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Evaluation of the Relationship Between Cardiovascular Risk and Fracture Risk in Patients Aged 65-75

Yıl 2024, Cilt: 5 Sayı: 2, 68 - 74, 30.04.2024

Öz

AIM: The aim of our study is to determine the relationship between fracture risk and cardiovascular risk in patients aged 67-75 years.
METHOD: Detailed anamnesis of the patients was taken and physical examinations were performed. Laboratory parameters including fasting plasma glucose, lipid profile, kidney, liver, thyroid functions and complete blood count were examined. Bone mineral densities were measured. Using the information obtained, cardiovascular risk scores (Framingham, SCORE, Q-Risk and BNF) and fracture risk scores (FRAX) were calculated. All cardiovascular risk score results were compared separately with FRAX and it was investigated whether there was a relationship between them.
RESULTS: 110 patients, 64 women and 46 men, were included in the study. Mean cardiovascular risk scores of the patients were calculated as follows; Framigham: 21.69 ± 11.55, SCORE: 27.14 ± 14.91, Q-Risk: 29.29 ± 12.95, BNF: 24.96 ± 14.14. Mean FRAX score was calculated as 5.59 ± 2.85. When the relationship between the scores were examined, the strongest relationship was between Framigham and Frax (r =0.42, p: <0.0001). This was followed by BNF (r =0.29, p: 0.002) and SCORE (r =0.20, p: 0.035), respectively. No significant relationship was detected between Q-risk score and FRAX (r = 0.17, p: 0.08).
CONCLUSION: There is a significant relationship between cardiovascular disease risk and fracture risk. It should be kept in mind that people with a high risk of cardiovascular disease also have a high risk of fracture, and protective measures should be taken. Likewise, people at high risk of fracture should be screened for cardiovascular diseases and treatment should be planned according to risk.

Kaynakça

  • 1. Townsend N, Nichols M, Scarborough P, Rayner M. Cardiovascular disease in Europe—epidemiological update 2015. European heart journal. 2015 Oct 21;36(40):2696-705.
  • 2. Liew SM, Blacklock C, Hislop J, Glasziou P, Mant D. Cardiovascular risk scores: qualitative study of how primary care practitioners understand and use them. British Journal of General Practice. 2013 Jun 1;63(611):e401-7.
  • 3. Sözen T, Özışık L, Başaran NÇ. An overview and management of osteoporosis. European journal of rheumatology. 2017 Mar;4(1):46.
  • 4. Tuzun S, Eskiyurt N, Akarirmak U, Saridogan M, Senocak M, Johansson H, et al. Incidence of hip fracture and prevalence of osteoporosis in Turkey: the FRACTURK study. Osteoporos Int 2012; 23: 949-55.
  • 5. D'Agostino RB, Sr Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation 2008;117:743–753.
  • 6. Conroy RM, Pyörälä K, Fitzgerald AE, Sans S, Menotti A, De Backer G, De Bacquer D, Ducimetiere P, Jousilahti P, Keil U, Njølstad I. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. European heart journal. 2003 Jun 1;24(11):987-1003.
  • 7. Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, Minhas R, Sheikh A, Brindle P. Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2. Bmj. 2008 Jun 26;336(7659):1475-82.
  • 8. Costache II, Miftode E, Petris O, Popa AD, Iliescu D, Eosefina GB. Associations between area of residence and cardiovascular risk. Revista de Cercetare si Interventie Sociala. 2015 Jun 1;49:68.
  • 9. Baldini V, Mastropasqua M, Francucci CM, D'Erasmo E. Cardiovascular disease and osteoporosis. J Endocrinol Invest. 2005;28(10 Suppl):69-72. PMID: 16550727.
  • 10. Doherty TM, Fitzpatrick LA, Inoue D, Qiao J-H, Fishbein MC, Detrano RC, Shah PK, Rajavashisth TB. Molecular, Endocrine, and Genetic Mechanisms of Arterial Calcification. Endocr Rev. 2004;25:629–672.
  • 11. Azeez TA. Osteoporosis and cardiovascular disease: a review. Mol Biol Rep. 2023 Feb;50(2):1753-1763. doi: 10.1007/s11033-022-08088-4. Epub 2022 Nov 30. PMID: 36449152.
  • 12. Vattikuti R, Towler DA. Osteogenic regulation of vascular calcification: an early perspective. Am J Physiol Endocrinol Metab. 2004;286:E686–E696.
  • 13. Bucay N, Sarosi I, Dunstan CR, Morony S, Tarpley J, Capparelli C, Scully S, Tan HL, Xu W, Lacey DL, Boyle WJ, Simonet WS. Osteoprotegerin-deficient mice develop early onset osteoporosis and arterial calcification. Genes Dev. 1998;12:1260–1268.
  • 14. Papanicolaou DA, Wilder RL, Manolagas SC, Chrousos GP. The pathophysiologic roles of interleukin-6 in human disease. Ann Intern Med. 1998;128:127–137.
  • 15. Harris TB, Ferrucci L, Tracy RP, Corti MC, Wacholder S, Ettinger WH Jr., Heimovitz H, Cohen HJ, Wallace R. Associations of elevated interleukin-6 and C-reactive protein levels with mortality in the elderly. Am J Med. 1999;106:506–512.
  • 16. Bertolini DR, Nedwin GE, Bringman TS, Smith DD, Mundy GR. Stimulation of bone resorption and inhibition of bone formationin vitro by human tumor necrosis factors. Nature. 1986;319:516–518.
  • 17. Cesari M, Penninx BW, Newman AB, Kritchevsky SB, Nicklas BJ, Sutton-Tyrrell K, Rubin SM, Ding J, Simonsick EM, Harris TB, Pahor M. Inflammatory Markers and Onset of Cardiovascular Events. Results From the Health ABC Study. Circulation. 2003;108:2317–2322.
  • 18. Mendelsohn ME. Protective effects of estrogen on the cardiovascular system. Am J Cardiol. 2002;20:12E–17E.
  • 19. Monroe DG, Spelsberg TC. Gonadal Steroids and Receptors. In: Favus MJ (ed) Primer on the Metabolic Bone Diseases and Disroders of mineral Metabolism. American Society for Bone and Mineral Research. 2003:32–38. Washington, DC.
  • 20. Laroche M, Moulinier L, Leger P, Lefebvre D, Mazieres B, Boccalon H. Bone mineral decrease in the leg with unilateral chronic occlusive arterial disease. Clin Exp Rheumatol. 2003;21:103–106.
  • 21. Kado DM, Browner WS, Blackwell T, Gore R, Cummings SR. Rate of bone loss is associated with mortality in older women: a prospective study. J Bone Miner Res. 2000;15:1974–1980.
  • 22. von der Recke P, Hansen MA, Hassager C. The association between low bone mass at the menopause and cardiovascular mortality. Am J Med. 1999;106:273– 278.
  • 23. Tanko L, Christiansen C, Cox DA, Geiger MJ, McNabb MA, Cummings SR. Relationship between osteoporosis and cardiovascular disease in postmenopausal women. J Bone Miner Res. 2005;20:1912–1920.
  • 24. Ensrud KE, Ewing SK, Taylor BC, Fink HA, Stone KL, Cauley JA, et al. Frailty and risk of falls, fracture, and mortality in older women: the study of osteoporotic fractures. J Gerontol A Biol Sci Med Sci. 2007;62:744–51.
  • 25. Kanis JA, Johnell O, De Laet C, Johansson H, Oden A, Delmas P, et al. A meta-analysis of previous fracture and subsequent fracture risk. Bone. 2004;35:375–82.

65-75 Yaş Arası Hastalarda Kardiyovasküler Risk ve Kırık Riski Arasındaki İlişkinin Değerlendirilmesi

Yıl 2024, Cilt: 5 Sayı: 2, 68 - 74, 30.04.2024

Öz

AMAÇ: Çalışmamızın amacı 67-75 yaş arası hastalarda kırık riski ve kardiyovasküler risk arasındaki ilişkiyi tespit etmektir.
METOT: Hastaların detaylı anamnezleri alınmış ve fizik muayeneleri yapılmıştır. Açlık plazma glukozu, lipid profili, böbrek, karaciğer, tiroid fonksiyonları ve tam kan sayımının yer aldığı laboratuvar parametreleri incelenmiştir. Kemik mineral yoğunlukları ölçülmüştür. Elde edilen bilgiler kullanılarak kardiyovasküler risk skorları (Framingham, SCORE, Q-Risk ve BNF) ve kırık riski skorları (FRAX) hesaplanmıştır. Tüm kardiyovasküler risk skoru sonuçları ayrı ayrı FRAX ile karşılaştırılmış ve aralarında bir ilişki olup olmadığı araştırılmıştır.
BULGULAR: Çalışmaya 64 kadın ve 46 erkek olmak üzere 110 hasta dahil edilmiştir. Hastaların KVH risk skorları şu şekilde hesaplanmıştır; Framigham: 21.69 ± 11.55, SCORE: 27.14 ± 14.91, Q-Risk: 29.29 ± 12.95, BNF: 24.96 ± 14.14. FRAX skoru 5.59 ± 2.85 olarak hesaplanmıştır. Skorlar arasındaki ilişki incelendiğinde en kuvvetli ilişki Framigham ve Frax arasındadır (r =0.42, p: <0.0001). Bunu sırası ile BNF (r =0.29, p: 0.002) ve SCORE (r =0.20, p: 0.035) takip etmektedir. Q-risk skoru ile FRAX arasında anlamlı bir ilişki tespit edilememiştir (r =0.17, p: 0.08).
SONUÇ: Kardiyovasküler hastalık riski ve kırık riski arasında anlamlı bir ilişki mevcuttur. Kardiyovasküler hastalık riski yüksek olan kişilerin kırık riskinin de yüksek olduğu akılda tutulmalı, korumaya yönelik önlemler alınmalıdır. Aynı şekilde kırık riski yüksek olan kişiler kardiyovasküler hastalıklar açısından taranmalı ve riske göre tedavi planlanmalıdır.

Kaynakça

  • 1. Townsend N, Nichols M, Scarborough P, Rayner M. Cardiovascular disease in Europe—epidemiological update 2015. European heart journal. 2015 Oct 21;36(40):2696-705.
  • 2. Liew SM, Blacklock C, Hislop J, Glasziou P, Mant D. Cardiovascular risk scores: qualitative study of how primary care practitioners understand and use them. British Journal of General Practice. 2013 Jun 1;63(611):e401-7.
  • 3. Sözen T, Özışık L, Başaran NÇ. An overview and management of osteoporosis. European journal of rheumatology. 2017 Mar;4(1):46.
  • 4. Tuzun S, Eskiyurt N, Akarirmak U, Saridogan M, Senocak M, Johansson H, et al. Incidence of hip fracture and prevalence of osteoporosis in Turkey: the FRACTURK study. Osteoporos Int 2012; 23: 949-55.
  • 5. D'Agostino RB, Sr Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation 2008;117:743–753.
  • 6. Conroy RM, Pyörälä K, Fitzgerald AE, Sans S, Menotti A, De Backer G, De Bacquer D, Ducimetiere P, Jousilahti P, Keil U, Njølstad I. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. European heart journal. 2003 Jun 1;24(11):987-1003.
  • 7. Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, Minhas R, Sheikh A, Brindle P. Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2. Bmj. 2008 Jun 26;336(7659):1475-82.
  • 8. Costache II, Miftode E, Petris O, Popa AD, Iliescu D, Eosefina GB. Associations between area of residence and cardiovascular risk. Revista de Cercetare si Interventie Sociala. 2015 Jun 1;49:68.
  • 9. Baldini V, Mastropasqua M, Francucci CM, D'Erasmo E. Cardiovascular disease and osteoporosis. J Endocrinol Invest. 2005;28(10 Suppl):69-72. PMID: 16550727.
  • 10. Doherty TM, Fitzpatrick LA, Inoue D, Qiao J-H, Fishbein MC, Detrano RC, Shah PK, Rajavashisth TB. Molecular, Endocrine, and Genetic Mechanisms of Arterial Calcification. Endocr Rev. 2004;25:629–672.
  • 11. Azeez TA. Osteoporosis and cardiovascular disease: a review. Mol Biol Rep. 2023 Feb;50(2):1753-1763. doi: 10.1007/s11033-022-08088-4. Epub 2022 Nov 30. PMID: 36449152.
  • 12. Vattikuti R, Towler DA. Osteogenic regulation of vascular calcification: an early perspective. Am J Physiol Endocrinol Metab. 2004;286:E686–E696.
  • 13. Bucay N, Sarosi I, Dunstan CR, Morony S, Tarpley J, Capparelli C, Scully S, Tan HL, Xu W, Lacey DL, Boyle WJ, Simonet WS. Osteoprotegerin-deficient mice develop early onset osteoporosis and arterial calcification. Genes Dev. 1998;12:1260–1268.
  • 14. Papanicolaou DA, Wilder RL, Manolagas SC, Chrousos GP. The pathophysiologic roles of interleukin-6 in human disease. Ann Intern Med. 1998;128:127–137.
  • 15. Harris TB, Ferrucci L, Tracy RP, Corti MC, Wacholder S, Ettinger WH Jr., Heimovitz H, Cohen HJ, Wallace R. Associations of elevated interleukin-6 and C-reactive protein levels with mortality in the elderly. Am J Med. 1999;106:506–512.
  • 16. Bertolini DR, Nedwin GE, Bringman TS, Smith DD, Mundy GR. Stimulation of bone resorption and inhibition of bone formationin vitro by human tumor necrosis factors. Nature. 1986;319:516–518.
  • 17. Cesari M, Penninx BW, Newman AB, Kritchevsky SB, Nicklas BJ, Sutton-Tyrrell K, Rubin SM, Ding J, Simonsick EM, Harris TB, Pahor M. Inflammatory Markers and Onset of Cardiovascular Events. Results From the Health ABC Study. Circulation. 2003;108:2317–2322.
  • 18. Mendelsohn ME. Protective effects of estrogen on the cardiovascular system. Am J Cardiol. 2002;20:12E–17E.
  • 19. Monroe DG, Spelsberg TC. Gonadal Steroids and Receptors. In: Favus MJ (ed) Primer on the Metabolic Bone Diseases and Disroders of mineral Metabolism. American Society for Bone and Mineral Research. 2003:32–38. Washington, DC.
  • 20. Laroche M, Moulinier L, Leger P, Lefebvre D, Mazieres B, Boccalon H. Bone mineral decrease in the leg with unilateral chronic occlusive arterial disease. Clin Exp Rheumatol. 2003;21:103–106.
  • 21. Kado DM, Browner WS, Blackwell T, Gore R, Cummings SR. Rate of bone loss is associated with mortality in older women: a prospective study. J Bone Miner Res. 2000;15:1974–1980.
  • 22. von der Recke P, Hansen MA, Hassager C. The association between low bone mass at the menopause and cardiovascular mortality. Am J Med. 1999;106:273– 278.
  • 23. Tanko L, Christiansen C, Cox DA, Geiger MJ, McNabb MA, Cummings SR. Relationship between osteoporosis and cardiovascular disease in postmenopausal women. J Bone Miner Res. 2005;20:1912–1920.
  • 24. Ensrud KE, Ewing SK, Taylor BC, Fink HA, Stone KL, Cauley JA, et al. Frailty and risk of falls, fracture, and mortality in older women: the study of osteoporotic fractures. J Gerontol A Biol Sci Med Sci. 2007;62:744–51.
  • 25. Kanis JA, Johnell O, De Laet C, Johansson H, Oden A, Delmas P, et al. A meta-analysis of previous fracture and subsequent fracture risk. Bone. 2004;35:375–82.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular İç Hastalıkları
Bölüm Araştırma Makaleleri
Yazarlar

Ece Yiğit 0000-0002-8293-3554

Dogac Oksen 0000-0003-4548-9543

Sema Uçak Basat 0000-0002-6479-1644

Yayımlanma Tarihi 30 Nisan 2024
Gönderilme Tarihi 26 Kasım 2023
Kabul Tarihi 20 Nisan 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 5 Sayı: 2

Kaynak Göster

AMA Yiğit E, Oksen D, Uçak Basat S. 65-75 Yaş Arası Hastalarda Kardiyovasküler Risk ve Kırık Riski Arasındaki İlişkinin Değerlendirilmesi. JMS. Nisan 2024;5(2):68-74.