03637nas a2200517 4500008004100000022001400041245008300055210006900138260001300207300001000220490000700230520224400237653002702481653000902508653002502517653001702542653002002559653001702579653002902596653001502625653002802640653001502668653002202683653001302705653001102718653002202729653002002751653001102771653001802782653000902800653001702809653001702826653002802843653003702871653002502908653001702933653002102950653002402971653001702995100001503012700001403027700001503041700001403056700001403070856003503084 2001 eng d a0002-861400aThe association of bone mineral density and depression in an older population.0 aassociation of bone mineral density and depression in an older p c2001 Jun a732-60 v493 a

OBJECTIVE: To evaluate the association between bone mineral density (BMD) and measurements of depression in an older population.

DESIGN: Population-based, cross-sectional study.

SETTING: Study subjects were participants in the Cardiovascular Health Study (CHS), a longitudinal, long-term, follow-up study, at the University of California Davis (Sacramento, California) and the University of Pittsburgh (Pittsburgh, Pennsylvania) clinical centers.

PARTICIPANTS: A random sample of 1,566 Medicare enrollees age 65 and older enrolled in the CHS.

MEASUREMENTS: Total hip BMD, measured using dual energy x-ray absorptiometry (DEXA), after adjustment for multiple covariates, was compared with depression evaluated with the Center for Epidemiological Studies 10-item Depression Scale (CES-Dm). Risk factors for osteoporosis were compared in depressed and nondepressed participants. Potential correlates were entered into a regression model. Depression scores were compared in normal, osteopenic, and osteoporotic individuals.

RESULTS: Sixteen percent of participants were clinically depressed; 9% had BMDs in the osteoporotic range. Mean BMD was 40 mg/cm2 lower in those with clinical depression. High CES-Dm scores were associated with lower BMD (P < .001) when adjusted for body mass index (BMI), age, kilocalories of activity, estrogen use, gender, race, smoking and drinking. When stratified by race, this remained true for all Caucasians (P < .01), all African Americans (P < .05), and when stratified by race and gender the association remained only for all Caucasian women (P < .001). In women and Caucasian men there was an increase in depression scores among individuals with osteoporotic-range BMDs.

CONCLUSIONS: A significant association was found between BMD and depressive symptoms after adjustment for osteoporosis risk factors. In Caucasians, depressive symptoms were associated with both osteoporotic and osteopenic levels of BMD. Causality cannot be ascribed, with only one measurement of BMD. We postulate that there may be an unmeasured third factor, such as an endogenous steroid, that is responsible for both low BMD and depression.

10aAbsorptiometry, Photon10aAged10aAnalysis of Variance10aBlack People10aBody Mass Index10aBone Density10aBone Diseases, Metabolic10aCalifornia10aCross-Sectional Studies10aDepression10aEnergy Metabolism10aExercise10aFemale10aFollow-Up Studies10aFractures, Bone10aHumans10aLinear Models10aMale10aOsteoporosis10aPennsylvania10aPopulation Surveillance10aPsychiatric Status Rating Scales10aRadionuclide Imaging10aRisk Factors10aSex Distribution10aSingle-Blind Method10aWhite People1 aRobbins, J1 aHirsch, C1 aWhitmer, R1 aCauley, J1 aHarris, T uhttps://chs-nhlbi.org/node/65602353nas a2200217 4500008004100000022001400041245009900055210006900154260001600223520171400239100001901953700001801972700001601990700001002006700001302016700001402029700001502043700002302058700001802081856003602099 2021 eng d a1433-296500aSerum non-esterified fatty acid levels and hip fracture risk: The Cardiovascular Health Study.0 aSerum nonesterified fatty acid levels and hip fracture risk The  c2021 Mar 023 a

Among elderly participants from the Cardiovascular Health Study, we found that non-esterified trans fatty acid levels had a significant prospective association with hip fracture risk. Other non-esterified fatty acid classes were not associated with hip fracture risk.

INTRODUCTION: Serum non-esterified fatty acids (NEFAs) are bioactive metabolic intermediates that can be taken up by bone tissue. Their associations with hip fracture risk have not been previously examined.

METHODS: Thirty-five individual NEFAs in five classes (saturated [SFA], mono-un-saturated [MUFA], poly-unsaturated n-6 and n-3 [PUFA], and trans-FA) were measured in Cardiovascular Health Study participants (n = 2139, mean age 77.8 years) without known diabetes. The multivariable associations of NEFA levels with hip fracture risk were evaluated in Cox hazards models.

RESULTS: We documented 303 incident hip fractures during 11.1 years of follow-up. Among the five NEFA classes, total trans FA levels were positively associated with higher hip fracture risk (HR 1.17 [95% CI, 1.04, 1.31; p = 0.01] per one standard deviation higher level). The SFA lignoceric acid (24:0) was positively associated with higher risk (HR 1.09 [1.04, 1.1]; p < 0.001), while behenic (22:0) and docosatetraenoic (22:4 n6) acids were associated with lower risk (HR 0.76 [0.61, 0.94]; p = 0.01; 0.84 [0.70, 1.00]; p = 0.05, respectively).

CONCLUSION: Total plasma trans NEFA levels are related to hip fracture risk, suggesting an unrecognized benefit of their systematic removal from food. Novel associations of individual NEFAs with hip fracture risk require confirmation in other cohort studies.

1 aBarzilay, J, I1 aBůžková, P1 aDjoussé, L1 aIx, J1 aKizer, J1 aCauley, J1 aMatthan, N1 aLichtenstein, A, H1 aMukamal, K, J uhttps://chs-nhlbi.org/node/8702