Table 3

ASCVD death according to BMD values and a clinical diagnosis of osteopenia or osteoporosis

Risk factorsAge-adjusted HR*
(95% CI)		P valueFully adjusted HR†
(95% CI)		P value
BMD as a continuous variable
Lumbar BMD (per 1-SD decrease)1.28 (1.16 to 1.41)<0.0011.24 (1.12 to 1.38)<0.001
Femur neck BMD (per 1-SD decrease)1.67 (1.43 to 1.96)<0.0011.57 (1.33 to 1.85)<0.001
Total hip BMD (per 1-SD decrease)1.76 (1.55 to 2.01)<0.0011.73 (1.50 to 1.99)<0.001
Diagnoses of osteopenia and osteoporosis based on the T-score
Lumbar T-score Number of women Event, n (%)
 Normal5 66058 (1.0)1 (reference)1 (reference)
 Osteopenia5 01477 (1.5)1.00 (0.71 to 1.41)0.9910.99 (0.70 to 1.40)0.975
 Osteoporosis2 007102 (5.1)2.17 (1.55 to 3.03)<0.0011.99 (1.40 to 2.83)<0.001
Femur neck T-score
 Normal5 83735 (0.6)1 (reference)1 (reference)
 Osteopenia5 845123 (2.1)1.54 (1.04 to 2.30)0.0321.52 (1.02 to 2.26)0.039
 Osteoporosis99979 (7.9)3.32 (2.12 to 5.21)<0.0012.93 (1.85 to 4.65)<0.001
Total hip T-score
 Normal7 22945 (0.6)1 (reference)1 (reference)
 Osteopenia4 621112 (2.4)1.96 (1.36 to 2.82)<0.0011.98 (1.38 to 2.86)<0.001
 Osteoporosis83180 (9.6)5.09 (3.37 to 7.68)<0.0014.90 (3.17 to 7.56)<0.001
Combined T-score
 Normal3 98524 (0.6)1 (reference)1 (reference)
 Osteopenia6 21487 (1.4)1.04 (0.65 to 1.66)0.8611.03 (0.65 to 1.65)0.890
 Osteoporosis2 482126 (5.1)2.34 (1.46 to 3.77)<0.0012.14 (1.32 to 3.48)0.002

  • Osteopenia was defined as a BMD T-score between −1.0 and −2.5, and osteoporosis was defined as a T-score below −2.5. Single-site BMD-related values (either BMD or a diagnosis of osteopenia/osteoporosis) of the indicated skeletal site were included in the Cox regression model with other covariates.

  • *Adjusted for age only.

  • †Adjusted for age, body mass index, hypertension, type 2 diabetes mellitus, hyperlipidaemia, current smoking and previous fracture.

  • ASCVD, atherosclerotic cardiovascular disease; BMD, bone mineral density; CI, confidence interval; HR, hazard ratio; SD, standard deviation.