Osteoporosis is associated with increased CVD mortality and all-cause mortality in alcohol-consuming individuals: A cohort study using data from NHANES

TL;DR

Osteoporosis increases the risk of death from heart disease and all causes in people who drink alcohol, according to a study using U.S. health data.

Contribution

This study is the first to show a strong link between osteoporosis and higher mortality in alcohol-consuming adults.

Findings

Osteoporosis was linked to a 60% higher risk of all-cause mortality in alcohol-consuming individuals.

Osteoporosis was associated with a 55% increased risk of cardiovascular disease mortality in alcohol consumers.

The association remained consistent across different age, sex, and risk factor groups.

Abstract

Osteoporosis, a skeletal disorder characterized by reduced bone density and increased fracture risk, imposes a significant global health burden, particularly in aging populations. Previous studies have highlighted the negative impact of alcohol consumption on bone health, but the interplay between osteoporosis and mortality risk in alcohol-consuming individuals remains underexplored. This study aimed to investigate the association between osteoporosis and cardiovascular disease (CVD) mortality and all-cause mortality in U.S. adults who consume alcohol.

This prospective cohort study utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning five cycles (2005–2010, 2013–2014, and 2017–2018). A total of 12,178 alcohol-consuming participants aged 20 years and older were included after excluding those with missing data or non-drinking status. Bone density was measured using dual-energy X-ray absorptiometry (DXA), and osteoporosis was defined using World Health Organization (WHO) T-score criteria (T-score ≤ −2.5). Mortality data were obtained through linkage with the National Death Index (NDI). Multivariable Cox proportional hazards regression models were employed to assess the relationship between osteoporosis and mortality outcomes, adjusting for demographic, socioeconomic, and clinical covariates.

Kaplan-Meier survival analysis revealed higher all-cause and CVD mortality rates in participants with osteoporosis compared to those without (Log-rank test P < 0.001 for both). After adjusting for potential confounders, osteoporosis was associated with a 1.60-fold increased risk of all-cause mortality (HR = 1.60, 95% CI = 1.26–2.03, P < 0.001) and a 1.55-fold increased risk of CVD mortality (HR = 1.55, 95% CI = 1.06–2.28, P = 0.025). Stratified analyses across age, sex, smoking status, and cardiovascular risk factors showed consistent results, with no significant interaction effects (P > 0.05). Sensitivity analyses confirmed the robustness of these findings.

Osteoporosis is positively associated with increased risks of all-cause and CVD mortality in alcohol-consuming individuals. These findings underscore the need for further research to elucidate the underlying mechanisms and inform preventive strategies targeting this high-risk population.

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