Cross-sectional association of bone mineral density with coronary artery calcification in an international multi-ethnic population-based cohort of men aged 40–49: ERA JUMP study

Nakama, Chikako; Kadowaki, Takashi; Choo, Jina; El-Saed, Aiman; Kadota, Aya; Willcox, Bradley J.; Fujiyoshi, Akira; Shin, Chol; Leader, Joseph K.; Miura, Katsuyuki; Ueshima, Hirotsugu; Kuller, Lewis H.; Bon, Jessica

doi:10.1016/j.ijcha.2020.100618

Cited by 4 publications

(4 citation statements)

References 51 publications

(131 reference statements)

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“…Although most studies have been conducted in women, especially in postmenopausal women, an international multi-ethnic study reported a significant inverse association between vertebral bone density (VBD) and coronary atherosclerosis in middle-aged men. [34] In contrast, the Rotterdam Study found no association between BMD and CACS in men and women (mean age, 64 years). [35] Likewise, the Study of Womens' Health Across the Nation did not show a significant association between BMD and CACS in premenopausal women.…”

Section: Discussionmentioning

confidence: 93%

The Association of Coronary Artery Calcium Score and Osteoporosis in Postmenopausal Women: A Cross-Sectional Study

et al. 2022

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Background: The association between osteoporosis, a common metabolic bone disorder, and atherosclerosis has been reported in different studies. In this study, we aimed to investigate the association between the coronary artery calcium score (CACS) and bone mineral density (BMD) at different sites and bone biomarkers in postmenopausal women.Methods: A total of 184 participants were enrolled in this study. The CACS and BMD at different sites, including the spinal, total hip, and femoral neck, were measured using computed tomography angiography and dual energy X-ray absorptiometry, respectively. Serum levels of osteocalcin, β-C-terminal telopeptide (β-CTX), parathyroid hormone, and 25-hydroxy-vitamin D were measured.Results: A negative association between CACS and bone biomarker levels (osteocalcin, P=0.021; β-CTX, P=0.013) was noted. The univariable model showed an association between CACS and osteoporosis of the femoral neck (P=0.03). It was found that with an increase of 10 U in CACS, the odds of osteoporosis at the femoral neck escalates by 2% (odds ratio=1.02, 95% confidence interval, 1.002–1.03) using the multivariate logistic regression model, while such an association with osteoporosis could not be found at the spinal site. The best cutoff point of the calcium score was estimated to be 127.Conclusions: The results suggest that in postmenopausal women, coronary atherosclerosis is independently associated with osteoporosis of the femoral neck, but such an association could not be detected with spinal osteoporosis. The importance of screening for osteoporosis in patients with cardiovascular disease and the implications of preventive measures in the primary care setting were highlighted considering the common risk factors.

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Section: Discussionmentioning

confidence: 93%

The Association of Coronary Artery Calcium Score and Osteoporosis in Postmenopausal Women: A Cross-Sectional Study

et al. 2022

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“…Similarly, in a multicenter Chinese population study, which included 3457 participants, lumbar spine vBMD was inversely associated with abdominal aortic calcification in men but not women [6]. The EBCT and Risk Factor Assessment among Japanese and US Men in the Post-World-War-II birth cohort study, which included 1134 men aged 40–49 years, also demonstrated an inverse association between vertebral bone density and CAC [24]. On the contrary, some other large studies found a reverse relationship between lumbar spine vBMD and CAC (abdominal aortic calcification) in postmenopausal women only [25–27] or both sexes [7,28,29].…”

Section: Discussionmentioning

confidence: 99%

Association between bone mineral density and coronary plaque burden in patients with coronary artery disease: a cross-sectional study using quantitative computed tomography

Geng,

Li,

Wang

et al. 2023

Coronary Artery Disease

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Purpose To evaluate the association between osteoporosis and coronary calcification and coronary plaque burden in patients with atherosclerosis and coronary artery disease (CAD). Methods This study included 290 men and 177 postmenopausal women with angiography-confirmed atherosclerosis or CAD who underwent chest multidetector row computed tomography covering L1-L2 between September 2020 and October 2021. Quantitative computed tomography was used to measure the lumbar vertebra’s bone mineral density (BMD). The coronary artery calcium score (CACS) and total coronary plaque burden were quantified using the Agatston and modified Gensini scores, respectively. Associations between BMD and CACS and modified Gensini scores were assessed using multivariate regression analysis. Lasso regression was used in model selection. Results In men, BMD was inversely associated with CACS [β = −0.24; 95% confidence interval (CI), −0.35 to −0.13; P < 0.001) and coronary artery calcification (CAC) presence [odds ratio (OR) = 0.71; 95% CI, 0.52–0.96; P = 0.03) in the unadjusted model. After adjusting for age, modified Gensini score, prior percutaneous coronary intervention and hypertension, BMD was inversely associated with CACS (β = −0.11; 95% CI, −0.22 to −0.01; P = 0.04). In postmenopausal women, BMD was inversely associated with CACS (β = −0.24; 95% CI, −0.39 to 0.10; P < 0.001) and CAC presence (OR = 0.66; 95% CI, 0.47–0.92; P = 0.01) in the unadjusted model but no other models (P > 0.05). In both sexes, BMD did not correlate with the modified Gensini score or CAD prevalence (all P > 0.05). Conclusion In patients with coronary atherosclerosis and CAD, BMD of the lumbar vertebra correlated inversely with CACS in men but not postmenopausal women. Additionally, BMD did not correlate with the modified Gensini score in both sexes.

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“…The subjects who met the following criteria were excluded: (1) patients with acute complications of diabetes, acute coronary syndrome and other high-risk characteristics; (2) patients with myocardial infarction, angina pectoris, valvular heart disease, cardiomyopathy; 16 (3) those who had previously undergone coronary artery bypass grafting or percutaneous coronary stenting; 17 (4) those who took lipid-lowering drugs such as atorvastatin or rosuvastatin in half year; 18 (5) Those with severe liver and kidney dysfunction; (6) those with diseases that significantly affected bone metabolism, such as hyperthyroidism and hypoparathyroidism; 19,20 (7) those who took calcium, vitamin D, antiepileptic drugs, hormones and other drugs that significantly affected bone metabolism within 1 year; 21 (8) those with malignant tumors and autoimmune diseases; 22,23 (9) relevant information was incomplete.…”

Section: Exclusion Criteriamentioning

confidence: 99%

“…In addition, several large clinical studies showed that CACs was significantly negatively correlated with BMD. 6 These studies suggested that vascular calcification and BMD may be closely related in pathological mechanism. However, some studies have suggested that there was no correlation between CACs and BMD after controlling for multiple risk factors.…”

Section: Introductionmentioning

confidence: 99%

Association Between Coronary Artery Calcium Score and Bone Mineral Density in Type 2 Diabetes Mellitus with Different Visceral Fat Area

Yang¹,

Zhang²,

Ye³

et al. 2022

DMSO

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Purpose The relationship between coronary artery calcification and bone mineral density (BMD) in T2DM is still unclear. The aim of this study is to analyze the association between coronary artery calcium score (CACs) and BMD in T2DM with different visceral fat area (VFA), and further to explore the clinical significance of CACs in predicting osteoporosis in T2DM patients. Patients and Methods A total of 479 T2DM patients aged ≥50 years were included. Agatston was applied to calculate CACs to evaluate the degree of coronary artery calcification. Dual-energy X-ray absorptiometry (DXA) was used to measure BMD. According to VFA, all subjects were divided into VFA <100cm 2 and VFA ≥100cm 2 group. Adjusted regression analysis was performed to analyze the association between CACs and BMD. ROC curve was used to analyze the optimal cut-off value of CACs for screening osteoporosis. Results The baseline showed that in VFA ≥100cm 2 group, CACs increased significantly than that in VFA <100cm 2 group (212.1±195.9 vs 139.3±141.8, p <0.001) and total hip BMD decreased obviously (0.968±0.19 vs 1.021±0.184, p =0.01). After multivariable adjustment, CACs was not significantly associated with BMD in all patients ( p >0.05). However, CACs was negatively associated with BMD of total hip and lumbar spine in patients with VFA ≥100cm 2 (total hip β=−0.087 p =0.01; lumbar spine β=−0.052 p =0.005), but not VFA <100cm 2 . ROC curve analysis showed that the optimal cut-off value of CACs for screening osteoporosis was 191.505. Conclusion The present study implied that associations between CACs and BMD varied by the visceral fat deposition. It is critical to evaluate the condition of visceral fat accumulation for exploring the complex interplay of coronary artery calcification and BMD in T2DM patients. It may be of some clinical value for CACs in predicting osteoporosis in T2DM with visceral obesity.

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Cross-sectional association of bone mineral density with coronary artery calcification in an international multi-ethnic population-based cohort of men aged 40–49: ERA JUMP study

Cited by 4 publications

References 51 publications

The Association of Coronary Artery Calcium Score and Osteoporosis in Postmenopausal Women: A Cross-Sectional Study

The Association of Coronary Artery Calcium Score and Osteoporosis in Postmenopausal Women: A Cross-Sectional Study

Association between bone mineral density and coronary plaque burden in patients with coronary artery disease: a cross-sectional study using quantitative computed tomography

Association Between Coronary Artery Calcium Score and Bone Mineral Density in Type 2 Diabetes Mellitus with Different Visceral Fat Area

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