{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:11:15Z","timestamp":1793293875346,"version":"4.5.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:00:00Z","timestamp":1713225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82370892"],"award-info":[{"award-number":["82370892"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82070910"],"award-info":[{"award-number":["82070910"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82100944"],"award-info":[{"award-number":["82100944"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82100494"],"award-info":[{"award-number":["82100494"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program","doi-asserted-by":"publisher","award":["2021YFC2501701"],"award-info":[{"award-number":["2021YFC2501701"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Health Research Project in Hunan Province","award":["20231696"],"award-info":[{"award-number":["20231696"]}]},{"DOI":"10.13039\/501100004735","name":"Natural Science Foundation of Hunan Province","doi-asserted-by":"publisher","award":["2022JJ40721"],"award-info":[{"award-number":["2022JJ40721"]}],"id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Scientific Research Launch Project"},{"name":"Second Xiangya Hospital of Central South University","award":["7673"],"award-info":[{"award-number":["7673"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The correlation between socio-economic status (SES) and bone-related diseases garners increasing attention, prompting a bidirectional Mendelian randomization (MR) analysis in this study. Genetic data on SES indicators (average total household income before tax, years of schooling completed, and Townsend Deprivation Index at recruitment), femoral neck bone mineral density (FN-BMD), heel bone mineral density (eBMD), osteoporosis, and five different sites of fractures (spine, femur, lower leg-ankle, foot, and wrist-hand fractures) were derived from genome-wide association summary statistics of European ancestry. The inverse variance weighted method was employed to obtain the causal estimates, complemented by alternative MR techniques, including MR-Egger, weighted median, and MR-pleiotropy residual sum and outlier (MR-PRESSO). Furthermore, sensitivity analyses and multivariable MR were performed to enhance the robustness of our findings. Higher educational attainment exhibited associations with increased eBMD (\u03b2: .06, 95% confidence interval [CI]: 0.01\u20130.10, P\u2009=\u20097.24\u2009\u00d7\u200910\u22123), and reduced risks of osteoporosis (OR: 0.78, 95% CI: 0.65\u20130.94, P\u2009=\u20098.49\u2009\u00d7\u200910\u22123), spine fracture (OR: 0.76, 95% CI: 0.66\u20130.88, P\u2009=\u20092.94\u2009\u00d7\u200910\u22124), femur fracture (OR: 0.78, 95% CI: 0.67\u20130.91, P\u2009=\u20091.33\u2009\u00d7\u200910\u22123), lower leg-ankle fracture (OR: 0.79, 95% CI: 0.70\u20130.88, P\u2009=\u20092.05\u2009\u00d7\u200910\u22125), foot fracture (OR: 0.78, 95% CI: 0.66\u20130.93, P\u2009=\u20095.92\u2009\u00d7\u200910\u22123), and wrist-hand fracture (OR: 0.83, 95% CI: 0.73\u20130.95, P\u2009=\u20097.15\u2009\u00d7\u200910\u22123). Material deprivation appeared to increase the risk of spine fracture (OR: 2.63, 95% CI: 1.43\u20134.85, P\u2009=\u20091.91\u2009\u00d7\u200910\u22123). A higher FN-BMD level positively affected increased household income (\u03b2: .03, 95% CI: 0.01\u20130.04, P\u2009=\u20096.78\u2009\u00d7\u200910\u22123). All these estimates were adjusted for body mass index, type 2 diabetes, smoking initiation, and frequency of alcohol intake. The MR analyses show that higher educational levels is associated with higher eBMD, reduced risk of osteoporosis and fractures, while material deprivation is positively related to spine fracture. Enhanced FN-BMD correlates with increased household income. These findings provide valuable insights for health guideline formulation and policy development.<\/jats:p>","DOI":"10.1093\/jbmr\/zjae060","type":"journal-article","created":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T02:40:09Z","timestamp":1712803209000},"page":"942-955","source":"Crossref","is-referenced-by-count":13,"title":["Assessment of causal association between the socio-economic status and osteoporosis and fractures: a bidirectional Mendelian randomization study in European population"],"prefix":"10.1093","volume":"39","author":[{"given":"Jia-Yue","family":"Duan","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, The Second Xiangya Hospital of Central South University , Changsha, 410011 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui-Xuan","family":"You","sequence":"additional","affiliation":[{"name":"Department of Dermatology , Hunan Key Laboratory of Medical Epigenetics, Clinical Medical Research Center for Systemic Autoimmune Diseases in Hunan Province, , Changsha, 410011 , China"},{"name":"The Second Xiangya Hospital of Central South University , Hunan Key Laboratory of Medical Epigenetics, Clinical Medical Research Center for Systemic Autoimmune Diseases in Hunan Province, , Changsha, 410011 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University , Changsha, 410011 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, The Second Xiangya Hospital of Central South University , Changsha, 410011 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Second Xiangya Hospital of Central South University , Changsha, 410011 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su-Kang","family":"Shan","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, The Second Xiangya Hospital of Central South University , Changsha, 410011 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Hui","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, The Second Xiangya Hospital of Central South University , Changsha, 410011 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Min","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, The Second Xiangya Hospital of Central South University , Changsha, 410011 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fu-Xing-Zi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, The Second Xiangya Hospital of Central South University , Changsha, 410011 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bei","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, The Second Xiangya Hospital of Central South University , Changsha, 410011 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Yun","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, The Second Xiangya Hospital of Central South University , Changsha, 410011 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, The Second Xiangya Hospital of Central South University , Changsha, 410011 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke-Xin","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, The Second Xiangya Hospital of Central South University , Changsha, 410011 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye-Chi","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, The Second Xiangya Hospital of Central South University , Changsha, 410011 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan-Lin","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, The Second Xiangya Hospital of Central South University , Changsha, 410011 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si-Yang","family":"He","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, The Second Xiangya Hospital of Central South University , Changsha, 410011 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Dermatology , Hunan Key Laboratory of Medical Epigenetics, Clinical Medical Research Center for Systemic Autoimmune Diseases in Hunan Province, , Changsha, 410011 , China"},{"name":"The Second Xiangya Hospital of Central South University , Hunan Key Laboratory of Medical Epigenetics, Clinical Medical Research Center for Systemic Autoimmune Diseases in Hunan Province, , Changsha, 410011 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling-Qing","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, The Second Xiangya Hospital of Central South University , Changsha, 410011 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,4,16]]},"reference":[{"issue":"9321","key":"2024080610511974200_ref1","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1016\/S0140-6736(02)08761-5","article-title":"Diagnosis of 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