Association of Severity of Coronary Lesions with Bone Mineral Density in Postmenopausal Women

Abstract

BackgroundCoronary artery disease (CAD) and osteoporosis (OP) are common diseases in postmenopausal women. In both cross-sectional and longitudinal epidemiologic studies, low bone mass has been related to increased frequency of CAD. However, available data on the relationship between bone mineral density (BMD) and severity of coronary lesions is limited.ObjectiveTo investigate association between the BMD and severity of coronary lesions assessed by Gensini score in postmenopausal women.MethodsThis study included 122 postmenopausal women who were diagnosed with CAD. These patients were divided into two groups according to the severity of coronary lesions assessed by the Gensini score - patients with mild coronary lesions (Gensini score < 25) and patients with severe coronary lesions (Gensini score ≥ 25). Femoral neck mineral density was measured with dual energy X-ray absorptiometry (DXA).ResultsThe study included postmenopausal women aged 64.31 ± 4.71 years, 85 of whom (69.7%) exhibited severe coronary lesions. Participants with severe coronary lesions had a significantly higher T score than did those with mild coronary lesions at the femoral neck (p < 0.05). The mean T-score was −0.84 ± 1.01 in mild coronary lesions group, −1.42 ± 1.39 in severe coronary lesions group (p < 0.05). Multivariable logistic regression analysis showed that osteopenia-osteoporosis at the Femoral neck (odds ratio 2.73; 95% confidence interval 1.06 to 6.13) was associated with an increased risk of developing severe coronary lesions. The multiple regression model showed that T-scores (b = −0.407, SE = 0.151, p=0.007) were the independent predictors of Gensini score.ConclusionThe relationship between severity of coronary lesions and BMD was significant in postmenopausal women. BMD, a low-cost technique involving minimal radiation exposure, widely used for osteoporosis screening, is a promising marker of severity of coronary lesions.

The interrelationship between the cardiovascular remodeling indicators and the state of bone mineral density in women with coronary artery disease

“…In the groups with BMD disorders, the number of patients who had calcinosis of two or more valves was significantly higher, and it was maximal in the group with osteoporosis. The studies of other authors also showed a link between calcification of the valves of the heart, coronary and peripheral arteries, and a decrease in BMD [13,[16][17][18], which can be explained by excessive activation of specific proteins (osteoprotegerin, osteocalcin), which leads not only to bone mineralization abnormalities, but also to the formation of ectopic calcification.…”

Calcification of lower extremity arteries is related to the presence of osteoporosis in postmenopausal women with type 2 diabetes mellitus: a cross-sectional observational study

“…Previous studies including ours [7] have suggested that calcification, not plagues, is associated with low BMD and higher risk for osteoporosis. The mechanism was considered to be the effects of chronic inflammation and/or the oxidative stress of calcium metabolism [11][12][13]. Risk factors, such as aging and decreased levels of sex hormones (especially estrogen), could lead to increased levels of inflammatory and oxidative stress cytokines [14,15].…”

“…For example, Alan et al found a significant association between cardiovascular disease and low bone mass [ 11 ]. BMD is a promising marker for the severity of coronary lesions [ 12 ] and coronary artery calcium [ 13 ]. Previous studies including ours [ 7 ] have suggested that calcification, not plagues, is associated with low BMD and higher risk for osteoporosis.…”

Prevalence of Musculoskeletal Disorders in Patients with Coronary Artery Disease

“…Если изолированной остеопении посвящены немногочисленные исследования, то проблема остео-пороза широко освещена. Несмотря на это, в ряде публикаций продемонстрировано, что у большинства пациентов с переломами МПК находится в диапазоне диагностики остеопении, что позволяет сделать вывод о том, что численность популяции с остеопенией выше, чем с остеопорозом [18,19]. В ходе настоящего исследования среди пациентов, поступивших для хирургического лечения ИБС, у 7,2% отмечены диагностические критерии остеопенического синдрома (остеопения/остеопороз), причем, практически в 10 раз чаще диагностировали остеопению, а не остеопороз (90,6 и 9,4% случаев соответственно).…”

“…Так, в исследование R. Xu и соавт. [19] были включены 122 женщины с ИБС в постменопаузе (средний возраст 64,31±4,71 года), у 19,6% пациентов диагностирован остеопороз и в два раза чаще -остеопения (41,8% случаев). При этом логистический регрессионный анализ показал взаимосвязь между остеопорозом/остеопенией и более тяжелым поражением коронарного русла (отношение шансов [ОШ] 2,51, 95% доверительный интервал [ДИ] 1,153-5,657; p=0,003).…”