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Background and Objective:Our previous study showed angiotensin converting enzyme (ACE) inhibitor use was associated with higher bone mineral density (BMD) in elderly people, especially male subjects, which suggested that ACE inhibitors may have a protective effect on age-related bone loss. In this study, we set to examine the independent effect of ACE inhibitor on bone loss in elder Chinese.
Methods:The subjects were come from two cohort studies, which set to investigate the risk factors of osteoporotic fractures in Hong Kong-dwelled elder Chinese. The subjects had a baseline interview and were followed up every two years for four years. Current smokers and those who took osteoporosis related medications and angiotensin Ⅱ type Ⅰ receptor blockers at either visit were excluded. Totally, 2161 subjects (1280 male and 881 female) were selected for this analysis. The ACE inhibitor users were compared with non-users using ANOVA test for continuous variables or chi-square test for categorical variables. Univariate analysis was performed to examine the associations between annualized percentage bone loss at total hip and some potential confounders. Those confounders which showed significant associations at P < 0.1 were included in the final multiple regression model as covariates to examine the independent effect of ACE inhibitor on bone loss at total hip and femoral neck.
Results:Unadjusted annualized percentage bone loss of male ACE inhibitor users were not different from non-users,however, female ACE inhibitor users had significantly greater bone loss both in total hip and femoral neck than non-users.Univariate analysis showed age, baseline body weight, annualized percentage weight change, baseline total hip BMD,history of diabetes and hypertension, steroid use, calcium supplement, thiazide diuretics use, loop diuretics use,beta-blocker use and calcium antagonist use were significantly associated with annualized percentage bone loss of total hip at P < 0.1 level. After adjusted for significant confounders, female continuous ACE inhibitor users had significantly greater bone loss at total hip and femoral neck.
Conclusion:Continuous use of ACE inhibitors over four years was associated with increased bone loss in total hip and femoral neck in older Chinese women.