Association between Bone Metabolism and the Severity of Chronic Heart Failure in Chinese Elderly Men and Women

Background: The role of bone metabolism markers for identifying the severity of chronic heart failure (CHF) in elderly adults had not been comprehensively investigated. Methods: 335 elderly patients (mean age 83.98 years, women 36.72%) were divided into mild CHF (NYHA class I+II) group and severe CHF (NYHA class III+IV) group. We performed a binary logistic regression analysis to identify the independent association of bone metabolism markers with the severity of CHF. Besides, we used ROC curve to explore the predictability of bone metabolism markers on CHF severity. Results: BMD levels of femoral neck in severe CHF group were significantly lower than that in mild CHF group with no gender difference. However, CTX-I, OC, PINP, ALP and PTH levels were significantly increased only in women with severe CHF. CTX-I (OR = 1.003, p = 0.008) was identified as an independent influencing factor positively associated with the severity of CHF in women after controlling for covariates. The predictability of CTX-I, OC, PINP and ALP for CHF severity was superior to NT-proBNP. Conclusion: The association between bone metabolism and CHF severity varied by genders. Bone metabolism markers, especially the CTX-I, might be a possible risk marker associated with CHF severity independent of NT-proBNP in women.