Covariates associated with bone loss but not used to calculate propensity scores were also entered into the models for adjustment . All statistical analyses were performed using the statistical package SAS, version 9.1 (SAS Institute, Inc., Cary, North Carolina). 5,229 were followed up for an average of A-769662 4.6 years in a prospective six-center cohort studyThe Osteoporotic Fractures in Men Study (MrOS). Bone mineral densities (BMD) at total hip, femoral neck, and trochanter were measured by Hologic densitometer (QDR 4500) at baseline and 12 months 4. Results Out of 3,494 eligible subjects with total data, 1,166 and 433 subjects reported use of ACE inhibitors and ARBs, respectively. When compared with nonusers, continuous use of ACE inhibitors was associated with a small (0.004 g/cm2) but significant increase in the average rate of BMD loss A-769662 at total hip and trochanter over 4 years after adjustment for confounders. Use of ARB was not significantly associated with bone loss. Conclusion Use of ACE inhibitors but not ARB may marginally increase bone loss in older men. level of <0.05 were included into the final multivariable regression models examining A-769662 the indie effects of use of ACE inhibitors and ARB on bone loss at total hip, femoral neck, and trochanter. Baseline age, age squared, current smoking, body weight, percentage weight switch, and duration of use of calcium and vitamin D supplements, androgen, antiandrogen, oral glucocorticoid, and inhaled steroid were regarded as acknowledged factors of bone loss and were predetermined to be covariates in the final multivariable regression models. As some patients might have taken ARBs after developing side effects from ACE inhibitors or concomitantly with ACE inhibitors, period of use of ARB or ACE inhibitor was joined a Rabbit Polyclonal to RPL27A covariate in the final multivariable regression models. Propensity score analysis was also performed. Propensity scores show the likelihood of a participants use of ACE inhibitors or ARB. Significant factors for the use of ACE inhibitors and ARB use were determined by stepwise logistic regression. As proportional odds assumption was not satisfied, generalized logits model was used. Linear regression was then performed to examine the impartial association between the use of ACE inhibitors or ARB and rates of bone loss, by adjusting for propensity scores. Covariates associated with bone loss but not used to calculate propensity scores were also joined into the models for adjustment . All statistical analyses were performed using the statistical package SAS, version 9.1 (SAS Institute, Inc., Cary, North Carolina). An level of 5% was used as the level of significance. Results Five thousand nine hundred ninety-five men were recruited at baseline. Of these, 5,229 (87.2%) were followed up at year 4. The average duration of follow-up was 4.6 years. Out of these, 330 participants were excluded from analysis because of use of osteoporosis-related medications; 1,032 participants were excluded because of missing drug use and product data at baseline (angiotensin-converting enzyme, angiotensin receptor blocker, Physical Activity Scale for the Elderly, chronic kidney disease *value (Pattern)value (pattern)Total hip??Multivariable adjusteda?0.020 (?0.044, 0.003)?0.025 (?0.049, ?0.002)?0.022 (?0.045, 0.001)?0.024 (?0.047, ?0.001)0.4473??Propensity score methodc0.006 (?0.018, 0.029)0.000 (?0.023, 0.024)0.005 (?0.018, 0.027)0.003 (?0.020, 0.025)0.7230Femoral neck??Multivariable adjusteda?0.014 (?0.042, 0.014)?0.009 (?0.037, 0.019)?0.008 (?0.035, 0.019)?0.009 (?0.036, 0.018)0.1585??Propensity score methodc0.008 (?0.020, 0.035)0.012 (?0.015, 0.039)0.014 (?0.013, 0.040)0.014 (?0.013, 0.040)0.1328Trochanter??Multivariable adjusteda?0.010 (?0.033, 0.013)?0.015 (?0.038, 0.008)?0.012 (?0.035, 0.010)?0.015 (?0.037, 0.008)0.2663??Propensity score methodc0.013 (?0.010, 0.037)0.008 (?0.015, 0.031)0.012 (?0.011, 0.034)0.010 (?0.012, 0.032)0.5178 Open in a separate window aMultiple linear regression model with the following covariates: age; age square; baseline body weight; PASE score; excess weight change percentage per year; race; site; education level; current smoking; chronic kidney disease; diabetes mellitus; cardiac failure at either visit; duration of use of thiazide, loop diuretic, nitrate, beta-blocker, calcium antagonist, glitazone, inhaled steroid, oral glucocorticoid, androgen, antiandrogen, calcium supplement, and vitamin D supplement; least expensive ankle-arm index; and ACE/ARB bCardiac failure; duration of use of thiazide, loop diuretic, beta-blocker, calcium antagonist, ARB, and vitamin D product; and diabetes were factors used to calculate propensity scores for ACE inhibitor cCardiac failure; duration of use of thiazide, loop diuretic, beta-blocker, calcium antagonist, inhaled steroid, and ACE inhibitor; site; PASE score; and diabetes were factors used to calculate propensity scores for ARB Conversation In this prospective cohort study of older men, use of ACE inhibitor was associated with a small but significant increase in rates of bone loss at total hip, impartial of potential confounders. The average complete difference in BMD loss associated with continuous use of ACE inhibitors over 4 years was approximately 0.004 g/cm2. Consistent with a cross-sectional study of older Chinese men and women , the average femoral neck BMD of continuous users of ACE inhibitors was significantly greater than that of nonusers in this study. Identical locating was seen in constant ARB users also, nonetheless it was relatively surprising to see such group variations in short-term ARB users aswell. This shows that the cross-sectional group differences in BMDs might have been confounded from the associated medical.
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