Aging and Chronic Disease
To examine risk factors for bone mineral density (BMD) and osteoporosis at the femoral neck (FN) and lumbar spine (LS) in a cross-sectional study among Puerto Rican adults, 47- 77 y.
The Boston Puerto Rican Osteoporosis Study (BPROS) is an ancillary study to the Boston Puerto Rican Health Study, a cohort of 1504 Puerto Rican adults from the Greater Boston area. A total of 973 participants participated in the BPROS, where data on sociodemographics, health and health behaviors, and medication use were collected through questionnaire, and anthropometrics measured. Dietary intake and supplement use were assessed using a food frequency questionnaire. Fasting blood samples were collected for biochemical analysis. BMD (g/cm2) at the FN and LS (L2-L4) was measured using dual-energy X-ray absorptiometry. Linear regression models estimated associations between risk factors and FN and LS BMD and logistic regression for osteoporosis (T-score ≤ -2.5 g/cm2) at the FN and/or LS. A total of 680 participants had complete data on risk factors and bone measures.
Results : Average age of participants was 59.9 y ± 7.6 y and 71.3% were women. The prevalence of osteoporosis was 10.6%. Age was inversely associated with FN BMD (Table 1). BMI and height were positively associated with BMD. Neither calcium intake from food sources nor plasma 25-OH vitamin D were associated with BMD (P >0.36). Bone medication and calcium supplement use were inversely associated with BMD, likely due to reverse causation. Magnesium intake from supplements was positively associated with LS and FN BMD (β=0.07, P=0.006 and β= 0.05, P=0.008). Moderate alcohol consumption was associated with lower odds of osteoporosis, compared to no intake (OR: 0.40, P=0.02; Table 2). Current smoking (vs. never smokers) was associated with increased odds of osteoporosis (OR: 2.5, P=0.02). Magnesium from supplements was associated with lower odds of osteoporosis (OR: 0.41, P=0.04).
Conclusions : In contrast to expectation, dietary calcium and plasma 25-OH vitamin D were not associated with bone. Interestingly, magnesium intake from supplements was associated with higher BMD and lower odds of osteoporosis. This requires further investigation, as this may serve as a feasible intervention to improve BMD and decrease risk of osteoporosis in this high-risk population.
Funding Sources : NIH/NIAMS K01 AR067894, NIH P50 HL105185, P01 AG023394, and R01 AG027087