Relationships between calcified atherosclerotic plaque and bone mineral density in African Americans with type 2 diabetes

Abstract

Inverse relationships have been reported between bone mineral density (BMD) and calcified atherosclerotic plaque (CP). This suggests these processes may be related. We examined relationships between BMD and CP in 753 African Americans with type 2 diabetes from 664 families, accounting for the effects of modifiable cardiovascular disease (CVD) risk factors. Association analyses were performed using generalized estimating equations (GEEs) to assess cross-sectional relationships between computed tomography–determined measures of thoracic and lumbar vertebral volumetric BMD (vBMD) and CP in the coronary and carotid arteries and infrarenal aorta. Significant inverse associations were seen between thoracic and lumbar vBMD and CP in all three vascular beds in unadjusted analyses. A fully adjusted model accounting for age, sex, body mass index, systolic blood pressure, low-density lipoprotein cholesterol, C-reactive protein, hemoglobin A1c, smoking, and hormone-replacement therapy revealed significant inverse associations between thoracic vBMD and CP in coronary and carotid arteries and aorta, whereas lumbar vBMD was associated with CP in coronary artery and aorta. Inverse associations exist between vertebral BMD and calcified atherosclerotic plaque in African-American men and women with type 2 diabetes. This relationship was independent of conventional CVD risk factors and supports the hypothesis that bone metabolism and atherosclerotic plaque mineralization are related processes.

Relationships Between Serum Adiponectin and Bone Density, Adiposity and Calcified Atherosclerotic Plaque in the African American-Diabetes Heart Study

“…We have also observed inverse relationships between vBMD and calcified atherosclerotic plaque (CP) in EAs (12,13). Nevertheless, relationships between adiponectin, vBMD, and subclinical cardiovascular disease (CVD) are poorly defined in AAs.…”

“…Coefficients of variation for these measures have previously been reported and were less than 1% for thoracic and lumbar BMD, and in sequential studies performed in the same individual, the precision error was 2.3% (13).…”

“…Self-reported and unrelated AAs with T2D were recruited from internal medicine clinics and community advertising in the AA-DHS (13). Participant examinations were conducted in the Clinical Research Unit of the Wake Forest Baptist Medical Center and included interviews for medical history and health behaviors, anthropometric measures, resting blood pressure (BP), 12-lead electrocardiography, fasting blood sampling, and spot urine collection.…”

“…Techniques for the coronary and carotid scans have been described in detail (13). In brief, participants were placed in the supine position on the CT couch over a quality control calibration phantom (Image Analysis, Inc, Columbia, Kentucky) for scans of the heart and abdomen.…”

Association between cardiovascular diseases and osteoporosis—reappraisal

“…8 In a group of siblings concordant for type 2 diabetes, severity of the coronary and aortic calcification was correlated negatively with spine volumetric BMD. 9 In other studies, the association between AAC severity and BMD was weak or non-significant. 10 -13 Limited data also suggest a weak but significant association between severe peripheral arterial disease (PAD) and lower BMD at the hip.…”