Pregnancy history, coronary artery calcification and bone mineral density in menopausal women

Abstract

Objective This study examined relationships, by pregnancy histories, between bone mineral density (BMD) and coronary artery calcification (CAC) in postmenopausal women. Methods Forty women identified from their medical record as having preeclampsia (PE) were age/parity-matched with 40 women having a normotensive pregnancy (NP). Vertebral (T04-09) BMD and CAC were assessed by Quantitative Computed Tomography in 73 (n=37 with PE and n=36 with NP) of the 80 women. Analyses included linear regression using generalized estimating equations. Results Women averaged 59 years of age and 35 years from the index pregnancy. There were no significant differences in cortical, trabecular or central BMD between groups. CAC was significantly greater in the PE group (P=0.026). In multivariable analysis, CAC was positively associated with cortical BMD (P=0.001) and negatively associated with central BMD (P=0.036). There was a borderline difference in the association between CAC and central BMD by pregnancy history (interaction, P=0.057). Conclusions Although CAC was greater in women with a history of PE, vertebral BMD did not differ between groups. However, both cortical and central BMD were associated with CAC. The central BMD association was marginally different by pregnancy history suggesting perhaps differences in underlying mechanisms of soft tissue calcification.

Inorganic Phosphate in the Pathogenesis of Pregnancy-Related Complications

“…The GAD in the preeclampsia is modestly higher in the preeclampsia group, which may contribute to this difference. Ectopic vascular calcification has also been previously associated with preeclampsia [22,33]. Indeed, we were able to detect calcified lesions on placental chorionic villi tissue slides of the preeclampsia group.…”

“…The average P i maternal urine level was higher in the preeclampsia group (8.50 ± 2.74 vs. 11.52 ± 2.90 mmol/L; p = 0.4653), but this difference was not statistically significant ( Figure 2 A). Ectopic vascular calcification has been previously associated with preeclampsia [ 22 , 33 ]. von Kossa staining was used to detect calcified lesions on placental tissue slides of the preeclampsia group studied ( Figure 2 B–E).…”

“…During pregnancy, maternal bone mineral density (BMD) and bone resorption markers are modestly increased [21,22,42,47]. With increased number of pregnancies, we hypothesize that the BMD and phosphorus and calcium bioavailability is reduced.…”

“…Studies show that bone turnover biochemical markers increase in pregnancies complicated by preeclampsia [20]. Interestingly enough, although maternal bone mineral density (BMD) is unaffected by preeclampsia [21,22], adult offspring who were previously exposed to maternal preeclampsia in the womb present higher BMD levels than those not exposed [23,24].…”

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

“…Many large studies (number of participants >1000) have reported an association of CAC with BMD [10] , [11] , [12] , [13] , [14] , [15] , [16] . To examine BMD and its association with CAC, some studies use dual-energy X-ray absorptiometry (DXA) [13] , [14] , [15] , [17] , [18] , [19] , [20] , [21] , the gold standard [22] while other studies computed a surrogate for vertebrae bone density (VBD) of the thoracic and lumber vertebrae depicted on CT images that assess CAC [12] , [16] , [23] , [24] . Several of these studies reported a significant inverse association of CAC with BMD in post-menopausal women [11] , [16] , [18] , [19] , [23] and elderly men [11] , [25] , similar to the results of the systematic review showing an association of BMD and fracture with CVD [7] .…”