Influence of Smoking on Bone Mineral Density in Elderly Men

Background: Smoking has deleterious effects on bone mass and is associated with the subsequent development of osteoporosis, particularly in elderly participants. The purpose of this study was to determine the influence of smoking in the elderly male smokers. Methods: All male participants aged 60 years and older of the Amirkola cohort who performed bone densitometry entered the study. Bone mineral density (BMD) was measured at the lumbar spine (LS) and femoral neck (FN) using the dual-energy X-ray absorptiometry method. In statistical analysis, the smokers and nonsmokers were compared according to BMD, frequency of low bone mass defined as BMD T-score <-1 at either LS or FN, and the number of bone fractures. SPSS software version 18 was used for analysis. Results: A total of 203 smokers with mean smoking duration of 21.67 +/- 17.7 years and the mean number of 36.4 + 15.8 cigarettes per day were compared with 408 nonsmokers. The mean BMD values in LS (0.90 +/- 0.14 vs. 0.94 +/- 0.19) and FN section (0.87 +/- 0.13 vs. 0.89 +/- 0.15) and also the frequency of bone fractures were significantly lower, and the frequency of low bone mass at either LS and FN was significantly higher in smokers (P = 0.014, 0.038, 0.003, and 0.004, respectively). In multiple logistic regression analysis, smoking was independently associated with low bone mass by odds ratio of = 2.27 (95% confidence interval: 1.49-3.44). Conclusions: These findings indicate a significant association between low bone mass and bone fracture at either LS or FN in the elderly male smokers.