Bone mineral density in patients with coronary artery disease and sarcopenia

Abstract

Objective: to assess the relationship between bone mineral density (BMD) and the muscular apparatus in male patients with coronary heart disease (CHD).Patients and methods. The investigation enrolled 79 male patients (median age, 63 [57; 66] years) with an established diagnosis of CHD verified by coronary angiography.Muscle mass was assessed by multispiral computed tomography, by determining the axial muscle tissue area (cm2 ) at the level of LIII. Muscle strength was measured with a wrist dynamometer. Muscle function was examined using the tests of the Short Physical Performance Battery (SPPB). BMD at the neck and proximal femur as a whole and at the lumbar spine was measured by dual energy X-ray absorptiometry.For comparative analysis, the patients were divided into three groups (EWGSOP, 2010). Group 1 included 31 patients without sarcopenia; Group 2 consisted of 21 patients with presarcopenia; and Group 3 comprised 27 patients with sarcopenia.Results and discussion. Osteopenic syndrome was diagnosed in 34 (43%) patients: osteopenia and osteoporosis in 31 (39%) and 3 (4%) patients, respectively. Normal BMD values were observed in 45 (57%) men. The prevalence of osteopenic syndrome was significantly higher in the patients with sarcopenia than in those with presarcopenia (p=0.050) and was comparable to that in men without sarcopenia (p>0.050). BMD at the neck and proximal femur as a whole was significantly lower in the patients with sarcopenia than in those without sarcopenia or with presarcopenia (p<0.050). There was a direct correlation between BMD and the characteristics of muscle mass and muscle strength. Regression analysis showed that the total skeletal muscle area at the level of LIII had a significant direct impact on BMD at the neck and proximal femur as a whole, and the reverse – walking speed.Conclusion. The relationship between the characteristics of the muscular apparatus and BMD requires further investigation.