Abstract
ABSTRACTOsteoporosis and cardiovascular disease (CVD) are both common causes of morbidity and mortality. Previous studies, mainly of people older than 60 years, suggest a relationship between these conditions. Our aim was to determine the association between bone characteristics and CVD markers in younger and middle‐aged individuals. Women (n = 3366) and their adolescent offspring (n = 4368) from the UK population‐based cohort study, Avon Longitudinal Study of Parents and Children (ALSPAC), were investigated. We measured total body (TB) and hip bone mineral density (BMD), TB bone area (BA) and bone mineral content (BMC) by dual‐energy X‐ray absorptiometry (DXA), and carotid intima‐media thickness (cIMT) by high‐resolution ultrasound. Arterial distensibility was calculated as the difference between systolic and diastolic arterial diameters. Linear regression determined associations between bone exposures and cIMT (in adolescents) and both cIMT and arterial distensibility (in women), generating partial correlation coefficients. Mean (SD) age of women was 48 (4.2) years, body mass index (BMI) was 26.2 (5.0) kg/m2, and 71% were premenopausal. In confounder‐adjusted analyses (age, height, lean mass, fat mass, menopause, smoking, estrogen replacement, calcium/vitamin D supplementation, and education) TB and hip BMD were both positively associated with cIMT (0.071 [0.030, 0.112], p = 0.001; 0.063 [0.025, 0.101], p = 0.001, respectively). Femoral neck BMD and TB BMD, BMC, and BA were positively associated with arterial distensibility. Mean (SD) age of adolescents was 17 (0.4) years, BMI was 23 (4.1) kg/m2, and 44.5% were male. Total hip and TB measurements were positively associated with cIMT, with similar magnitudes of association to those found in their mothers. In contrast to most published findings, we identified weak positive associations between BMD and cIMT in predominantly premenopausal women and their adolescent offspring. We found greater femoral neck BMD and TB DXA measurements to be associated with reduced arterial stiffness. Rather than a relationship with preclinical atherosclerosis, in these relatively young populations, we speculate our associations between BMD, cIMT, and arterial distensibility may reflect a shared relationship between bone and vascular growth and development. © 2016 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
Highlights
Osteoporosis and cardiovascular disease (CVD) are both common age-related conditions associated with increased morbidity and mortality
The intima consists of endothelium, the media is composed of smooth muscle cells, whereas the adventitia is mainly composed of elastic and collagen fibers.[6] the unmineralized organic component of bone, the osteoid, is composed of collagen along with other components such as matrix vesicles, osteopontin, and other non-collagenous bone matrix proteins.[7]. Whereas symptomatic CVD might result in reduced physical activity, and sedentary behavior could lead to reductions in bone mineral density (BMD), this in isolation is unlikely to explain associations between carotid intima-media thickness (cIMT) and BMD or osteoporotic outcomes
Total body BMD, bone mineral content (BMC), and bone area (BA) were all positively associated with cIMT, and these associations were strengthened after adjustment for age (Table 2)
Summary
Osteoporosis and cardiovascular disease (CVD) are both common age-related conditions associated with increased morbidity and mortality. The intima consists of endothelium, the media is composed of smooth muscle cells, whereas the adventitia is mainly composed of elastic and collagen fibers.[6] the unmineralized organic component of bone, the osteoid, is composed of collagen along with other components such as matrix vesicles, osteopontin, and other non-collagenous bone matrix proteins.[7] Whereas symptomatic CVD might result in reduced physical activity, and sedentary behavior could lead to reductions in BMD, this in isolation is unlikely to explain associations between cIMT and BMD or osteoporotic outcomes. All adjusted for age, it is difficult in studies where all participants are older to fully control for all agerelated characteristics that might produce a non-causal (confounded) association between CVD and BMD. We hypothesized that preclinical atherosclerosis (measured by cIMT) would be associated with lower BMD even in younger populations than had hitherto been studied
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