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Outline
The aim of this study is to comprehensively analyze the causal relationship between osteoporosis and cognitive impairment in China community using the combination of observational study and Mendelian randomization (MR).
Baseline data from the West China Health and Aging Cohort Study were used to explore phenotypic associations between L1-L4 bone mineral density (BMD), total hip BMD, femoral neck BMD, osteoporosis, osteopenia and cognitive function. A two-sample MR design was used to evaluate the causal association between BMD and Alzheimer’s disease (AD) using summary statistics from published genome-wide association studies, with single nucleotide polymorphisms (SNPs) significantly associated with BMD as instrumental variables and AD as the outcome variable.
The cross-sectional study showed that after adjusting for a series of confounding factors, osteoporosis was found to be negatively associated with Mini-Mental State Examination (MMSE) score compared with normal bone mass group (β=-0.84, 95% CI: -1.39~-0.29, P=0.003), indicating that the patients with osteoporosis had lower MMSE scores and worse cognitive function than those with normal bone mass, and the results were robust. The relationship between BMD at different sites and cognitive scores was different.Specifically, total hip BMD (β=1.58, 95% CI: 0.20-2.95, P=0.024) and L1-L4 BMD (β=1.17, 95% CI: 0.13-2.21, P=0.028) were positively correlated with MMSE score, while femoral neck BMD was not significantly correlated with MMSE score (β=1.34, 95% CI: -0.11-2.79, P=0.070). Two-sample MR analysis using 86 SNPs associated with heel BMD-T values in a Chinese population as instrumental variables showed no causal association between heel BMD-T and AD risk (IVW: OR=0.95, 95% CI: 0.84-1.07, P=0.417). The results of multiple sensitivity analyses were robust.
The evidence from this study suggests a positive association between osteoporosis and cognitive impairment in Chinese, but further studies are needed to confirm the causal relationship between the two traits. Based on the common risk factors and pathogenesis, it is beneficial in practice to strengthen the management of osteoporosis patients, especially those with low total hip BMD and L1-L4 BMD, to prevent the occurrence of cognitive impairment.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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