Association of coronary artery calcium with bone mineral density in postmenopausal women

Xu, Rui; Yang, Haiming; Li, Yuqing; Guo, Aixia; Ayiti, Aliya; Chen, Xinchun; Gong, Rui; Banu, Guli; Jian, Li-Dang; Gao, Yun; Sheng, Ke; Maimti, Yasinjan

doi:10.1097/mca.0000000000000402

Cited by 14 publications

(23 citation statements)

References 26 publications

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“…The odds for coronary artery calcification in osteoporotic women were over three-fold higher compared with those in women with a normal BMD. 11 …”

Section: Discussionmentioning

confidence: 99%

“…BMD results were reported as T-scores, which were also categorized into three groups according to the World Health Organization (WHO) criteria for diagnosing osteoporosis: normal BMD (T-score≥-1 SD); osteopenia (T < -1 SD and > -2.5 SD); and osteoporosis (T-score ≤ -2.5 SD). 11 …”

Section: Methodsmentioning

confidence: 99%

“…These findings indicate that decreased BMD may increase the risk of CAD. 11 However, little is known about the association between decreased BMD and severity of coronary lesions in postmenopausal woman.…”

Section: Introductionmentioning

confidence: 99%

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

Xu¹,

Cheng²,

Zhang³

et al. 2018

Arquivos Brasileiros De Cardiologia

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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.

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“…The odds for coronary artery calcification in osteoporotic women were over three-fold higher compared with those in women with a normal BMD. 11 …”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

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

Xu¹,

Cheng²,

Zhang³

et al. 2018

Arquivos Brasileiros De Cardiologia

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“…Thus, aberrant levels of osteoprotegerin, sclerostin, or FGF-23 may explain and predict the occurrence of both osteoporotic fractures and cardiovascular events. 15 , 17 …”

Section: Introductionmentioning

confidence: 99%

Role of smooth muscle cells in vascular calcification: implications in atherosclerosis and arterial stiffness

Durham

Speer

Scatena

et al. 2018

Cardiovascular Research

727

662

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Vascular calcification is associated with a significant increase in all-cause mortality and atherosclerotic plaque rupture. Calcification has been determined to be an active process driven in part by vascular smooth muscle cell (VSMC) transdifferentiation within the vascular wall. Historically, VSMC phenotype switching has been viewed as binary, with the cells able to adopt a physiological contractile phenotype or an alternate ‘synthetic’ phenotype in response to injury. More recent work, including lineage tracing has however revealed that VSMCs are able to adopt a number of phenotypes, including calcific (osteogenic, chondrocytic, and osteoclastic), adipogenic, and macrophagic phenotypes. Whilst the mechanisms that drive VSMC differentiation are still being elucidated it is becoming clear that medial calcification may differ in several ways from the intimal calcification seen in atherosclerotic lesions, including risk factors and specific drivers for VSMC phenotype changes and calcification. This article aims to compare and contrast the role of VSMCs in driving calcification in both atherosclerosis and in the vessel media focusing on the major drivers of calcification, including aging, uraemia, mechanical stress, oxidative stress, and inflammation. The review also discusses novel findings that have also brought attention to specific pro- and anti-calcifying proteins, extracellular vesicles, mitochondrial dysfunction, and a uraemic milieu as major determinants of vascular calcification.

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“…The inverse relationship between bone density and coronary calcification has been described in several different clinical contexts, suggesting that plaque calcification and bone demineralization share common pathophysiological mechanisms. However, in other studies, associations between CCS and BMD were also not always maintained after adjustments to factors that could affect more CCS …”

Section: Discussionmentioning

confidence: 99%

Coronary artery calcium score in female rheumatoid arthritis patients: Associations with apolipoproteins and disease biomarkers

et al. 2019

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Aims and methods In rheumatoid arthritis (RA), cardiovascular (CV) comorbidities are a major cause of mortality. Coronary Calcium Score (CCS) assessed by computed tomography has been associated with RA prognosis. In this work, we aimed to assess CCS in female RA patients and determine CCS association with different clinical, laboratory and imaging disease parameters. Results We evaluated 60 female patients, with a mean age of 53.6 ± 10.4 years, a mean Disease Activity Score of 28 joints (DAS28) (4v) and Health Assessment Questionnaire (HAQ) of 4.542 ± 1.317 and 1.488 ± 0.631, respectively, and a disease duration of 14.7 ± 10.3 years. Mean CCS value was 35.192 ± 117.786. CCS > 10 was significantly associated with CV risk factors (age: odds ratio [OR] = 1.120; P = .002, body mass index [BMI] ≥ 25 kg/m2: OR = 0.271; P = .025, high‐density lipoprotein [HDL]: OR = 0.011; P = .025, low‐density lipoprotein/ HDL ratio: OR = 2.084; P = .030, apolipoprotein A1 [ApoA1]: OR = 0.965; P = .014, apolipoprotein B/ApoA1 [ApoB/ApoA1] ratio: OR = 59.834; P = .011, homocysteine: OR = 1.287; P = .045, diabetes: OR = 10.400; P = .043, and anti‐diabetic therapy: OR = 10.667, P = .041), disease parameters (C‐reactive protein [CRP]: OR = 1.038; P = .046, DAS[4v]: OR = 1.900; P = .009, DAS28[4v; CRP]: OR = 1.700; P = .019, DAS[3v]: OR = 1.947; P = .010, DAS28[3v; CRP]: OR = 1.696; P = .022, HAQ: OR = 3.299; P = .023, erosion score: OR = 1.015; P = .012, and total modified Sharp/van der Heijde Score: OR = 1.008; P = .035), biomarkers (osteoprotegerin: OR = 1.505; P = .022), and bone mineral density (femoral: OR = 0.005; P = .018, lumbar spine: OR = 0.001; P = .002, left hand: OR = 7.9 × 10−9; P = .005, and osteoporosis: OR = 6.628; P = .007). After adjustment for age and BMI, significant associations were maintained with ApoA1, ApoB/ApoA1 ratio, homocysteine, CRP, DAS(4v), DAS(4v; CRP), DAS(3v) and DAS(3v; CRP). A sensitivity analysis undertaken after excluding the 6 diabetics yielded similar results. Conclusions Our work reinforces the hypothesis that in RA, CCS may be a useful tool in CV risk assessment, particularly valuable in poorer controlled patients with certain lipoprotein profiles.

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Association of coronary artery calcium with bone mineral density in postmenopausal women

Abstract: BMD identified on images from dual-energy X-ray absorptiometry were strongly related to multidetector computed tomography measures of CAC. This low-cost, minimal radiation technique used widely for OP screening is a promising marker of generalized coronary atherosclerosis.

Cited by 14 publications

References 26 publications

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

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

Role of smooth muscle cells in vascular calcification: implications in atherosclerosis and arterial stiffness

Coronary artery calcium score in female rheumatoid arthritis patients: Associations with apolipoproteins and disease biomarkers

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