Influence of Homocysteine and Vertebral Fractures on prevalent Abdominal Aortic Calcification in Postmenopausal Women: A multicentric cross-sectional study

Imad Ghozlani,Zhor Ouzzif,Mirieme Ghazi,Anass Kherrab,Abdellah El Maghraoui,Radouane Niamane,Aissam El Maataoui,Aziza Mounach

doi:10.15342/ijms.v4ri.125

Abstract

The main of this study was to examine the relationship between plasma homocysteine (Hcy), asymptomatic osteoporotic vertebral fractures (VFs) using vertebral fracture assessment (VFA) and prevalent abdominal aortic calcification (AAC) in Moroccan postmenopausal women. The study cohort consisted of 188 consecutive postmenopausal women with no prior known diagnosis of osteoporosis or taking medication interfering with bone metabolism. Mean age, weight, height, body mass index and plasma homocysteine were determined. Lateral VFA images and scans of the lumbar spine and proximal femur were obtained using a Lunar Prodigy Vision densitometer (GE Healthcare Inc., Waukesha, WI). VFs were defined using a combination of Genant’s semiquantitative approach and morphometry. VFA images were also scored for prevalent AAC using a validated 24 point scale. Fifty-eight (30.9%) patients had densitometric osteoporosis. VFs were identified using VFA in 76 (40.4%) patients: 61 women had grade 1 VFs and 15 had grade 2 or 3 VFs. One hundred twenty nine women (68.6%) did not have any detectable AAC, whereas the prevalence of significant atherosclerotic burden defined as AAC score of 5 or higher, was 13.8%. A significant positive correlation between AAC score and homocysteine was observed. Women with extended AAC, were older, had a lower weight, BMI and BMD, higher homocysteine levels and more prevalent VFs than women without extended AAC. Multiple regression analysis showed that the presence of extended AAC was significantly associated with Age and grade 2/3 VFs and not independently associated with homocysteine levels. This study did not confirm that homocysteine is important determinant of extended AAC in postmenopausal women. However, this significant atherosclerotic marker is independently associated with VFs regardless of age

Highlights

Osteoporosis and cardiovascular diseases are two major public health problems
We examined the influence of homocysteine and asymptomatic osteoporotic vertebral fractures using vertebral fracture assessment (VFA) on prevalent abdominal aortic calcification in Moroccan postmenopausal women
Our study showed that vertebral fracture is indicator of the increased risk for extended aortic calcification regardless age in healthy postmenopausal women with a broad age range

Summary

Introduction

Osteoporosis and cardiovascular diseases are two major public health problems. Both are associated with high morbidity, long-term hospitalization, mortality and loss of independence leading to institutionalization [1, 2]. Vertebral fractures (VFs) are the most common osteoporotic fractures which are important to detect because they have been associated with reduced quality of life and increased risk of future vertebral and non-vertebral fractures [3]. The costs of these fractures are high for society [4]. A number of methods have been developed for interpretation of spinal X-rays, including the Genant semiquantitative method, which has been used as a surrogate gold standard in a number of key osteoporosis studies [7]. It has been shown in many populations that this technique can simultaneously identify abdominal aortic calcification (AAC) (Fig. 1) and improve the utility of this technology for this population even further [11]

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