Research cracks higher fracture risk in women

A novel way of analysing scans from bone density machines has revealed that more than 50 per cent of older women have advanced blood vessel disease, putting them at an increased risk of suffering a bone fracture.


Bone density scans are already widely used to identify individuals with osteoporosis (low bone mineral density), which can lead to fractures.


Now Edith Cowan University (ECU) researchers have found that while around 1 in 10 of the women in the study had osteoporosis, over half of them also had a build-up of calcium in the aorta, increasing their risk of fracture regardless of bone mineral density.


It’s estimated around 1.2 million Australians have osteoporosis, with women being at greater risk than men. Fractures in the elderly cost Australia more than $3 billion each year.


Novel fracture risk factor

Researchers examined the scans of more than 1000 older Australian women taken in the late 1990s, collected during bone density testing by UWA/ECU adjunct Professor Richard Prince.


They found these scans also reveal the presence of calcium in the abdominal aorta, the major artery between the heart and the abdomen, which is associated with an increased bone fracture risk.


The work builds on previous research that found that aortic calcification is associated with an increased risk of suffering a heart attack or stroke.


Lead researcher Dr Josh Lewis from ECU’s School of Medical and Health Sciences said his team found advanced calcification in the aortas of just over half of the women’s scans.


“These women had a 40 per cent greater risk of suffering any fracture in the next 10 years following their scan, independent of their bone mineral density,” he said.


“If we can give people early warning that they are at an increased risk of falls and fracture, we can help them to make diet and other lifestyle changes that can lower their future risk of a range of chronic age-related diseases.


“While the concept of blood vessel disease increasing fracture risk is not new, our study shows we can use widely available bone density machines to quickly and easily assess this novel fracture risk factor at the same time as bone density testing.”


Next step: automatic detection

Dr Lewis said work is now underway with a team of Artificial Intelligence researchers at ECU led by Professor David Suter to develop an algorithm that can automatically detect the aortic calcium build-up in bone density scans.


“This will allow bone density scans to become an even more powerful tool for the prevention of falls and fractures, which are a leading cause of disability for older Australians.”


Dr Lewis worked with researchers from the Universities of Sydney, Western Australia, Minnesota, Fudan, Oslo and Hinda and Arthur Marcus Institute for Aging Research, a research affiliate of Harvard Medical School on the project.


‘Association between abdominal aortic calcification, bone mineral density and fracture in older women’ is published in the Journal of Bone and Mineral Research.


3 December 2019.