Cigarette smoking and hip volumetric bone mineral density and cortical volume loss in older adults: The AGES-Reykjavik study.

• Main Authors: Marques, Elisa A, Elbejjani, Martine, Gudnason, Vilmundur, Sigurdsson, Gunnar, Lang, Thomas, Sigurdsson, Sigurdur, Aspelund, Thor, Siggeirsdottir, Kristin, Launer, Lenore, Eiriksdottir, Gudny, Harris, Tamara B
• Format: Article in Journal/Newspaper
• Language: unknown
• Published: eScholarship, University of California 2018
• Subjects: Pelvic Bones; Humans; Bone Resorption; Tomography; X-Ray Computed; Bone Density; Aged; 80 and over; Iceland; Female; Male; Cortical Bone; Cigarette Smoking; Aging; Bone QCT; General population studies; Proximal femur; Smoker; Osteoporosis; Clinical Research; Tobacco; Tobacco Smoke and Health; Prevention; Prevention of disease and conditions; and promotion of well-being; 3.1 Primary prevention interventions to modify behaviours or promote wellbeing; Cancer; Musculoskeletal; Biological Sciences; Engineering; Medical and Health Sciences; Endocrinology & Metabolism
• Online Access: https://escholarship.org/uc/item/5sj6n38z

This study aimed to explore the relationships of several indicators of cigarette smoking habits (smoking status, pack-years, age at smoking initiation and smoking cessation) with quantitative computed tomographic (QCT)-derived proximal femur bone measures (trabecular vBMD, integral vBMD and the ratio of cortical to total tissue volume (cvol/ivol)) and with subsequent change in these measures over the next five years. A total of 2673 older adults (55.9% women), aged 66-92 years at baseline from the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study, who had two QCT scans of the hip were studied. In multivariable linear regression models, compared to never-smokers, current smokers had lower cvol/ivol at baseline and former-smokers had poorer measures on all outcomes (lower trabecular vBMD, integral vBMD and cvol/ivol), even when adjusted for several potential confounders. Further, among former smokers, those with higher pack-years had worse bone outcomes and those with longer duration since smoking cessation had better bone health at baseline. Analyses of change in bone measures revealed that compared to never-smokers, current smokers had significantly greater loss of trabecular vBMD, integral vBMD, and cvol/ivol. The regression models included adjustment for sex, age, education, and baseline body mass index, creatinine, % weight change from age 50, 25OHD, physical activity level, high-sensitive C-Reactive protein levels, alcohol and coffee consumption, history of diabetes mellitus, arthritis, and respiratory diseases. In conclusion, both current and former smoking showed adverse associations with bone health assessed with QCT. Results suggest that current smoking in particular may aggravate the rate of bone loss at older age and highlight implications for targeting this risk factor in populations that present higher smoking prevalence and vulnerability to bone fragility.