Preliminary study on relationship between vertebral fracture and aortic calcification in postmenopausal women

Abstract

The prevalence of aortic calcification and osteoporosis increases with age. Several studies have postulated a direct relationship between the two disorders, suggesting that aortic calcification results from a redistribution of skeletal calcium in osteoporosis. We have undertaken a case-controlled study to reevaluate the possible relationship between the two age-related processes. Lateral spine radiographs of 122 postmenopausal Turkish women were analyzed to determine the presence or absence of vertebral fracture (n 1=44 andn 2=78, respectively). Abdominal aortic calcification was quantified in both groups using a subjective grading system (from no calcification to dense calcification adjacent to three vertebrae) and a semiquantitative method. Using the subjective method, the prevalence of aortic calcification increased from 41% in subjects aged 50–65 years to 78% in those over 75 years of age (И2=10.8;P<.005). The prevalence of aortic calcification was similar in women with and without vertebral fracture (60.0%vs 57.7%;P=.63). Using the semiquantitative method, there was no significant difference in the severity of abdominal aortic calcification between subjects with and without vertebral fractures (P=.74). Using logistic regression, the direction of the odds ratio suggested a greater risk of vertebral fracture in the presence of moderate or severe aortic calcification (1.3; 95% CI 0.5–3.9) and multiple loss of intervertebral disk spaces (2.0; 95% CI 0.6–7.4), but the number of subjects was small and the confidence intervals wide. These results do not support the hypothesis of a direct relationship between calcification and vertebral osteoporosis as a result of calcium redistribution in postmenopausal women. It is likely that factors other than vertebral deformity are of importance in the development of aortic calcification in the elderly.