Abdominal aortic calcification and risk of fracture among older women - The SOF study

Szulc, Pawel; Blackwell, Terri; Kiel, Douglas P; Schousboe, John T; Cauley, Jane; Hillier, Teresa; Hochberg, Marc; Rodondi, Nicolas; Taylor, Brent C; Black, Dennis; Cummings, Steven; Ensrud, Kristine E (2015). Abdominal aortic calcification and risk of fracture among older women - The SOF study. Bone, 81, pp. 16-23. Elsevier 10.1016/j.bone.2015.06.019

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Data concerning the link between severity of abdominal aortic calcification (AAC) and fracture risk in postmenopausal women are discordant. This association may vary by skeletal site and duration of follow-up. Our aim was to assess the association between the AAC severity and fracture risk in older women over the short- and long term. This is a case-cohort study nested in a large multicenter prospective cohort study. The association between AAC and fracture was assessed using Odds Ratios (OR) and 95% confidence intervals (95%CI) for vertebral fractures and using Hazard Risks (HR) and 95%CI for non-vertebral and hip fractures. AAC severity was evaluated from lateral spine radiographs using Kauppila's semiquantitative score. Severe AAC (AAC score 5+) was associated with higher risk of vertebral fracture during 4 years of follow-up, after adjustment for confounders (age, BMI, walking, smoking, hip bone mineral density, prevalent vertebral fracture, systolic blood pressure, hormone replacement therapy) (OR=2.31, 95%CI: 1.24-4.30, p<0.01). In a similar model, severe AAC was associated with an increase in the hip fracture risk (HR=2.88, 95%CI: 1.00-8.36, p=0.05). AAC was not associated with the risk of any non-vertebral fracture. AAC was not associated with the fracture risk after 15 years of follow-up. In elderly women, severe AAC is associated with higher short-term risk of vertebral and hip fractures, but not with the long-term risk of these fractures. There is no association between AAC and risk of non-vertebral-non-hip fracture in older women. Our findings lend further support to the hypothesis that AAC and skeletal fragility are related.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine

UniBE Contributor:

Rodondi, Nicolas








Jacques Donzé

Date Deposited:

23 Mar 2016 11:54

Last Modified:

26 Mar 2016 12:23

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Abdominal aortic calcification; Bone mineral density; Elderly women; Fragility fracture





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