Abstract
Osteoporosis is associated with cardiovascular disease, but the relationship between bone mineral density (BMD) and cardiac structure and function remains incompletely understood. This cross-sectional study analyzed baseline data from 1233 participants (median age 60 years; 59% female) in the Osteoarthritis and Cardiovascular Health Cohort. BMD was categorized as normal (T-score ≥ − 1.0, n = 364), osteopenia (− 2.5 < T-score < − 1.0, n = 404), or osteoporosis (T-score ≤ − 2.5, n = 465). Cardiac parameters were measured via echocardiography. Multivariable linear regression adjusted for age, sex, and cardiovascular risk factors. Osteoporosis was associated with higher LAVI (median: 29 vs. 26 mL/m2, P < 0.001) and RWT (0.38 vs. 0.37, P = 0.047) compared to normal BMD. After adjustment, T-score was inversely associated with LAVI (β = − 0.358, P = 0.043) and RWT (β = − 0.003, P = 0.013). Subgroup analyses showed stronger effects in women (LAVI β = − 0.737, P = 0.001) and participants < 50 years (LAVI β = − 0.909, P = 0.022). No significant associations were observed for left ventricular mass index, ejection fraction, or diastolic function metrics. Lower BMD, measured by tibial ultrasound, is independently associated with left atrial enlargement and increased ventricular wall thickness, particularly in women and younger adults. These findings suggest shared pathophysiological mechanisms between bone loss and cardiac remodeling, warranting more in-depth research.
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Data availability
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. De-identified individual participant data, statistical code, and supporting documentation will be made available via Haoran Wang (washingtonhr@163.com) upon request. Data access will be granted following approval by the study’s Data Access Committee.
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Acknowledgements
The authors thank the staff and participants of the “Longitudinal Investigation of Osteoarthritis and Cardiovascular Health Status” cohort study for their contributions. Haoran Wang (washingtonhr@163.com) and Qiaotao Xie (18639998899@126.com) confirms compliance with authorship criteria and acknowledges receipt of written permissions for all contributions and disclosures.
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This study was supported by grants from the National Natural Science Foundation of China (81803318), the Henan Provincial Science and Technology Research Project (232300420069, 232102310231, 232300420289), and the Henan Ministry of Education (22B320003). The funders had no role in study design, data collection, analysis, interpretation, manuscript preparation, or the decision to submit for publication.
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H.W. contributed to conception, data analysis, manuscript drafting/revision, statistical expertise, and funding acquisition; Q.W. participated in study design, data analysis, and manuscript editing from an orthopedic perspective; B.H., J.B., and J.C. were responsible for data collection/assembly; N.W., D.L., and J.W. provided data organization and logistical/administrative support; Q.X. involved in study design and manuscript review. H.W. and Q.X. confirm responsibility for the work’s integrity. All authors reviewed the manuscript.
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Ethical approval was obtained from the Institutional Review Board of Luohe Central Hospital on April 13th, 2023 (approval number 2023010). All participants provided written informed consent, and procedures adhered to the 2000 revision of the Helsinki Declaration.
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Wang, H., Wang, Q., He, B. et al. Osteoporosis and cardiac remodeling in middle-aged and older adults: a cross-sectional study. Sci Rep (2026). https://doi.org/10.1038/s41598-026-37360-x
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DOI: https://doi.org/10.1038/s41598-026-37360-x
