidity, mortality and costs. J Am Geriatr Soc 51:364–70PubMedCrossRef
4.
go back to reference Penninx BW, Pahor M, Woodman RC, Guralnik JM (2006) Anemia in old age is associated with increased mortality and hospitalization. J Gerontol A Biol Sci Med Sci 61:474–479PubMed Penninx BW, Pahor M, Woodman RC, Guralnik JM (2006) Anemia in old age is associated with increased mortality and hospitalization. J Gerontol A Biol Sci Med Sci 61:474–479PubMed
5.
go back to reference Fujimoto H, Fujimoto K, Ueda A, Ohata M (1999) Hypoxemia is a risk factor for bone mass loss. J Bone Miner Metab 17:211–216PubMedCrossRef Fujimoto H, Fujimoto K, Ueda A, Ohata M (1999) Hypoxemia is a risk factor for bone mass loss. J Bone Miner Metab 17:211–216PubMedCrossRef
6.
go back to reference Karul AB, Karadag F, Yensel N, Altinisik M, Altun C, Cildag O (2003) Should COPD patients be routinely evaluated for bone mineral density? J Bone Miner Metab 21:242–246 Karul AB, Karadag F, Yensel N, Altinisik M, Altun C, Cildag O (2003) Should COPD patients be routinely evaluated for bone mineral density? J Bone Miner Metab 21:242–246
7.
go back to reference Laudisio A, Marzetti E, Antonica L, Cocchi A, Bernabei R, Zuccalà G (2008) Association of left ventricular function with bone mineral density in older women: a population-based study. Calcif Tissue Int 82:27–33PubMedCrossRef Laudisio A, Marzetti E, Antonica L, Cocchi A, Bernabei R, Zuccalà G (2008) Association of left ventricular function with bone mineral density in older women: a population-based study. Calcif Tissue Int 82:27–33PubMedCrossRef
8.
go back to reference Sarrai M, Duroseau H, D’Augustine J, Moktan S, Bellevue R (2007) Bone mass density in adults with sickle cell disease. Br J Haematol 136:666–672PubMedCrossRef Sarrai M, Duroseau H, D’Augustine J, Moktan S, Bellevue R (2007) Bone mass density in adults with sickle cell disease. Br J Haematol 136:666–672PubMedCrossRef
9.
go back to reference Gasche C (2000) Complications of inflammatory bowel disease. Hepatogastroenterology 47:49–56PubMed Gasche C (2000) Complications of inflammatory bowel disease. Hepatogastroenterology 47:49–56PubMed
10.
go back to reference Taal MW, Masud T, Green D, Cassidy MJ (1999) Risk factors for reduced bone density in haemodialysis patients. Nephrol Dial Transplant 14:1922–1928PubMedCrossRef Taal MW, Masud T, Green D, Cassidy MJ (1999) Risk factors for reduced bone density in haemodialysis patients. Nephrol Dial Transplant 14:1922–1928PubMedCrossRef
11.
go back to reference Gaddi A, Cicero AF, Wani FO, Dormi A, Pasquarelli V, D’Addato S (2001) The realization of a project aimed at reducing the plasmatic lipid level in a large Italian population improves the mean calcium daily intake: the Brisighella Study. Eur J Clin Nutr 55:97–106PubMedCrossRef Gaddi A, Cicero AF, Wani FO, Dormi A, Pasquarelli V, D’Addato S (2001) The realization of a project aimed at reducing the plasmatic lipid level in a large Italian population improves the mean calcium daily intake: the Brisighella Study. Eur J Clin Nutr 55:97–106PubMedCrossRef
12.
go back to reference Washburn RA, Smith KW, Jette AM, Janney CA (1993) The Physical Activity Scale for the Elderly (PASE): development and evaluation. J Clin Epidemiol 46:153–162PubMedCrossRef Washburn RA, Smith KW, Jette AM, Janney CA (1993) The Physical Activity Scale for the Elderly (PASE): development and evaluation. J Clin Epidemiol 46:153–162PubMedCrossRef
13.
go back to reference Pahor M, Chrischilles EA, Guralnik JM, Brown SL, Wallace RB, Carbonin P (1994) Drug data coding and analysis in epidemiologic studies. Eur J Clin Epidemiol 10:405–411CrossRef Pahor M, Chrischilles EA, Guralnik JM, Brown SL, Wallace RB, Carbonin P (1994) Drug data coding and analysis in epidemiologic studies. Eur J Clin Epidemiol 10:405–411CrossRef
14.
go back to reference PHS–HCFA (1980) International classification of diseases, 9th rev. Public Health Service–Health Care Financing Administration, Washington, DC PHS–HCFA (1980) International classification of diseases, 9th rev. Public Health Service–Health Care Financing Administration, Washington, DC
15.
go back to reference World Health Organization. Nutritional Anaemias (1968) Report of a WHO Scientific Group. Technical Report Series No. 405. World Health Organization, Geneva World Health Organization. Nutritional Anaemias (1968) Report of a WHO Scientific Group. Technical Report Series No. 405. World Health Organization, Geneva
16.
go back to reference Krieg MA, Cornuz J, Ruffieux C, Sandini L, Büche D, Dambacher MA, Hartl F, Häuselmann HJ, Kraenzlin M, Lippuner K, Neff M, Pancaldi P, Rizzoli R, Tanzi F, Theiler R, Tyndall A, Wimpfheimer K, Burckhardt P (2003) Comparison of three bone ultrasounds for the discrimination of subjects with and without osteoporotic fractures among 7562 elderly women. J Bone Miner Res 18:1261–1266PubMedCrossRef Krieg MA, Cornuz J, Ruffieux C, Sandini L, Büche D, Dambacher MA, Hartl F, Häuselmann HJ, Kraenzlin M, Lippuner K, Neff M, Pancaldi P, Rizzoli R, Tanzi F, Theiler R, Tyndall A, Wimpfheimer K, Burckhardt P (2003) Comparison of three bone ultrasounds for the discrimination of subjects with and without osteoporotic fractures among 7562 elderly women. J Bone Miner Res 18:1261–1266PubMedCrossRef
17.
go back to reference Langton CM, Palmer SB, Porter RW (1984) The measurement of broadband ultrasonic attenuation in cancellous bone. Eng Med 13:89–91PubMedCrossRef Langton CM, Palmer SB, Porter RW (1984) The measurement of broadband ultrasonic attenuation in cancellous bone. Eng Med 13:89–91PubMedCrossRef
18.
go back to reference WHO scientific group on the prevention and management of osteoporosis (2000) Prevention and management of osteoporosis: report of a WHO scientific group. WHO technical report series, 921 Geneva, WHO Library WHO scientific group on the prevention and management of osteoporosis (2000) Prevention and management of osteoporosis: report of a WHO scientific group. WHO technical report series, 921 Geneva, WHO Library
19.
go back to reference Kanis JA, Gluer CC (2000) An update on the diagnosis and assessment of osteoporosis with densitometry. Committee of Scientific Advisors, International Osteoporosis Foundation. Osteoporos Int 11:192–202PubMedCrossRef Kanis JA, Gluer CC (2000) An update on the diagnosis and assessment of osteoporosis with densitometry. Committee of Scientific Advisors, International Osteoporosis Foundation. Osteoporos Int 11:192–202PubMedCrossRef
20.
go back to reference Cooper C, Campion G, Melton LJ 3rd (1992) Hip fractures in the elderly: a world-wide projection. Osteoporosis Int 2:285–289CrossRef Cooper C, Campion G, Melton LJ 3rd (1992) Hip fractures in the elderly: a world-wide projection. Osteoporosis Int 2:285–289CrossRef
21.
go back to reference National Center for health statistics (1986) 1985 summary, national hospital discharge survey; advance data from vital and health statistics, n 127. DHHS (PHS) 86–1250. Hyattsville, MD, Sept. 25 National Center for health statistics (1986) 1985 summary, national hospital discharge survey; advance data from vital and health statistics, n 127. DHHS (PHS) 86–1250. Hyattsville, MD, Sept. 25
22.
go back to reference Autier P, Haentjens P, Bentin J, Baillon JM, Grivegnée AR, Closon MC, Boonen S (2000) Costs induced by hip fractures: a prospective controlled study in Belgium. Osteoporosis Int 11:373–380CrossRef Autier P, Haentjens P, Bentin J, Baillon JM, Grivegnée AR, Closon MC, Boonen S (2000) Costs induced by hip fractures: a prospective controlled study in Belgium. Osteoporosis Int 11:373–380CrossRef
23.
go back to reference Schousboe JT, Taylor BC, Fink HA, Kane RL, Cummings SR, Orwoll ES, Melton LJ 3rd, Bauer DC, Ensrud KE (2007) Cost-effectiveness of bone densitometry followed by treatment of osteoporosis in older men. JAMA 298:629–637PubMedCrossRef Schousboe JT, Taylor BC, Fink HA, Kane RL, Cummings SR, Orwoll ES, Melton LJ 3rd, Bauer DC, Ensrud KE (2007) Cost-effectiveness of bone densitometry followed by treatment of osteoporosis in older men. JAMA 298:629–637PubMedCrossRef
24.
go back to reference Penninx BW, Guralnik JM, Onder G, Ferrucci L, Wallace RB, Pahor M (2003) Anemia and decline in physical performance among older persons. Am J Med 115:104–110PubMedCrossRef Penninx BW, Guralnik JM, Onder G, Ferrucci L, Wallace RB, Pahor M (2003) Anemia and decline in physical performance among older persons. Am J Med 115:104–110PubMedCrossRef
25.
go back to reference Penninx BW, Pahor M, Cesari M, Corsi AM, Woodman RC, Bandinelli S, Guralnik JM, Ferrucci L (2004) Anemia is associated with disability and decreased physical performance and muscle strength in the elderly. J Am Geriatr Soc 52:719–724PubMedCrossRef Penninx BW, Pahor M, Cesari M, Corsi AM, Woodman RC, Bandinelli S, Guralnik JM, Ferrucci L (2004) Anemia is associated with disability and decreased physical performance and muscle strength in the elderly. J Am Geriatr Soc 52:719–724PubMedCrossRef
26.
go back to reference Woodman R, Ferrucci L, Guralnik J (2005) Anemia in older adults. Curr Opin Hematol 12:123–128PubMed Woodman R, Ferrucci L, Guralnik J (2005) Anemia in older adults. Curr Opin Hematol 12:123–128PubMed
27.
go back to reference Penninx BW, Pluijm SM, Lips P, Woodman R, Miedema K, Guralnik JM, Deeg DJ (2005) Late-life anemia is associated with increased risk of recurrent falls. J Am Geriatr Soc 53:2106–2111PubMedCrossRef Penninx BW, Pluijm SM, Lips P, Woodman R, Miedema K, Guralnik JM, Deeg DJ (2005) Late-life anemia is associated with increased risk of recurrent falls. J Am Geriatr Soc 53:2106–2111PubMedCrossRef
28.
go back to reference Mineo TC, Ambrogi V, Mineo D, Fabbri A, Fabbrini E, Massoud R (2005) Bone mineral density improvement after lung volume reduction surgery for severe emphysema. Chest 127:1960–1966PubMedCrossRef Mineo TC, Ambrogi V, Mineo D, Fabbri A, Fabbrini E, Massoud R (2005) Bone mineral density improvement after lung volume reduction surgery for severe emphysema. Chest 127:1960–1966PubMedCrossRef
29.
go back to reference Leng S, Chaves P, Koenig K, Walston J (2002) Serum interleukin-6 and hemoglobin as physiological correlates in the geriatric syndrome of frailty: a pilot study. J Am Geriatr Soc 50:1268–1271PubMedCrossRef Leng S, Chaves P, Koenig K, Walston J (2002) Serum interleukin-6 and hemoglobin as physiological correlates in the geriatric syndrome of frailty: a pilot study. J Am Geriatr Soc 50:1268–1271PubMedCrossRef
30.
go back to reference Cesari M, Pahor M, Lauretani F, Penninx BW, Bartali B, Russo R, Cherubini A, Woodman R, Bandinelli S, Guralnik JM, Ferrucci L (2005) Bone density and hemoglobin levels in older persons: results from the InCHIANTI study. Osteoporos Int 16:691–699PubMedCrossRef Cesari M, Pahor M, Lauretani F, Penninx BW, Bartali B, Russo R, Cherubini A, Woodman R, Bandinelli S, Guralnik JM, Ferrucci L (2005) Bone density and hemoglobin levels in older persons: results from the InCHIANTI study. Osteoporos Int 16:691–699PubMedCrossRef
31.
go back to reference Laudisio A, Marzetti E, Antonica L, Settanni S, Georgakakis I, Bernabei R, Franceschi C, Zuccalà G (2007) Masticatory dysfunction is associated with osteoporosis in older men. J Clin Periodontol 34:964–968PubMedCrossRef Laudisio A, Marzetti E, Antonica L, Settanni S, Georgakakis I, Bernabei R, Franceschi C, Zuccalà G (2007) Masticatory dysfunction is associated with osteoporosis in older men. J Clin Periodontol 34:964–968PubMedCrossRef
32.
go back to reference Cauley JA, Danielson ME, Boudreau RM, Forrest KY, Zmuda JM, Pahor M, Tylavsky FA, Cummings SR, Harris TB, Newman AB, Health ABC Study (2007) Inflammatory markers and incident fracture risk in older men and women: the health aging and body composition study. J Bone Miner Res 22:1088–1095PubMedCrossRef Cauley JA, Danielson ME, Boudreau RM, Forrest KY, Zmuda JM, Pahor M, Tylavsky FA, Cummings SR, Harris TB, Newman AB, Health ABC Study (2007) Inflammatory markers and incident fracture risk in older men and women: the health aging and body composition study. J Bone Miner Res 22:1088–1095PubMedCrossRef
33.
go back to reference Jilka RL, Hangoc G, Girasole G, Passeri G, Williams DC, Abrams JS, Boyce B, Broxmeyer H, Manolagas SC (1992) Increased osteoclast development after estrogen loss: mediation by interleukin-6. Science 257:88–91PubMedCrossRef Jilka RL, Hangoc G, Girasole G, Passeri G, Williams DC, Abrams JS, Boyce B, Broxmeyer H, Manolagas SC (1992) Increased osteoclast development after estrogen loss: mediation by interleukin-6. Science 257:88–91PubMedCrossRef
34.
go back to reference Wieczorowska-Tobis K, Niemir ZI, Podkówka R, Korybalska K, Mossakowska M, Breborowicz A (2006) Can an increased level of circulating IL-8 be a predictor of human longevity. Med Sci Monit 12:CR118–CR121PubMed Wieczorowska-Tobis K, Niemir ZI, Podkówka R, Korybalska K, Mossakowska M, Breborowicz A (2006) Can an increased level of circulating IL-8 be a predictor of human longevity. Med Sci Monit 12:CR118–CR121PubMed
35.
go back to reference Baraldi-Junkins CA, Beck AC, Rothstein G (2000) Hematopoieis and cytokines. Relevance to cancer and aging. Hematol Oncol Clin North Am 14:45–61PubMedCrossRef Baraldi-Junkins CA, Beck AC, Rothstein G (2000) Hematopoieis and cytokines. Relevance to cancer and aging. Hematol Oncol Clin North Am 14:45–61PubMedCrossRef
36.
go back to reference Skedros JG, Sybrowsky CL, Stoddard GJ (2007) The osteoporosis self-assessment screening tool: a useful tool for the orthopaedic surgeon. J Bone Joint Surg Am 89:765–772PubMedCrossRef Skedros JG, Sybrowsky CL, Stoddard GJ (2007) The osteoporosis self-assessment screening tool: a useful tool for the orthopaedic surgeon. J Bone Joint Surg Am 89:765–772PubMedCrossRef
37.
go back to reference Nayak S, Olkin I, Liu H, Grabe M, Gould MK, Allen IE, Owens DK, Bravata DM (2006) Meta-analysis: accuracy of quantitative ultrasound for identifying patients with osteoporosis. Ann Intern Med 144:832–841PubMed Nayak S, Olkin I, Liu H, Grabe M, Gould MK, Allen IE, Owens DK, Bravata DM (2006) Meta-analysis: accuracy of quantitative ultrasound for identifying patients with osteoporosis. Ann Intern Med 144:832–841PubMed
38.
go back to reference Marín F, González-Macías J, Díez-Pérez A, Palma S, Delgado-Rodríguez M (2006) Relationship between bone quantitative ultrasound and fractures: a meta-analysis. J Bone Miner Res 21:1126–1135PubMedCrossRef Marín F, González-Macías J, Díez-Pérez A, Palma S, Delgado-Rodríguez M (2006) Relationship between bone quantitative ultrasound and fractures: a meta-analysis. J Bone Miner Res 21:1126–1135PubMedCrossRef
Metadata
Title
Haemoglobin levels are associated with bone mineral density in the elderly: a population-based study
Authors
Alice Laudisio
Emanuele Marzetti
Francesco Pagano
Roberto Bernabei
Giuseppe Zuccalà
Publication date
01-02-2009
Publisher
Springer-Verlag
Published in
Clinical Rheumatology / Issue 2/2009
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-008-0998-6

Other articles of this Issue 2/2009

Clinical Rheumatology 2/2009 Go to the issue