20113
2019
eng
e027257
9
article
1
2020-03-11
--
--
Lipoprotein(a) plasma levels, bone mineral density and risk of hip fracture: a post hoc analysis of the Women’s Health Initiative, USA
Objectives
Elevated Lipoprotein(a) (Lp[a]) is a well-known risk factor for cardiovascular disease. However, its roles in bone metabolism and fracture risk are unclear. We therefore investigated whether plasma Lp(a) levels were associated with bone mineral density (BMD) and incident hip fractures in a large cohort of postmenopausal women.
Design
Post hoc analysis of data from the Women’s Health Initiative (WHI), USA.
Setting
40 clinical centres in the USA.
Participants
The current analytical cohort consisted of 9698 white, postmenopausal women enrolled in the WHI, a national prospective study investigating determinants of chronic diseases including heart disease, breast and colorectal cancers and osteoporotic fractures among postmenopausal women. Recruitment for WHI took place from 1 October 1993 to 31 December 1998.
Exposures
Plasma Lp(a) levels were measured at baseline.
Outcome measures
Incident hip fractures were ascertained annually and confirmed by medical records with follow-up through 29 August 2014. BMD at the femoral neck was measured by dual X-ray absorptiometry in a subset of participants at baseline.
Statistical analyses
Cox proportional hazards and logistic regression models were used to evaluate associations of quartiles of plasma Lp(a) levels with hip fracture events and hip BMD T-score, respectively.
Results
During a mean follow-up of 13.8 years, 454 incident cases of hip fracture were observed. In analyses adjusting for confounding variables including age, body mass index, history of hysterectomy, smoking, physical activity, diabetes mellitus, general health status, cardiovascular disease, use of menopausal hormone therapy, use of bisphosphonates, calcitonin or selective-oestrogen receptor modulators, baseline dietary and supplemental calcium and vitamin D intake and history of fracture, no significant association of plasma Lp(a) levels with low hip BMD T-score or hip fracture risk was detected.
Conclusions
These findings suggest that plasma Lp(a) levels are not related to hip BMD T-score or hip fracture events in postmenopausal women.
BMJ Open
10.1136/bmjopen-2018-027257
urn:nbn:de:bvb:20-opus-201139
BMJ Open (2019) 9:e027257. https://doi.org/10.1136/bmjopen-2018-027257
false
true
CC BY-NC: Creative-Commons-Lizenz: Namensnennung, Nicht kommerziell 4.0 International
Bernhard Haring
Carolyn J Crandall
Laura Carbone
Simin Liu
Wenjun Li
Karen C Johnson
Jean Wactawski-Wende
Aladdin H Shadyab
Margery L Gass
Victor Kamensky
Jane A Cauley
Sylvia Wassertheil-Smoller
eng
uncontrolled
hip fracture
Medizin und Gesundheit
open_access
Medizinische Klinik und Poliklinik I
Förderzeitraum 2019
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/20113/Haring_BMJOpen_2019.pdf.pdf
12948
2013
eng
e000369
2
article
1
2016-03-10
--
--
Cardiovascular Disease and Cognitive Decline in Postmenopausal Women: Results From the Women's Health Initiative Memory Study
Background-—Data on cardiovascular diseases (CVD) and cognitive decline are conflicting. Our objective was to investigate if CVD is associated with an increased risk for cognitive decline and to examine whether hypertension, diabetes, or adiposity modify the effect of CVD on cognitive functioning.
Methods and Results-—Prospective follow-up of 6455 cognitively intact, postmenopausal women aged 65 to 79 years old enrolled in the Women’s Health Initiative Memory Study (WHIMS). CVD was determined by self-report. For cognitive decline, we assessed the incidence of mild cognitive impairment (MCI) or probable dementia (PD) via modified mini-mental state examination (3 MS) score, neurocognitive, and neuropsychiatric examinations. The median follow-up was 8.4 years. Women with CVD tended to be at increased risk for cognitive decline compared with those free of CVD (hazard ratio [HR], 1.29; 95% CI: 1.00, 1.67). Women with myocardial infarction or other vascular disease were at highest risk (HR, 2.10; 95% CI: 1.40, 3.15 or HR, 1.97; 95% CI: 1.34, 2.87). Angina pectoris was moderately associated with cognitive decline (HR 1.45; 95% CI: 1.05, 2.01) whereas no significant relationships were found for atrial fibrillation or heart failure. Hypertension and diabetes increased the risk for cognitive decline in women without CVD. Diabetes tended to elevate the risk for MCI/PD in women with CVD. No significant trend was seen for adiposity.
Conclusions-—CVD is associated with cognitive decline in elderly postmenopausal women. Hypertension and diabetes, but not adiposity, are associated with a higher risk for cognitive decline. More research is warranted on the potential of CVD prevention for preserving cognitive functioning.
Journal of the American Heart Association
10.1161/JAHA.113.000369
urn:nbn:de:bvb:20-opus-129487
Journal of the American Heart Association 2013;2:e000369 doi: 10.1161/JAHA.113.000369
Bernhard Haring
Xiaoyan Leng
Jennifer Robinson
Karen C. Johnson
Rebecca D. Jackson
Rebecca Beyth
Jean Wactawski-Wende
Moritz Wyler von Ballmoos
Joseph S. Goveas
Lewis H. Kuller
Sylvia Wassertheil-Smoller
eng
uncontrolled
postmenopausal women
eng
uncontrolled
cognitive decline
eng
uncontrolled
cardiovascular diseases
Medizin und Gesundheit
open_access
Medizinische Klinik und Poliklinik I
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/12948/058_Haring_Cardiovascular_Disease.pdf
11137
2013
eng
article
1
2015-03-20
--
--
Cardiovascular Disease and Cognitive Decline in Postmenopausal Women: Results From the Women’s Health Initiative Memory Study
Background Data on cardiovascular diseases (CVD) and cognitive decline are conflicting. Our objective was to investigate if CVD is associated with an increased risk for cognitive decline and to examine whether hypertension, diabetes, or adiposity modify the effect of CVD on cognitive functioning.
Methods and Results: Prospective follow‐up of 6455 cognitively intact, postmenopausal women aged 65 to 79 years old enrolled in the Women's Health Initiative Memory Study (WHIMS). CVD was determined by self‐report. For cognitive decline, we assessed the incidence of mild cognitive impairment (MCI) or probable dementia (PD) via modified mini‐mental state examination (3 MS) score, neurocognitive, and neuropsychiatric examinations. The median follow‐up was 8.4 years. Women with CVD tended to be at increased risk for cognitive decline compared with those free of CVD (hazard ratio [HR], 1.29; 95% CI: 1.00, 1.67). Women with myocardial infarction or other vascular disease were at highest risk (HR, 2.10; 95% CI: 1.40, 3.15 or HR, 1.97; 95% CI: 1.34, 2.87). Angina pectoris was moderately associated with cognitive decline (HR 1.45; 95% CI: 1.05, 2.01) whereas no significant relationships were found for atrial fibrillation or heart failure. Hypertension and diabetes increased the risk for cognitive decline in women without CVD. Diabetes tended to elevate the risk for MCI/PD in women with CVD. No significant trend was seen for adiposity.
Conclusions: CVD is associated with cognitive decline in elderly postmenopausal women. Hypertension and diabetes, but not adiposity, are associated with a higher risk for cognitive decline. More research is warranted on the potential of CVD prevention for preserving cognitive functioning.
10.1161/JAHA.113.000369)
urn:nbn:de:bvb:20-opus-111376
Journal of the American Heart Association 2013; 2:e000369 doi: 10.1161/JAHA.113.000369
Bernhard Haring
Xiaoyan Leng
Jennifer Robinson
Karen C. Johnson
Rebecca D. Jackson
Rebecca Beyth
Jean Wactawski-Wende
Moritz Wyler von Ballmoos
Joseph S. Goveas
Lewis H. Kuller
Sylvia Wassertheil-Smoller
eng
uncontrolled
cardiovascular diseases
eng
uncontrolled
cognitive decline
eng
uncontrolled
postmenopausal women
Medizin und Gesundheit
open_access
Medizinische Klinik und Poliklinik I
Förderzeitraum 2014
Deutsches Zentrum für Herzinsuffizienz (DZHI)
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/11137/037_Haring_JAHA.pdf
9596
2013
eng
article
1
--
--
--
Laxative use and incident falls, fractures and change in bone mineral density in postmenopausal women: results from the Women’s Health Initiative
Background
Laxatives are among the most widely used over-the-counter medications in the United States but studies examining their potential hazardous side effects are sparse. Associations between laxative use and risk for fractures and change in bone mineral density [BMD] have not previously been investigated.
Methods
This prospective analysis included 161,808 postmenopausal women (8907 users and 151,497 nonusers of laxatives) enrolled in the WHI Observational Study and Clinical Trials. Women were recruited from October 1, 1993, to December 31, 1998, at 40 clinical centers in the United States and were eligible if they were 50 to 79 years old and were postmenopausal at the time of enrollment. Medication inventories were obtained during in-person interviews at baseline and at the 3-year follow-up visit on everyone. Data on self-reported falls (≥2), fractures (hip and total fractures) were used. BMD was determined at baseline and year 3 at 3 of the 40 clinical centers of the WHI.
Results
Age-adjusted rates of hip fractures and total fractures, but not for falls were similar between laxative users and non-users regardless of duration of laxative use. The multivariate-adjusted hazard ratios for any laxative use were 1.06 (95% confidence interval [CI], 1.03-1.10) for falls, 1.02 (95% CI, 0.85-1.22) for hip fractures and 1.01 (95% CI, 0.96-1.07) for total fractures. The BMD levels did not statistically differ between laxative users and nonusers at any skeletal site after 3-years intake.
Conclusion
These findings support a modest association between laxative use and increase in the risk of falls but not for fractures. Its use did not decrease bone mineral density levels in postmenopausal women. Maintaining physical functioning, and providing adequate treatment of comorbidities that predispose individuals for falls should be considered as first measures to avoid potential negative consequences associated with laxative use.
BMC Geriatrics
10.1186/1471-2318-13-38
http://www.biomedcentral.com/1471-2318/13/38
urn:nbn:de:bvb:20-opus-95960
In: BMC Geriatrics (2013) 13: 38, doi:10.1186/1471-2318-13-38
Bernhard Haring
Mary Pettinger
Jennifer W. Bea
Jean Wactawski-Wende
Ryan M. Carnahan
Judith K. Ockene
Moritz Wyler von Ballmoos
Robert B. Wallace
Sylvia Wassertheil-Smoller
eng
uncontrolled
laxative
eng
uncontrolled
use
eng
uncontrolled
fall
eng
uncontrolled
fracture
eng
uncontrolled
bone mineral density
eng
uncontrolled
aging
Medizin und Gesundheit
open_access
Medizinische Klinik und Poliklinik I
Förderzeitraum 2013
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/9596/Haring_1471-2318-13-38.pdf