Discussion
AMD, bone loss, osteopenia, senile osteoporosis, osteoporosis
FRAGILITY FRACTURE, BONE LOSS, OSTEOPENIA, BONE DISEASES, SENILE OSTEOPOROSIS, PATHOGENESIS, OSTEOPOROSIS
Our study revealed an association between a decrease in femoral BMD and the occurrence of AMD in men older than 50 years. In contrast, we did not observe any differences in the densitometric parameters of women in relation to AMD prevalence. The results of our study provide grounds for actively screening for AMD among patients with osteopenia. Routine screening diagnostics in the form of the Amsler grid eye test should be considered in patients with low bone density.Published data on the coincidence of osteoporosis and AMD are scarce. The first such study included only Caucasian women aged >75 years from the USA [The pathogenesis of AMD is multifactorial, and the molecular mechanisms underlying its development are still not understood. Its pathogenesis involves environmental and genetic factors, disorders of the complement system, lipid abnormalities, angiogenic and inflammatory pathways, and the extracellular matrix [One possible reason for the coexistence of AMD with bone loss or decreased BMD is the impairment of autophagy observed in both conditions. Both AMD and senile osteoporosis are associated with decreased autophagic activity. Impaired autophagy plays a pivotal role in the onset and progression of osteoporosis [P62/SQSTM1 may also be involved in bone diseases, as a high frequency of The prevalence of AMD in our study was 10.8%. Although the global prevalence of AMD is estimated at 8.7%, a meta-analysis has suggested that its prevalence is higher in European countries (12.3%–18.3%) [Our study is not without limitations. First, it was limited by its observational nature, relatively small number of patients, and lack of detailed data on AMD status. Second, we did not analyze the effects of other factors involved in the coincident development of AMD and osteoporosis, e.g., smoking, alcohol consumption, and dietary calcium intake. We did not have access to fragility fracture data or a fall registry for the study population. Furthermore, the health data of the study participants were obtained at a single timepoint. As certain parameters, such as BMD, body mass index, calcium intake, and serum vitamin D level, change over time, this factor should be considered a potential confounder. Third, the group of women with AMD was older than that without AMD. As the risks of AMD and osteoporosis both increase with age, this factor may explain the lack of a significant relationship between AMD and low BMD in women in this study. Differences in BMD between men with and those without AMD were detected only in the femoral region and not in the lumbar spine. We could not further explore this association, as dual-energy X-ray absorptiometry does not provide insights into bone quality and structure. Despite these limitations, this is the first study in which the link between a low hip BMD and AMD was demonstrated in a Polish population.In conclusion, further longitudinal research with a larger group of participants is required to confirm the link and potential pathogenic association between AMD and a low BMD in the Polish population.