Relation between intima-media thickness and bone mineral density in postmenopausal women: a cross-sectional study

Abstract

Relation between intima-media thickness and bone mineral density in postmenopausal women: a cross-sectional study ABSTRACTCONTEXT AND OBJECTIVES: Controversy exists regarding the relationship between atherosclerosis and osteoporosis. The aim of this study was to determine the relationship between intima-media thickness (IMT) of the common carotid artery (CCA), presence of calcified atherosclerotic plaques and bone mineral density (BMD) evaluated by dual energy X-ray absorptiometry (DXA), in postmenopausal women. DESIGN AND SETTING:Cross-sectional study at Second Internal Medicine Clinic, Cluj-Napoca, Romania. METHODS:We studied the IMT (left and right CCA and mean IMT) and T-score (lumbar spine L2-L4, femoral neck and total hip) in 100 postmenopausal women (mean age 64.5 years). The presence of calcified atherosclerotic plaque and osteoporotic vertebral fractures was also noted. RESULTS:IMT in the left and right CCA and mean IMT were significantly associated with T-score measured for the lumbar spine L2-L4, femoral neck and total hip, with lower T-score, in the osteoporotic group than in the normal and osteopenic groups (P < 0.05). IMT had a significantly negative correlation with the lumbar spine T-score and femoral neck T-score; and mean IMT with lowest T-score. Mean IMT (P < 0.001), high blood pressure (P = 0.005) and osteoporotic vertebral fractures (P = 0.048) showed statistical significance regarding the likelihood of developing atherosclerotic plaque. CONCLUSIONS:In women referred for routine osteoporosis screening, the relationship between CCA, atherosclerosis and osteoporosis can be demonstrated using either cortical or trabecular BMD. Vertebral fractures may be considered to be a likelihood factor for atherosclerotic plaque development. RESUMÉN CONTEXTO Y OBJETIVOS:Hay controversias en cuanto a la relación entre la arterioesclerosis y la osteoporosis. El objetivo del estudio fue determinar la relación entre el espesor mío-intimal (EMI) de la arteria carótida común (ACC), la presencia de placas arterioescleróticas calcificadas, y la densidad mineral ósea (DMO) evaluada a través de absorciometría de rayos X de energía dual (DEXA) en mujeres posmenopáusicas. DISEÑO Y ENTORNO:Estudio transversal en la Segunda Clínica de Medicina Interna, Cluj-Napoca, Rumania. MÉTODOS:Hemos estudiado el EMI (ACC izquierda y derecha y EMI promedio) y el T-score (espina lumbar L2-L4, cuello femoral y cadera total) en 100 mujeres posmenopáusicas (edad promedia 64.5 años). Se ha observado también la presencia de las placas arterioescleróticas calcificadas y de la fractura vertebral osteoporótica.RESULTADOS: El EMI en ACC izquierda y derecha, como también el EMI promedio se ha asociado sobre todo con el T-score medido en la espina lumbar L2-L4, cuello femoral y cadera total o el valor más bajo del T-score, en el grupo osteoporótico, en comparación con el grupo normal y el osteopénico (P < 0.05). Se ha registrado una correlación significativamente negativa entre el EMI y el T-score de espina lumbar, el T-score del cuello femora...

Association between Lumbar Bone Mineral Density and Carotid Intima-Media Thickness in Korean Adults: a Cross-sectional Study of Healthy Twin Study

“…In support of this explanation, one study found that femur BMD was inversely associated with CIMT, whereas lumbar BMD was not (10). However, since even the findings regarding the association of lumbar spine BMD with CIMT vary between studies (101132), variation regarding the site of BMD measurement cannot fully explain the discrepancies between these studies. Second, different age distributions between studies may have resulted in these discrepancies.…”

“…Therefore, an inverse association between BMD and atherosclerosis seems plausible in postmenopausal women. Some studies found an inverse association between BMD and CIMT (81332). However, other studies in Morocco, the USA, Finland, China, Japan, and Korea (including the present study) did not find any association between lumbar BMD and CIMT, or any other surrogate marker of atherosclerosis, in postmenopausal women (1011141620).…”

Carotid Intima‐Media Thickness is Inversely Related to Bone Density in Female but not in Male Patients with Acute Stroke

“…Evidence from cell culture to epidemiologic studies has demonstrated significant relations between low BMD and atherosclerosis . Several studies conducted in general population support the possibility of a link between osteoporosis and atherosclerosis . In a cross‐sectional, population‐based study of 2543 men and 2726 postmenopausal women, low bone mass is associated with an increased risk of echogenic calcified atherosclerotic plaques .…”

“…Metaanalysis of four studies (25,760 participants, 1,237 cases of stroke) shows that for every decrease in 1 SD in BMD, there is an increased risk of incident stroke among women (pooled relative risk 1.22; 95% confidence intervals, 1.09‐1.37) . These two diseases have common pathophysiological mechanisms and the presence of one is a predictor for the other . Though several plausible molecular and systemic factors have been proposed, the reasons for such a causal relationship between low BMD and atherosclerosis are not fully understood.…”

Medicina cardiovascular brasileira baseada em evidências

“…Fodor et al 19 evaluated the association between osteoporosis and atherosclerosis in postmenopausal women. The aim of this study was to determine the association between the thickness of the intima and media layers of common carotid arteries, the atherosclerotic plaques and bone density.…”