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Цель исследования -изучить связь между кальцификацией коронарных артерий (КА) и остеопеническим синдромом (ОПе) у муж-чин с ишемической болезнью сердца (ИБС). Материал и методы. Обследовано 102 мужчины в возрасте 51 года -75 лет [61 (55; 65) (r=-0,25; р=0,01), 20; р=0,04), МПК шейки бедра (r=-0,23; р=0,02), 19; р=0,04

Развитие атеросклероза-комплексный многофакторный процесс, в котором важную роль играют маркеры формирования и резорбции костной ткани и который тесно связан с кальцификацией интимы сосудов и фиброзных бляшек. Цель исследования-оценка связи показателей костного ремоделирования (катепсин К, С-терминальный телопептид коллагена типа I-CTXI и остеопонтин), минеральной плотности кости (МПК) и тяжести коронарного атеросклероза у мужчин со стабильной ишемической болезнью сердца (ИБС). Пациенты и методы. В исследовании участвовали 102 мужчины с верифицированной стабильной ИБС. Оценивали данные коронарографии, денситометрии, концентрацию в крови катепсина К, остеопонтина и CTXI. Результаты. Концентрация катепсина К и СТХI у пациентов с ИБС была достоверно выше, а концентрация остеопонтинадостоверно ниже, чем у мужчин без ИБС. Не выявлено связи уровня маркеров костного ремоделирования с вариантом поражения венечных артерий и тяжестью коронарного атеросклероза. Показано, что у больных с высоким баллом коронарного атеросклероза по шкале SYNTAX концентрация катепсина К при наличии остеопенического синдрома (ОПС) оказалась в 5,5 раза ниже, чем у больных с аналогичной тяжестью атеросклероза и нормальной МПК. Анализ уровня остеопонтина и СТХI с позиций наличия ОПС свидетельствует об отсутствии различий в зависимости как от варианта поражения коронарных сосудов, так и от его тяжести. Выводы. Современные данные свидетельствуют о наличии общих механизмов развития двух социально значимых состояний-атеросклероза и ОП. Феномен «содружественного» развития этих заболеваний в основном изучался у женщин постменопаузального возраста. Однако сегодня ОП все чаще встречается и у мужчин, ассоциируясь с более тяжелыми проявлениями коронарного атеросклероза, чем у больных без признаков остеопении.

BackgroundThe problem of the relationship between osteoporosis in men and risk factors for atherosclerosis is insufficiently studied.ObjectivesThe aim was to assess the lipid profile of the blood depending on the BMD in men with CHD.Methods93 men older than 50 years (mean age – 60.8±6.9 years) with coronary artery disease verified by coronary angiography were examined. The concentration of total cholesterol (OHS), triglycerides (TG), high and low density lipoprotein cholesterol (HDL and LDL cholesterol) in serum was determined by spectrophotometric method. T-criterion of the femoral neck and lumbar spine was used for the assessment of BMD, which was investigated by the method of two-energy absorptiometry (densitometer Excel XR-46, NORLAND, USA). According to the T-criterion, patients were divided into 3 groups: I – 30 patients with osteoporosis (T-criterion ≤-2.5), II – 44 patients with osteopenia (T-criterion from -1 to -2.5) and III – 19 men with normal BMD (T-criterion ≥-1).ResultsMost men with established CHD dyslipidemia (95.7% of patients): hypercholesterolemia – 76.3%, elevated level of LDL cholesterol – 81.7% of the patients, hypertriglyceridemia in 49.5%, a decrease in the concentration of HDL cholesterol – 44.1% of cases. In all three groups of patients hypercholesterolemia (80, 75 and 73.7% of patients in groups I, II and III, p>0.05) and increased LDL-C concentration (83.3, 84.1 and 73.7% of men in groups I, II and III, p>0.05) were revealed. Reduction of HDL cholesterol level was determined in 46.7% of cases in group I, 43.2% in group II and 42.1% in group III (p>0.05). Hypertriglyceridemia was registered in 60% of patients with osteoporosis, 43.2% - with osteopenia and 47.4% – with normal BMD (p>0.05). Correlation analysis of the relationship of lipid metabolism with the T-criterion in all patients included in the study did not reveal significant relationships (p>0.05).ConclusionThe results of the study indicate the presence of severe dyslipidemia and the absence of dependence of lipid parameters on the state of BMD in men with CHD.Disclosure of InterestsNone declared

Background:Objectives:Assess the severity of coronary atherosclerosis in men with coronary heart disease (CHD) depending on bone mineral density (BMD).Methods:102 of men with verified CHD aged 51-75 (60 .8 ± 6.9) were examined. All patients performed two-energy X-ray absorption of lumbar vertebrae bodies LI-LIV and hip necks (Excell XR-46, Norland, USA) and polyproject coronarangiography (Innova, General Electric, USA). On the basis of results of densitometry on value of T-criterion (the recommendation of ISCD, 2007) estimated BMD condition: normal BMD (T criterion ≥-1), osteopenia (T-criterion from-1 to-2.5) and osteoporosis (OP) (T criterion <-2.5). According to the SYNTAX scale (www.syntaxscore.com), the following degrees of coronary artery (CA) injury severity were isolated to quantify the expression of atherosclerotic injury: low (22 or less), intermediate (23-32) and high (33 or more). According to the result of multispiral computed tomography of CA, calcium index of vessels was determined by the Agatston method using the CaScore program. On the basis of the calcium index value the degree of CA calcinosis was evaluated: 0 - absence of calcinosis, 1-10 - minimal, 11 - 100 - moderate, 101-400 - increased, more than 400 - expressed calcinosis.Results:According to the results of densitometry, patients were found to have 21 patients (20.6%) with normal BMD, 48 (47.0%) - osteopenia and 33 (32.4%) -osteoporosis. Osteopenic syndrome (OPS) was found in 79.4% of men. All patients tested, depending on the degree of CA calcinosis, were distributed as follows: 57.8% of men had pronounced CA calcinosis, 25.5% - increased, 6.9% - moderate, 2.0% - minimal, 7.8% of patients had no CA calcinosis. In a comparative analysis of the degree of coronary calcinosis in men with CHD depending on the T-criterion, it was found that the majority of patients with OPS (69.7% of patients with OP and 60.4% with OPe) had pronounced CA calcinosis. In men with normal BMD, the prevalence of pronounced CA calcinosis (33.3%) was significantly lower than in patients with OPS (p < 0.050). Calcinosis-negative CA was recorded reliably more frequently in patients with normal BMD (28.6%) compared to men with low BMD (p < 0.050). The results of the work demonstrated the relationship of the studied parameters of coronary atherosclerosis expression with densitometry indicators in men with CHD. Thus, the inverse correlation of the BMD at the level of the hip neck with the number of significant stenoses of the spacecraft (r = -0.19; P = 0.045) and the degree of coronary calcinosis (r = -0.23; P = 0.022) and similar dependence of BMD of vertebral bodies LI-LIV with coronary calcinosis degree (r = -0.19; р=0,046). A direct correlation between CA calcinosis and FRAX hip fracture risk (r = 0,24; р=0,018). Inverse correlation of parameters of atherosclerotic damage of CA (number of significant stenoses and degree of calcinosis) with BMD was established, and direct correlation of CA calcinosis degree with risk of hip fracture on FRAX scale in male persons with CHD over 50 years of age was revealed.Conclusion:The findings suggest in favor of likely common mechanisms for developing atherosclerosis with OP and allow coronary calcinosis to be considered as a condition potentially increasing the risk of hip fracture.Disclosure of Interests:None declared