Abstract
Controversy exists regarding the relationship between atherosclerosis and osteoporosis. The aim of this study was to determine the relationship between intima-media thickness (IMT) of the common carotid artery (CCA), presence of calcified atherosclerotic plaques and bone mineral density (BMD) evaluated by dual energy X-ray absorptiometry (DXA), in postmenopausal women. Cross-sectional study at Second Internal Medicine Clinic, Cluj-Napoca, Romania. We studied the IMT (left and right CCA and mean IMT) and T-score (lumbar spine L2-L4, femoral neck and total hip) in 100 postmenopausal women (mean age 64.5 years). The presence of calcified atherosclerotic plaque and osteoporotic vertebral fractures was also noted. IMT in the left and right CCA and mean IMT were significantly associated with T-score measured for the lumbar spine L2-L4, femoral neck and total hip, with lower T-score, in the osteoporotic group than in the normal and osteopenic groups (P < 0.05). IMT had a significantly negative correlation with the lumbar spine T-score and femoral neck T-score; and mean IMT with lowest T-score. Mean IMT (P < 0.001), high blood pressure (P = 0.005) and osteoporotic vertebral fractures (P = 0.048) showed statistical significance regarding the likelihood of developing atherosclerotic plaque. In women referred for routine osteoporosis screening, the relationship between CCA, atherosclerosis and osteoporosis can be demonstrated using either cortical or trabecular BMD. Vertebral fractures may be considered to be a likelihood factor for atherosclerotic plaque development.
Highlights
Osteoporosis and cardiovascular diseases are known to be major causes of morbidity and mortality in postmenopausal women.[1,2] A large number of studies have demonstrated a relationship between bone pathology and vascular disease, suggesting that there are common pathways that affect negatively bone metabolism and the vasculature,[3,4,5,6] and that the presence of one is a predictor for the other.[7]
From multiple logistic regression to examine the likelihood of developing atherosclerotic plaque based on several independent variables, we found that the mean intima-media thickness (IMT) (P < 0.001, odds ratios (OR) 4.96E+26, E = 3.38 x 10+25), high blood pressure (P = 0.005, OR 4.54) and osteoporotic vertebral fractures (P = 0.048, OR 0.21) presented statistical significance
We showed that the association between IMT and bone mineral density (BMD) was independent of the sites of IMT measurement and BMD measurement (Tscores for L2-L4 and femoral neck, and lowest T-score value at these sites)
Summary
Osteoporosis and cardiovascular diseases are known to be major causes of morbidity and mortality in postmenopausal women.[1,2] A large number of studies have demonstrated a relationship between bone pathology and vascular disease, suggesting that there are common pathways that affect negatively bone metabolism and the vasculature,[3,4,5,6] and that the presence of one is a predictor for the other.[7] the nature of the association between osteoporosis and atherosclerosis remains unknown. Measurement of intima-media thickness (IMT) in the distal common carotid artery is increasingly being used as an independent risk factor for the development of cardiovascular events due to atherosclerosis.[8,9] Carotid atherosclerosis has been associated with lumbar spine bone mass in postmenopausal women[10] and calcification of the atherosclerotic plaques with low bone mineral density (BMD),[11] which suggests that women with osteoporosis are at a higher risk of having cardiovascular events. Standardization of carotid IMT measurements and recommendations for a carotid ultrasound scanning protocol were recently published,[14,15] thereby enabling homogenous data collection and analysis
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Schedule a callMore From: Sao Paulo medical journal = Revista paulista de medicina
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