Osteoporosis and atherosclerosis: a post-mortem MDCT study of an elderly cohort

Issever, Ahi Sema; Kentenich, Marie; Köhlitz, Torsten; Diederichs, Gerd; Zimmermann, Elke

doi:10.1007/s00330-013-2903-1

Cited by 7 publications

(5 citation statements)

References 38 publications

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“…Interestingly, this finding was observed even in the frail group with history of cardiovascular disease, as mentioned before. On the other hand, the results of calcium score observed in the present study are comparable with previous findings investigating this variable in healthy elderly [44], reinforcing the vascular calcification as an age-dependent entity.…”

Section: Discussionsupporting

confidence: 95%

Adipose tissue compartments, muscle mass, muscle fat infiltration, and coronary calcium in institutionalized frail nonagenarians

Idoate¹,

Cadore

Casas‐Herrero

et al. 2014

Eur Radiol

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Section: Discussionsupporting

confidence: 95%

Adipose tissue compartments, muscle mass, muscle fat infiltration, and coronary calcium in institutionalized frail nonagenarians

Idoate¹,

Cadore

Casas‐Herrero

et al. 2014

Eur Radiol

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“…After assessing the 35 potentially-relevant articles, 25 articles (23 case-control studies and 2 cohort studies) involving 10,299 patients met the inclusion criteria [ 5 , 15 – 18 , 23 – 42 ]. The primary reasons for exclusion were as follows: one paper was a cadaver study [ 43 ]; one study failed to relate the data to low BMD and atherosclerotic vascular abnormalities [ 44 ]; one study was based on male patients with with type 2 diabetes mellitus, and the exposure was not relevant [ 45 ]; three articles were excluded because the study population size was unavailable and the association between low BMD and atherosclerosis was not presented [ 9 , 46 , 47 ]; and four studies were excluded because they were not case-control or cohort studies [ 12 , 48 – 50 ]. The details of study selection are presented in Fig 1 .…”

Section: Resultsmentioning

confidence: 99%

Decreased Bone Mineral Density Is an Independent Predictor for the Development of Atherosclerosis: A Systematic Review and Meta-Analysis

Wang

et al. 2016

PLoS ONE

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BackgroundThere is conflicting evidence regarding the association between decreased bone mineral density (BMD) and atherosclerosis. To this end, we performed a systematic review and meta-analysis to clarify the association.MethodsTo identify relevant studies, PubMed, Embase, and the Cochrane Library were systematically searched up to November 2015. All observational and comparative studies directly investigating the relationship between decreased BMD and clinical consequences of atherosclerotic vascular abnormalities, including carotid artery calcification (CAC), cardiovascular disease (CAD), and coronary artery disease (CAD) were obtained, without limitation of language or publication year.ResultsA total of 25 studies involving 10,299 patients were included. The incidence of atherosclerotic vascular abnormalities was significantly increased in low BMD patients, compared to patients with normal BMD (OR, 1.81, 95% CI [1.01, 2.19], p<0.00001)). Similar results were also observed for postmenopausal women (OR, 2.23, 95% CI [1.72, 2.89], p<0.00001). Subgroup analyses of osteopenia, osteoporosis, and normal BMD also revealed that the combined ORs for the incidence of atherosclerotic vascular abnormalities increased as BMD decreased. Of note, after adjusting for age, sex, body mass index (BMI) and other vascular risk factors, decreased BMD remained significantly associated with the incidence of atherosclerotic vascular abnormalities (OR, 2.96, 95% CI [2.25, 3.88], p < 0.00001).ConclusionsBased on the results of this study, decreased BMD is an independent predictor for the development of atherosclerosis in elderly individuals. Moreover, the risk of atherosclerotic vascular abnormalities increased as BMD decreased. Future studies focusing on individuals with different severities of atherosclerosis and comorbidities are of interest.

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“…Lastly, although our scanners were calibrated weekly, we did not use a calibration phantom in this study as is done in QCT of the spine. We were therefore unable to provide BMD as milligrams hydroxyapatite per cubic centimetre and our method has lower precision compared to QCT [ 30 , 31 ]. However, previous studies have shown that, although precision was lower compared to QCT, BMD estimation techniques without phantom calibration were nevertheless promising for assessing fracture risk [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Inter-observer and inter-examination variability of manual vertebral bone attenuation measurements on computed tomography

Pompe

Jong

et al. 2016

Eur Radiol

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ObjectiveTo determine inter-observer and inter-examination variability of manual attenuation measurements of the vertebrae in low-dose unenhanced chest computed tomography (CT).MethodsThree hundred and sixty-seven lung cancer screening trial participants who underwent baseline and repeat unenhanced low-dose CT after 3 months because of an indeterminate lung nodule were included. The CT attenuation value of the first lumbar vertebrae (L1) was measured in all CTs by one observer to obtain inter-examination reliability. Six observers performed measurements in 100 randomly selected CTs to determine agreement with limits of agreement and Bland-Altman plots and reliability with intraclass correlation coefficients (ICCs). Reclassification analyses were performed using a threshold of 110 HU to define osteoporosis.ResultsInter-examination reliability was excellent with an ICC of 0.92 (p < 0.001). Inter-examination limits of agreement ranged from -26 to 28 HU with a mean difference of 1 ± 14 HU. Inter-observer reliability ICCs ranged from 0.70 to 0.91. Inter-examination variability led to 11.2 % reclassification of participants and inter-observer variability led to 22.1 % reclassification.ConclusionsVertebral attenuation values can be manually quantified with good to excellent inter-examination and inter-observer reliability on unenhanced low-dose chest CT. This information is valuable for early detection of osteoporosis on low-dose chest CT.Key Points• Vertebral attenuation values can be manually quantified on low-dose unenhanced CT reliably.• Vertebral attenuation measurements may be helpful in detecting subclinical low bone density.• This could become of importance in the detection of osteoporosis.Electronic supplementary materialThe online version of this article (doi:10.1007/s00330-015-4145-x) contains supplementary material, which is available to authorized users.

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Osteoporosis and atherosclerosis: a post-mortem MDCT study of an elderly cohort

Cited by 7 publications

References 38 publications

Adipose tissue compartments, muscle mass, muscle fat infiltration, and coronary calcium in institutionalized frail nonagenarians

Adipose tissue compartments, muscle mass, muscle fat infiltration, and coronary calcium in institutionalized frail nonagenarians

Decreased Bone Mineral Density Is an Independent Predictor for the Development of Atherosclerosis: A Systematic Review and Meta-Analysis

Inter-observer and inter-examination variability of manual vertebral bone attenuation measurements on computed tomography

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