Association between bone characteristics and cardiovascular risk factors among adults in selected urban areas in Selangor, Malaysia
Cardiovascular disease (CVD) and osteoporosis (OP) are two significant public health-care issues globally with increased morbidity and mortality. The rising proportion of the ageing population globally indicates that urgent action is required to tackle the projected burden of CVD and OP. Increasi...
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| Format: | Thesis |
| Language: | English |
| Published: |
2021
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| Subjects: | |
| Online Access: | http://psasir.upm.edu.my/id/eprint/103874/1/SAFARINA%20BINTI%20MOHAMAD%20-%20IR.pdf |
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| Summary: | Cardiovascular disease (CVD) and osteoporosis (OP) are two significant public
health-care issues globally with increased morbidity and mortality. The rising
proportion of the ageing population globally indicates that urgent action is
required to tackle the projected burden of CVD and OP. Increasing evidence now
supports a direct association between these chronic conditions. Understanding
this link in pathophysiology is important for the prevention and treatment of these
disorders. Previous studies have revealed contradicting associations between
CVD and OP. The escalating prevalence of OP and CVD globally with its
increased morbidity and mortality notwithstanding the contradictory results on
their association stresses the need for further research on this topic. No previous
study has evaluated bone characteristics with Pattern B lipoprotein profile, which
are individuals with atherogenic small dense low density lipoprotein cholesterol
(LDL) particles. Hence this study aimed to determine the associations between
bone characteristics and CVD risk factors, including Pattern B among adults in
selected urban areas in Selangor, Malaysia. This was a cross sectional study
involving 331 healthy subjects aged ≥ 45 years old from three selected
residential areas in Puchong, Serdang, and Kajang, who were invited for a health
screening at Puchong Specialist Centre. Recruitment was by convenience nonrandom
sampling. Sociodemographic factors and clinical characteristics were
recorded in the proforma after informed consent. Biochemical analyses on
fasting samples were outsourced to Pantai Premier Laboratory. Data analysis
was done using IBM SPSS Statistic version 25.0 for Windows. The prevalence
of osteopenia and osteoporosis are 41.4% and 17.2%, respectively. Pattern B is
detected in 48.9% with 39.9% having metabolic syndrome (MetS). Waist
circumference (WC) and high-density lipoprotein cholesterol (HDL) are
associated with abnormal bone mineral density (BMD) status and increased WC,
hyperglycaemia, deranged lipid profile and MetS are associated with a higher
BMD. The association between WC, fasting blood sugar (FBS), triglyceride (TG)
with BMD, respectively is not driven by total fat since the associations remained
highly significant after adjustment for total fat. However, it is gender-specific. For
HDL and MetS, however, this association with BMD is driven by total fat in
females as it becomes attenuated after adjusting for it. A higher BMD is reported
among MetS subjects but the effects of MetS on BMD varied by gender and
skeletal site. Apart from the bone resorption marker, c-terminal telopeptide of
type 1 collagen (CTX), there was no significant association between Pattern B
and bone parameters. However, after adjusting for age, gender, race and total
fat, there was no significant difference for CTX between Pattern A (individuals
with non-atherogenic large buoyant LDL) and Pattern B. The only significant
bone parameter associated with MetS is Mg, which is a protective factor. This
study’s results suggest that there are skeletal site and gender specific
differences in the association between CVD risk factors with abnormal BMD
status and BMD per se. The relative contribution of these risk factors would vary
with skeletal sites considering that the rate of bone loss at different skeletal sites
are diverse due to the variations in the composition of each bone and the
heterogeneity in bone microstructure. A higher BMD was demonstrated among
MetS subjects but the effects of MetS on BMD varied by gender and skeletal site.
The only significant bone parameter associated with MetS in this study is Mg,
which is a protective factor. MetS is a combination of CVD risk factors that
include obesity, a factor associated with increased BMD, and inflammation, a
factor that lowers BMD. In this study, the findings suggest that adiposity may
have a protective effect on BMD. |
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