Associations of the 10-year probability of osteoporotic fractures with the total cardiovascular risk and cardiovascular diseases due to atherosclerosis among urban and rural populations

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OBJECTIVE

To analyze the relationship of the absolute risk (AR) of osteoporotic fractures (AR-OF) with the total cardiovascular risk (CVR) and cardiovascular diseases caused by atherosclerosis (CVD-A) among the urban and rural population of the Russian Federation.

MATERIAL AND METHODS

The study included representative samples of urban and rural population of men (n=1821) and women (n=2427) aged 40—69 years from 4 regions of the Russian Federation: the Republic of Karelia, Krasnodar Krai, Ryazan and Omsk regions, surveyed in the framework of the ESSE-RF-2 project. AR-OF was evaluated using the Russian FRAX model without taking into account bone mineral density. The total CVR was studied in individuals under 65 years of age based on the SCORE scale for high-risk countries. In patients with a history of angina pectoris, myocardial infarction, stroke, heart rhythm disorders, the relationship of these diseases with AR-OF was also studied.

RESULTS

Among all study participants, the frequency of high AR of major fractures (MF) was 6.4%. High and very high CVR was detected in 9.7% of 40—64-year-old population with no history of CVD-A and diabetes mellitus. Among women living in the city, compared to rural women the high AR-MF was more often registered (10.5% vs 7.5%; p<0.05), at the same time, there were no such differences in men. The frequency of high and very high CVR was the same among urban and rural residents and didn’t depend on the gender. In both women and men, regardless their place of residence a significant direct correlation of AR-OF was found with CVR. In the presence of high and very high CVR (≥5%) this relationship was confirmed by the logistic regression analysis: AR-hip fractures (HF) ≥1% increased 1.8 times (95% CI 1.4—2.2; p<0.001), AR-MF ≥10% — 1.4 times (95% CI 1.2—1.8; p<0.05), high AR-MF, according to the threshold of therapeutic intervention — 1.3 times (95% CI 1.2—1.7; p<0.05). Among the urban and rural population a positive correlation of all studied CVD-A with AR-MF and AR-HF was found only in women, while in men — only with AR-HF.

CONCLUSION

It was shown that the AR-OF and CVR in men didn’t depend on the type of settlement. In women, the type of settlement affected the distribution of the AR-OF and this risk was higher in urban women compared to those who lived in rural areas. It was found that high AR of MF and HF was associated with high and very high CVR regardless of gender. At the same time, in women the relationship between CVD-A and AR-MF and AR-HF was found while in men only with AR-HF. The identified associations related to both urban and rural populations.

Keywords:

osteoporosis

osteoporotic fractures

10-year probability of fractures

risk of fractures

cardiovascular disease

atherosclerosis

total cardiovascular risk

urban population

rural population

Authors:

Myagkova M.A.

National Medical Research Center for Therapy and Preventive Medicine

Skripnikova I.A.

National Medical Research Center for Therapy and Preventive Medicine

Shalnova S.A.

National Medical Research Center for Therapy and Preventive Medicine

SPIN RSCI: 9189-8637
Scopus AuthorID: 6603427718
ORCID: 0000-0003-2087-6483

Vygodin V.A.

National Medical Research Center for Therapy and Preventive Medicine

Drapkina O.M.

National Medical Research Center for Therapy and Preventive Medicine;
A.I. Yevdokimov Moscow State University of Medicine and Dentistry

SPIN RSCI: 4456-1297
Scopus AuthorID: 57208852308
ResearcherID: G-8443-2016
ORCID: 0000-0002-4453-8430

Redko A.N.

Kuban State Medical University

ORCID: 0000-0002-3454-1599

Viktorova I.A.

Omsk State Medical University

Prishchepa N.N.

Center for Medical Prevention of the Republic of Karelia

Yakushin S.S.

Ryazan State Medical University named after Academician I.P. Pavlov

Received:

12.04.2021

Accepted:

15.04.2021

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