Vertebral fractures and abdominal aortic calcification in postmenopausal women. A cohort study

Abstract

IntroductionVertebral fracture assessment (VFA) imaging with a bone densitometer can simultaneously detect prevalent vertebral fractures (VFs) and abdominal aortic calcification (AAC). ObjectiveTo study the relation between the prevalence of VFs using VFA in asymptomatic women and the prevalence and severity of AAC. DesignThis is a cross-sectional study. SettingsSubjects were recruited in a third care center from asymptomatic women selected from the general population. ParticipantsWe enrolled 908 post-menopausal women with a mean age of 60.9years±7.7 (50 to 91) with no prior known diagnosis of osteoporosis or taking medication interfering with bone metabolism. Primary and secondary outcome measuresLateral VFA images and scans of the lumbar spine and proximal femur were obtained using a GE Healthcare Lunar Prodigy densitometer. VFs were defined using a combination of Genant semiquantitative (SQ) approach and morphometry. VFA images were scored for AAC using a validated 24 point scale. ResultsVFA images showed that 179 of the participants (19.7%) had at least one grade 2/3 VF, 81% did not have any detectable AAC whereas the prevalence of significant atherosclerotic burden, defined as AAC score of 5 or higher, was 12%. The group of women with 2/3 VFs had a statistically significant higher AAC score and higher proportion of subjects with extended AAC, and lower weight, height, and lumbar spine and hip BMD and T-scores than those without VFA-identified VFs. Multiple regression analysis showed that the presence of grade 2/3 VFs was significantly associated with age, BMI, history of peripheral fracture, AAC score≥5 and densitometric osteoporosis. ConclusionIn post-menopausal women, extended AAC is independently associated with prevalent VFs regardless of age, BMI, history of fractures, and BMD.