Total bone mineral density is inversely associated with stroke: A family osteoporosis cohort study in rural China

Background: The relationship of osteoporosis and stroke is still not fully clarified. Apart from the well-known risk factors for stroke, bone mineral density (BMD) has gained more interest in recent years. Aim: To further elucidate the relationship between BMD and stroke risk, a prospective cohort study in the Chinese rural population was conducted. Design: Retrospective analysis of a family osteoporosis cohort. Methods: Our subjects were selected from an osteoporosis cohort conducted in Anqing, China. All participants underwent a questionnaire assessment, clinical examinations and laboratory assessments. During the follow-up period, the number of people who had a stroke was recorded. Generalized estimating equation regression analysis was performed to determine the significance of the association between BMD and stroke. Results: A total of 17868 people were included. A two-way interaction test of sex and BMD on stroke was significant (P = 0.002). There was a significant difference in BMD and stroke morbidity in the male group (P = 0.003). When BMD was assessed as quartiles and the lowest quartile was used as reference, a significantly lower risk for stroke was observed in Q2-4. Notably, no significant difference was observed in female participants with adjusted odds ratio (P > 0.05). The P-value for interaction was calculated. The body mass index (P = 0.014) and waist-To-hip ratio (P = 0.027) were found to be significantly associated with BMD and stroke risk in female participants. Conclusions: In Chinese rural areas, total BMD may negatively correlated with stroke, especially in men.