Abstract
Summary
The relationship between social disadvantage and bone mineral density (BMD) is complex and remains unclear; furthermore, little is known of the relationship with vertebral deformities. We observed social disadvantage to be associated with BMD for females, independent of body mass index (BMI). A lower prevalence of vertebral deformities was observed for disadvantaged males.
Introduction
The relationship between social disadvantage and BMD appears complex and remains unclear, and little is known about the association between social disadvantage and vertebral wedge deformities. We examined the relationship between social disadvantage, BMD and wedge deformities in older adults from the Tasmanian Older Adult Cohort.
Methods
BMD and wedge deformities were measured by dual-energy X-ray absorptiometry and associations with extreme social disadvantage was examined in 1,074 randomly recruited population-based adults (51 % female). Socioeconomic status was assessed by Socio-economic Indexes for Areas values derived from residential addresses using Australian Bureau of Statistics 2001 census data. Lifestyle variables were collected by self-report. Regression models were adjusted for age, BMI, dietary calcium, serum vitamin D (25(OH)D), smoking, alcohol, physical inactivity, calcium/vitamin D supplements, glucocorticoids and hormone therapy (females only).
Results
Compared with other males, socially disadvantaged males were older (65.9 years versus 61.9 years, p = 0.008) and consumed lower dietary calcium and alcohol (both p ≤ 0.03). Socially disadvantaged females had greater BMI (29.9 ± 5.9 versus 27.6 ± 5.3, p = 0.002) and consumed less alcohol (p = 0.003) compared with other females. Socially disadvantaged males had fewer wedge deformities compared with other males (33.3 % versus 45.4 %, p = 0.05). After adjustment, social disadvantage was negatively associated with hip BMD for females (p = 0.02), but not for males (p = 0.70), and showed a trend for fewer wedge deformities for males (p = 0.06) but no association for females (p = 0.85).
Conclusions
Social disadvantage appears to be associated with BMD for females, independent of BMI and other osteoporosis risk factors. A lower prevalence of vertebral deformities was observed for males of extreme social disadvantage. Further research is required to elucidate potential mechanisms for these associations.
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Acknowledgements
We thank the participants who made this study possible. The assistance of J Cochrane for data extraction is gratefully acknowledged.
Funding
National Health and Medical Research Council (NHMRC) of Australia, the Arthritis Foundation of Australia, the Tasmanian Community Fund and the University of Tasmania (Institutional Research Grant scheme) funded this study. SL Brennan is the recipient of NHMRC Early Career Fellowship (1012472). AE Wluka is the recipient of NHMRC Clinical Career Development Award (545876). G Jones is the recipient of NHMRC Practitioner Fellowship (1025222).
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Brennan, S.L., Winzenberg, T.M., Pasco, J.A. et al. Social disadvantage, bone mineral density and vertebral wedge deformities in the Tasmanian Older Adult Cohort. Osteoporos Int 24, 1909–1916 (2013). https://doi.org/10.1007/s00198-012-2211-7
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DOI: https://doi.org/10.1007/s00198-012-2211-7