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Nie X, Zhang Q, Wang Y, Liu Z, Xie D, Song Q, Yang C, Yu T, Sun Y. Causal effects of osteoporosis on structural changes in specific brain regions: a Mendelian randomization study. Cereb Cortex 2024; 34:bhad528. [PMID: 38216525 DOI: 10.1093/cercor/bhad528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/15/2023] [Accepted: 12/16/2023] [Indexed: 01/14/2024] Open
Abstract
Observational studies have reported that osteoporosis is associated with cortical changes in the brain. However, the inherent limitations of observational studies pose challenges in eliminating confounding factors and establishing causal relationships. And previous observational studies have not reported changes in specific brain regions. By employing Mendelian randomization, we have been able to infer a causal relationship between osteoporosis and a reduction in the surficial area (SA) of the brain cortical. This effect is partially mediated by vascular calcification. We found that osteoporosis significantly decreased the SA of global brain cortical (β = -1587.62 mm2, 95%CI: -2645.94 mm2 to -529.32 mm2, P = 0.003) as well as the paracentral gyrus without global weighted (β = - 19.42 mm2, 95%CI: -28.90 mm2 to -9.95 mm2, P = 5.85 × 10-5). Furthermore, we estimated that 42.25% and 47.21% of the aforementioned effects are mediated through vascular calcification, respectively. Osteoporosis leads to a reduction in the SA of the brain cortical, suggesting the presence of the bone-brain axis. Vascular calcification plays a role in mediating this process to a certain extent. These findings establish a theoretical foundation for further investigations into the intricate interplay between bone, blood vessels, and the brain.
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Affiliation(s)
- Xinlin Nie
- Department of Orthopedic Center, the First Hospital of Jilin University, Changchun 130000, China
| | - Qiong Zhang
- Department of Orthopedic Center, the First Hospital of Jilin University, Changchun 130000, China
| | - Yixuan Wang
- Department of Otolaryngology Head and Neck Surgery, Shaanxi Provincial People's Hospital, Xi'an 710000, China
| | - Zhaoliang Liu
- Department of Orthopedic Center, the First Hospital of Jilin University, Changchun 130000, China
| | - Dongheng Xie
- Department of Orthopedic Center, the First Hospital of Jilin University, Changchun 130000, China
| | - Qingxu Song
- Department of Orthopedic Center, the First Hospital of Jilin University, Changchun 130000, China
| | - Chen Yang
- Department of Orthopedic Center, the First Hospital of Jilin University, Changchun 130000, China
| | - Tiecheng Yu
- Department of Orthopedic Center, the First Hospital of Jilin University, Changchun 130000, China
| | - Yang Sun
- Department of Orthopedic Center, the First Hospital of Jilin University, Changchun 130000, China
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Kraav J, Zagura M, Remmel L, Mäestu E, Jürimäe J, Tillmann V. Rapid trabecular bone growth in puberty associated with stiffer arteries in adulthood - longitudinal study on healthy young males. Arch Osteoporos 2023; 18:62. [PMID: 37133622 DOI: 10.1007/s11657-023-01257-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/22/2023] [Indexed: 05/04/2023]
Abstract
Longitudinal bone content data from puberty to adulthood was assessed in 102 healthy males and associations with arterial health in adulthood was analysed. Bone growth in puberty was related to arterial stiffening and final bone mineral content to decreased arterial stiffness. Relationships with arterial stiffness were dependent on the studied bone regions. INTRODUCTION Our aim was to assess the relationships between arterial parameters in adulthood and bone parameters in several locations longitudinally from puberty to 18-years and cross-sectionally at 18-years. METHODS 102 healthy male data from a 7-year follow-up study was used to analyse total body (TB), femoral neck (FN) and lumbar spine (LS) mineral content and density by DXA, carotid intima-media thickness (cIMT) by ultrasound, carotid-femoral pulse wave velocity (cfPWV) and heart rate adjusted augmentation index (AIxHR75) by applanation tonometry. RESULTS Linear regression analysis revealed negative associations between LS bone mineral density (BMD) and cfPWV [ß=-1.861, CI -3.589, -0.132, p=0.035] which remained significant [ß=-2.679, CI -4.837, -0.522, p=0.016] after adjustment to smoking, lean mass, weight category, pubertal stage, physical fitness, and activity. For AIxHR75 similar results were present [ß=-0.286, CI -0.553, -0.020, p=0.035], but were dependent on confounders. Analysis on pubertal bone growth speed showed independent positive associations to AIxHR75 between Δ FN bone mineral apparent density (BMAD) [ß=672.50, CI 348.07, 996.93, p<0.001] and Δ LS BMAD [ß=700.40, CI 57.384, 1343.423, p=0.033]. Further analysis combining pubertal bone growth and adulthood BMC revealed that the relationships of AIxHR75 with LS BMC and ΔFN BMAD were independent of each other. CONCLUSION Trabecular bone regions like lumbar spine and femoral neck, showed stronger relationships with arterial stiffness. Rapid bone growth in puberty is related to arterial stiffening, while final bone mineral content relates to decreased arterial stiffness. These results could indicate that bone metabolism is independently associated with arterial stiffness rather than bone and arteries just having common traits of growth and maturation.
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Affiliation(s)
- Juta Kraav
- Institute of Clinical Medicine, University of Tartu, 50406, Tartu, Estonia.
| | - Maksim Zagura
- Department of Biochemistry, Centre of Excellence for Translational Medicine, University of Tartu, Tartu, Estonia
| | - Liina Remmel
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007, Tartu, Estonia
| | - Evelin Mäestu
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007, Tartu, Estonia
| | - Jaak Jürimäe
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007, Tartu, Estonia
| | - Vallo Tillmann
- Children's Clinic, Tartu University Hospital, 50406, Tartu, Estonia
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Güneş M, Kara Z, Yavuzer S, Yavuzer H, Bolayirli İM, Oşar Siva Z. Relationship Between Carotid Intima-Media Thickness and Osteoporosis in Type 2 Diabetic Patients: Cross-Sectional Study in the Third-Level Center. Metab Syndr Relat Disord 2022; 20:592-598. [PMID: 36251930 DOI: 10.1089/met.2022.0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Aim: Although atherosclerosis and osteoporosis (OP) are seen in elderly patients, it is still a matter of research whether there is an age-independent relationship between them. In our study, we planned to investigate the relationship between carotid intima-media thickness (CIMT), OP, and bone turnover parameters in patients with type 2 diabetes mellitus (DM2) of both sexes. Materials and Methods: A total of 69 patients and 40 healthy volunteers with chronic diseases such as DM2, hypertension, hyperlipidemia, and OP. Group 1 had 27 patients with DM2 and OP, group 2 had 42 patients with DM2 and no OP, and group 3 had 40 healthy volunteers without DM2 and OP. Results: In the control group, CIMT was measured lower than the patients with DM2 (0.8 + 0.1 and 1.1 + 0.3, P < 0.001, respectively). Femur T score and lumbar T score values of patients with DM2 were lower than the control group (-0.48 + 1.1 and 0.7 + 0.6, P < 0.001, and -1.3 + 1.5 and 0.6 + 0.5, P < 0.001, respectively). Bone turnover markers in DM2 compared to the control group (C-terminal telopeptide of type 1 collagen: 240.9 ± 211.1 and 606.5 ± 200.8, P < 0.001; bone-specific alkaline phosphatase: 47.9 ± 15.5 and 431.5 ± 140, P < 0.001; and osteocalcin: 13.2 ± 5.0 and 19.7 ± 9.2, P < 0.001, respectively) were lower. Patients with femoral region (TSF) T score and lumbar region (TSL) T score below -2.5 were found to have higher CIMT values than those without (1.2 ± 0.23 mm and 0.9 ± 0.23 mm, P = 0.006, and 1.1 ± 0.28 mm and 0.95 ± 0.21 mm, P = 0.003, respectively). In linear regression analysis, age (β = 0.01, P < 0.001), OP (β = 0.166, P = 0.001), and DDM2 (β = 0.222, P = 0.04) were found to be effective on CIMT, while DM2 (β) = -0.754, P < 0.001), CIMT (β = -0.258, P = 0.021), body mass index (β = 0.355, P = 0.028), and age (β = -0.229, P = 0.029) were found to be independent factors on TSF. Conclusion: Bone turnover and bone mineral density are decreased in DM2 patients. In addition, subclinical atherosclerosis is more common in DM2 patients. Findings suggest that there is a relationship between subclinical atherosclerosis and OP due to metabolic factors other than age.
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Affiliation(s)
- Mutlu Güneş
- Department of Endocrinology, Metabolism and Diabetes, Health Sciences University, Highly Specialization Training and Research Hospital, Bursa, Turkey
| | - Zehra Kara
- Department of Endocrinology, Metabolism and Diabetes, University of İstanbul-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Serap Yavuzer
- Department of İnternal Medicine Disease, University of Biruni, Istanbul, Turkey
| | - Hakan Yavuzer
- Department of İnternal Medicine Disease, University of İstanbul-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - İbrahim Murat Bolayirli
- Department of Biochemistry, University of İstanbul-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - Zeynep Oşar Siva
- Department of Endocrinology, Metabolism and Diabetes, University of İstanbul-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
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Zhang X, Xu Y, Li F, Chen M. Associations between bone mineral density and subclinical peripheral arterial disease in elderly men with type 2 diabetes mellitus. Osteoporos Int 2022; 33:1715-1724. [PMID: 35451624 DOI: 10.1007/s00198-022-06404-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 04/12/2022] [Indexed: 12/24/2022]
Abstract
UNLABELLED The association between peripheral arterial disease (PAD) and osteoporosis in elderly men with type 2 diabetes mellitus (T2DM) remains unclear. We demonstrated the association between subclinical PAD and decreased total hip bone mineral density (BMD) in men aged ≥ 55 years with T2DM, providing clinical clues for the early detection of decreased bone density in total hip. PURPOSE To investigate the association between subclinical peripheral arterial disease (PAD) and bone mineral density (BMD) at total hip, femoral neck, and lumbar spine (L1-4) in elderly men with type 2 diabetes mellitus (T2DM). METHODS We identified 2,466 patients with confirmed diabetes in this retrospective cross-sectional study. A total of 272 men aged ≥ 55 years with T2DM (50 with subclinical PAD and 222 without PAD) were analyzed. Partial correlation analysis was conducted to explore the associations between ankle-brachial index (ABI) and BMD. Multivariate logistic regression analysis was performed to analyze the contributor for low bone density (T-score < - 1.0). RESULTS Patients with T2DM and subclinical PAD (ABI ≤ 0.9) had significantly lower total hip BMD and T-score (BMD, 0.87 ± 0.14 vs. 0.92 ± 0.15 g/cm2, P = 0.014; T-score, -1.30 [-1.70 to -0.45] vs. -0.80 [-1.40 to 0.00], P = 0.009) than those in the control group. The partial correlation analyses indicated that ABI significantly correlated with the total hip T-score (adjusted r = 0.166, P = 0.009). The logistic regression analysis indicated that subclinical PAD was an independent risk factor for the risk of decreased bone density in total hip (adjusted odds ratio [95% CI]: 8.933 [1.075-74.222], P = 0.043). CONCLUSION: Subclinical PAD (ABI ≤ 0.9) could be used as a risk factor for decreased total hip BMD in men aged ≥ 55 years with T2DM, which provides clinical clues for the early detection of low bone density in total hip in such populations.
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Affiliation(s)
- X Zhang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Y Xu
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - F Li
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - M Chen
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Associations of vascular and bone status in arthritis patients. Sci Rep 2021; 11:19504. [PMID: 34593938 PMCID: PMC8484288 DOI: 10.1038/s41598-021-99071-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 09/14/2021] [Indexed: 12/17/2022] Open
Abstract
Cardiovascular (CV) disease and osteoporosis (OP) have been associated with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Bone and vascular biomarkers and parameters along with the effect of 1-year anti-TNF therapy on these markers were assessed in order to determine correlations between vascular pathophysiology and bone metabolism in RA and AS. Thirty-six patients treated with etanercept or certolizumab pegol and 17 AS patients treated with ETN were included in a 12-month follow-up study. Bone and vascular markers were previously assessed by ELISA. Bone density was measured by DXA and quantitative CT (QCT). Flow-mediated vasodilation (FMD), common carotid intima-media thickness (IMT) and pulse-wave velocity (PWV) were assessed by ultrasound. Multiple correlation analyses indicated associations between bone and vascular markers. Osteoprotegerin, sclerostin and cathepsin K were significantly associated with FMD, IMT and PWV, respectively (p < 0.05). Moreover, total and trabecular BMD determined by QCT inversely correlated with IMT (p < 0.05). On the other hand, among vascular parameters, platelet-derived growth factor BB and IMT correlated with DXA femoral and QCT total BMD, respectively (p < 0.05). In the RM-ANOVA analysis, anti-TNF treatment together with baseline osteocalcin, procollagen 1 N-terminal propeptide (P1NP) or vitamin D3 levels determined one-year changes in IMT (p < 0.05). In the MANOVA analysis, baseline disease activity indices (DAS28, BASDAI), the one-year changes in these indices, as well as CRP exerted effects on multiple correlations between bone and vascular markers (p < 0.05). As the pattern of interactions between bone and vascular biomarkers differed between baseline and after 12 months, anti-TNF therapy influenced these associations. We found a great number of correlations in our RA and AS patients undergoing anti-TNF therapy. Some of the bone markers have been associated with vascular pathophysiology, while some vascular markers correlated with bone status. In arthritis, systemic inflammation and disease activity may drive both vascular and bone disease.
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Pepe J, Della Grotta G, Santori R, De Martino V, Occhiuto M, Cilli M, Minisola S, Cipriani C. Lumbar spine bone mineral density and trabecular bone score-adjusted FRAX, but not FRAX without bone mineral density, identify subclinical carotid atherosclerosis. J Endocrinol Invest 2021; 44:1989-1995. [PMID: 33576953 PMCID: PMC8357690 DOI: 10.1007/s40618-021-01517-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 01/20/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Osteoporosis and atherosclerosis share common risk factors. Aim of this study was to test if FRAX (which is an algorithm that can identify subjects at risk of fracture), without or with BMD values, also adjusted for trabecular bone score (TBS) was able to identify subclinical atherosclerosis, evaluated by measurement of carotid intima media thickness (cIMT ≥ 0.9 mm) as compared to DXA values. METHODS Ninety postmenopausal women underwent DXA measurement and cIMT evaluation. For each patient, the FRAX algorithm for major osteoporotic fracture (M) and for hip fracture (H) without BMD was computed, together with FRAX with BMD and TBS-adjusted FRAX. Serum levels of osteoprotegerin, sRANKL, and interleukin-6 were also measured. RESULTS There were no differences in anthropometric parameters and cardiovascular risk factors between subjects with cIMT ≥ 0.9 mm (35% of subjects, group A) compared to those with cIMT < 0.9 mm (group B). The prevalence of osteoporosis and FRAX BMD, TBS-adjusted FRAX both for M and H were higher in group A compared to group B. The best ROC curves to identify subjects with a cIMT ≥ 0.9 mm were: lumbar spine T-score, with a threshold of - 2.5 SD (area under the curve, AUC 0.64; p = 0.02) with a sensibility of 50% and a specificity of 76%; TBS-adjusted FRAX H with a sensibility of 50% and a specificity of 72% (AUC 0.64; p = 0.01 with a threshold of 3%). Interleukin-6 positively correlated with FRAX BMD H and M. CONCLUSIONS FRAX without BMD does not identify subclinical carotid atherosclerosis, while lumbar spine T-score and TBS-adjusted FRAX H similarly detected it with higher specificity for T-score.
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Affiliation(s)
- J Pepe
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, (SCIAC), "Sapienza" University of Rome, Rome, Italy.
| | - G Della Grotta
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, (SCIAC), "Sapienza" University of Rome, Rome, Italy
| | - R Santori
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, (SCIAC), "Sapienza" University of Rome, Rome, Italy
| | - V De Martino
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, (SCIAC), "Sapienza" University of Rome, Rome, Italy
| | - M Occhiuto
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, (SCIAC), "Sapienza" University of Rome, Rome, Italy
| | - M Cilli
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, (SCIAC), "Sapienza" University of Rome, Rome, Italy
| | - S Minisola
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, (SCIAC), "Sapienza" University of Rome, Rome, Italy
| | - C Cipriani
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, (SCIAC), "Sapienza" University of Rome, Rome, Italy
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Wang Y, Wang R, Liu Y, Bai L, Liu L, He L, Deng H, Li T, Xu S, Chen L, Wen K, Qi B. Associations between bone mineral density in different measurement locations and coronary artery disease: a cross-sectional study. Arch Osteoporos 2021; 16:100. [PMID: 34169345 DOI: 10.1007/s11657-021-00940-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 05/04/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED The bone mineral density (BMD) loss is closely related to coronary heart disease (CAD). The BMD measured at different locations differ in BMD values, the risk to CAD, and the capability to identify CAD. An average BMD of the right and left femoral neck being below - 1.70 has the ability to indicate risk of CAD. PURPOSE Previous studies have reported that low bone mineral density (BMD) is closely related to coronary artery disease (CAD); however, it is not clear that the BMD loss at which location to what extent has the greatest effect in identifying risk of CAD. This study aimed to evaluate the ability of different measurement sites of BMD in identifying CAD and analyze the best measurement sites and the optimal cut-off of BMD for CAD. METHODS This was a cross-sectional study in which 180 of 817 participants were diagnosed with CAD. All participants in the study were measured by dual-energy X-ray absorptiometry (DEXA) for BMD at 8 locations, and following measurements were derived: the average BMD of lumbar spine (L1-L4), femoral neck (left and right), and total proximal femur (left and right). The association between BMD at different locations and CAD was analyzed using logistic regression. The receiver operating characteristic (ROC) curve was used to select the optimal measurement location and cut-off value of the BMD for identifying CAD. RESULTS There were significant differences in BMD at 3 different measurement locations. Higher BMD is a protective factor against CAD, which is more pronounced in the femoral neck and total proximal femur (ORs = 0.47 ~ 0.66, P < 0.001) than in the lumbar spine (ORs = 0.74 ~ 0.79, P < 0.001). The optimal site for predicting the risk of CAD by BMD is the femoral neck, with the AUC (area under the ROC curve) is 0.72 (95% CI: 0.67 ~ 0.76) and the cut-off is - 1.70. CONCLUSION The BMD below particular cut-off of the femoral neck rather than of the lumbar spine may have certain further research value for revealing the risk of CAD.
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Affiliation(s)
- Yaoling Wang
- Department of Geriatrics, Union Hospital of Tongji Medical College Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Ruiyun Wang
- Department of Geriatrics, Union Hospital of Tongji Medical College Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Yun Liu
- Department of Geriatrics, Union Hospital of Tongji Medical College Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Lijuan Bai
- Department of Geriatrics, Union Hospital of Tongji Medical College Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Lihua Liu
- Department of Geriatrics, Union Hospital of Tongji Medical College Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Linfeng He
- Department of Geriatrics, Union Hospital of Tongji Medical College Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Heng Deng
- Department of Geriatrics, Union Hospital of Tongji Medical College Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Tao Li
- Department of Geriatrics, Union Hospital of Tongji Medical College Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Sha Xu
- Department of Geriatrics, Union Hospital of Tongji Medical College Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Li Chen
- Novartis Pharmaceuticals Corporation, East Hanover, USA
| | - Kai Wen
- School of Software & Microelectronics, Peking University, Beijing, China
| | - Benling Qi
- Department of Geriatrics, Union Hospital of Tongji Medical College Huazhong University of Science & Technology, Wuhan, 430022, China.
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Dudinskaya EN, Tkacheva ON, Matchekhina LV, Eruslanova KA, Kovalev IA, Shkolnikova MA, Leontjeva IV. The relationship of bone mineral density with the of the intima-media thickness in premenopausal women. OSTEOPOROSIS AND BONE DISEASES 2021. [DOI: 10.14341/osteo12698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background: Osteoporosis and cardiovascular disease (CVD) are among the most common causes of morbidity, disability and death worldwide. In recent years, more and more data have been accumulating on the presence of an age-independent relationship and general pathogenetic mechanisms of a decrease in bone mineral density (BMD) and the development of CVD. It has been shown that a decrease in BMD is an important independent predictor of the risk of atherosclerosis of the great arteries and is associated with increased calcification of the aorta and other vessels. The strongest relationship between these parameters was observed in the study of the female population, in connection with which we selected a group of middle-aged women for analysis.Objective: to investigate the association between bone mineral density and carotid intima-media thickness in middle-aged women.Results: 35 women were included in the study. The mean age was 44,74±4,32 years. We found the following changes in arterial wall characteristics: atherosclerosis — 21,9% women, increased carotid intima thickness — 15,7% women. Low bone mineral density for chronological age (Z-criteria -2,0 and less) was found in 7 patients at the age of 35±2,7 years. We discovered a negative correlation between the markers of subclinical atherosclerosis and bone mass: Ccarotid intimamedia thickness negatively correlated with bone mineral density in hip (p<0,05), and presence of atherosclerosis plaques was associated with lower bone mineral density in the proximal part of hip (p<0,05).Conclusion: The findings about negative association between bone mineral density of hip with preclinical markers of atherosclerosis allow us to make a conclusion about their interaction.
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Affiliation(s)
- Ekaterina N. Dudinskaya
- Pirogov National Research Medical University “Russian Gerontology Research and Clinical Centre”
| | - Olga N. Tkacheva
- Pirogov National Research Medical University “Russian Gerontology Research and Clinical Centre”
| | - Lubov V. Matchekhina
- Pirogov National Research Medical University “Russian Gerontology Research and Clinical Centre”
| | - Kseniia A. Eruslanova
- Pirogov National Research Medical University “Russian Gerontology Research and Clinical Centre”
| | - Igor A. Kovalev
- Veltischev Research and Clinical Institute for Pediatrics of the Pirogov National Research Medical University
| | - Maria A. Shkolnikova
- Veltischev Research and Clinical Institute for Pediatrics of the Pirogov National Research Medical University
| | - Irina V. Leontjeva
- Veltischev Research and Clinical Institute for Pediatrics of the Pirogov National Research Medical University
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Zhang Q, Chen T, Zhang Y, Lyu L, Zhang B, Huang C, Zhou X, Wu Y, Li Z. MiR-30c-5p regulates adventitial progenitor cells differentiation to vascular smooth muscle cells through targeting OPG. Stem Cell Res Ther 2021; 12:67. [PMID: 33468212 PMCID: PMC7814722 DOI: 10.1186/s13287-020-02127-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/28/2020] [Indexed: 11/28/2022] Open
Abstract
Background As the most important component of the vascular wall, vascular smooth muscle cells (VSMCs) participate in the pathological process by phenotype transformation or differentiation from stem/progenitor cells. The main purpose of this study was to reveal the role and related molecular mechanism of microRNA-30c-5p (miR-30c-5p) in VSMC differentiation from adventitial progenitor cells expressing stem cell antigen-1(Sca-1). Methods In this study, we detected the expression of miR-30c-5p in human normal peripheral arteries and atherosclerotic arteries. In vitro, a stable differentiation model from adventitial Sca-1+ progenitor cells to VSMCs was established using transforming growth factor-β1 (TGF-β1) induction and the expression of miR-30c-5p during the process was observed. Then, we explored the effect of miR-30c-5p overexpression and inhibition on the differentiation from adventitial Sca-1+ progenitor cells to VSMCs. The target genes of miR-30c-5p were identified by protein chip and biological analyses and the expression of these genes in the differentiation process were detected. Further, the relationship between the target gene and miR-30c-5p and its effect on differentiation were evaluated. Finally, the co-transfection of miR-30c-5p inhibitor and small interfering RNA (siRNA) of the target gene was implemented to verify the functional target gene of miR-30c-5p during the differentiation from adventitial Sca-1+ progenitor cells to VSMCs, and the dual-luciferase reporter gene assay was performed to detect whether the mRNA 3′untranslated region (UTR) of the target gene is the direct binding site of miR-30c-5p. Results The expression of miR-30c-5p in the human atherosclerotic arteries was significantly lower than that in the normal arteries. During the differentiation from adventitial Sca-1+ progenitor cells to VSMCs, the expression of VSMC special markers including smooth muscle α-actin (SMαA), smooth muscle-22α (SM22α), smooth muscle myosin heavy chain (SMMHC), and h1-caponin increased accompanied with cell morphology changing from elliptic to fusiform. Meanwhile, the expression of miR-30c-5p decreased significantly. In functional experiments, overexpression of miR-30c-5p inhibited SMαA, SM22α, SMMHC, and h1-caponin at the mRNA and protein levels. In contrast, inhibition of miR-30c-5p promoted the expression of SMαA, SM22α, SMMHC, and h1-caponin. The target gene, osteoprotegerin (OPG), was predicted through protein chip and bioinformatics analyses. Overexpression of miR-30c-5p inhibited OPG expression while inhibition of miR-30c-5p had an opposite effect. Co-transfection experiments showed that low expression of OPG could weaken the promotion effect of miR-30c-5p inhibitor on the differentiation from adventitial Sca-1+ progenitor cells to VSMCs and the dual-luciferase reporter gene assay demonstrated that miR-30c-5p could target the mRNA 3′UTR of OPG directly. Conclusions This study demonstrates that miR-30c-5p expression was significantly decreased in atherosclerotic arteries and miR-30c-5p inhibited VSMC differentiation from adventitial Sca-1+ progenitor cells through targeting OPG, which may provide a new target for the treatment of VSMCs-associated diseases.
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Affiliation(s)
- Qing Zhang
- Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang Province, P.R. China
| | - Ting Chen
- Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang Province, P.R. China
| | - Yun Zhang
- Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang Province, P.R. China
| | - Lingxia Lyu
- Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang Province, P.R. China
| | - Bohuan Zhang
- Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang Province, P.R. China
| | - Chengchen Huang
- Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang Province, P.R. China
| | - Xuhao Zhou
- Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang Province, P.R. China
| | - Yutao Wu
- Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang Province, P.R. China.
| | - Zhoubin Li
- Department of Lung Transplantation, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang Province, P.R. China.
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10
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Mazzucchelli R, Rodríguez-Martín S, García-Vadillo A, Crespí-Villarías N, Gil M, Rodriguez-Miguel A, Barreira D, Garcia-Lledó A, de Abajo FJ. Risk of acute myocardial infarction among new users of bisphosphonates: a nested case-control study. Osteoporos Int 2020; 31:2403-2412. [PMID: 32662036 DOI: 10.1007/s00198-020-05538-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/07/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To test the hypothesis that bisphosphonates reduce AMI risk among new users and to assess whether the effect depends on the duration of treatment. METHODS Case-control study nested in a primary cohort composed of patients aged 40 to 99 years, with at least 1-year registry in the BIFAP database throughout the study period 2002-2015. Out of this cohort, incident AMI cases were identified and five controls per case were randomly selected, matched by exact age, sex, and index date. The association of AMI with current, recent and past use of bisphosphonates was assessed by computing adjusted odds ratios (AOR) and their corresponding 95% confidence interval (CI) through an unconditional logistic regression. Only initiators of bisphosphonates were considered. RESULTS A total of 23,590 cases of AMI and 117,612 controls were included. The mean age was 66.8 (SD 13.4) years, and 72.52% was male, in both groups. About 276 (1.17%) cases and 1458 (1.24%) controls were current users of bisphosphonates yielding an AOR of 0.98 (95% CI 0.854-1.14). Recent and past use were not associated with a reduced risk, either, nor was it found a reduction with treatment duration (AOR less than 1 year = 0.92; 95% CI 0.73-1.15; AOR more than 1 year = 1.03; 95% CI 0.86-1.23). Stratified analysis by age, sex and background cardiovascular risk did not show an effect modification by these variables. CONCLUSION The results do not support a cardioprotective effect of bisphosphonates regardless of the duration of treatment, age, sex or background cardiovascular risk. However, a small protective effect could have been masked if patients with osteoporosis have had a background higher risk of AMI.
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Affiliation(s)
- R Mazzucchelli
- Rheumatology Unit, Hospital Universitario Fundación Alcorcón, 28922, Alcorcón, Madrid, Spain
| | - S Rodríguez-Martín
- Clinical Pharmacology Unit, Hospital Universitario Príncipe de Asturias, 28805, Alcalá de Henares, Madrid, Spain
- Department of Biomedical Sciences (Pharmacology), Facultad de Medicina y Ciencias de la Salud, Universidad de Alcala (IRYCIS), 28805, Alcalá de Henares, Madrid, Spain
| | - A García-Vadillo
- Rheumatology Department, Hospital Universitario La Princesa, 28006, Madrid, Madrid, Spain
| | | | - M Gil
- Division of Pharmacoepidemiology and Pharmacovigilance of the Spanish Agency on Medicines and Medical Devices (AEMPS), 28022, Madrid, Spain
| | - A Rodriguez-Miguel
- Clinical Pharmacology Unit, Hospital Universitario Príncipe de Asturias, 28805, Alcalá de Henares, Madrid, Spain
- Department of Biomedical Sciences (Pharmacology), Facultad de Medicina y Ciencias de la Salud, Universidad de Alcala (IRYCIS), 28805, Alcalá de Henares, Madrid, Spain
| | - D Barreira
- Clinical Pharmacology Unit, Hospital Universitario Príncipe de Asturias, 28805, Alcalá de Henares, Madrid, Spain
- Department of Biomedical Sciences (Pharmacology), Facultad de Medicina y Ciencias de la Salud, Universidad de Alcala (IRYCIS), 28805, Alcalá de Henares, Madrid, Spain
| | - A Garcia-Lledó
- Department of Cardiology, Hospital Universitario Príncipe de Asturias, 28805, Alcalá de Henares, Madrid, Spain
- Department of Medicine, Universidad de Alcalá, 28805, Alcalá de Henares, Madrid, Spain
| | - F J de Abajo
- Clinical Pharmacology Unit, Hospital Universitario Príncipe de Asturias, 28805, Alcalá de Henares, Madrid, Spain.
- Department of Biomedical Sciences (Pharmacology), Facultad de Medicina y Ciencias de la Salud, Universidad de Alcala (IRYCIS), 28805, Alcalá de Henares, Madrid, Spain.
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11
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Early vascular ageing biomarkers in osteoporotic outpatients: a pilot study. Sci Rep 2020; 10:19421. [PMID: 33173083 PMCID: PMC7656252 DOI: 10.1038/s41598-020-76427-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/26/2020] [Indexed: 02/06/2023] Open
Abstract
Osteoporosis and atherosclerosis are significant public health problems that often coexist, especially in the elderly. Although some studies have reported an age-dependent relationship, others have suggested a causal relationship between osteoporosis and atherosclerosis. The aim of our study was to evaluate the cardiovascular risk in a population of patients with osteoporosis by measuring carotid intima-media thickness (cIMT) and carotid-femoral pulse wave velocity (cf-PWV). A total of 58 patients with osteoporosis and an equal number of healthy control subjects were enrolled. All subjects underwent (1) a bone densitometry examination using dual X-ray absorptiometry, (2) a vascular evaluation for the measurements of cIMT and cf-PWV and (3) a blood sample for the evaluation of lipids and phosphocalcic metabolism. Patients with osteoporosis had a significant increase in cIMT and cf-PWV. There was also a significant inverse correlation between the femoral neck BMD and cf-PWV values. In conclusion, osteoporotic outpatients have earlier vascular ageing, with an increase of arterial stiffness. These data support a possible association between osteoporosis and atherosclerosis independent of age.
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12
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Mishra BH, Mishra PP, Mononen N, Hilvo M, Sievänen H, Juonala M, Laaksonen M, Hutri-Kähönen N, Viikari J, Kähönen M, Raitakari OT, Laaksonen R, Lehtimäki T. Lipidomic architecture shared by subclinical markers of osteoporosis and atherosclerosis: The Cardiovascular Risk in Young Finns Study. Bone 2020; 131:115160. [PMID: 31759205 DOI: 10.1016/j.bone.2019.115160] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/02/2019] [Accepted: 11/18/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Studies have shown that osteoporosis and atherosclerosis are comorbid conditions sharing common risk factors and pathophysiological mechanisms. Understanding these is crucial in order to develop shared methods for risk stratification, prevention, diagnosis and treatment. The aim of this study was to apply a system-level bioinformatics approach to lipidome-wide data in order to pinpoint the lipidomic architecture jointly associated with surrogate markers of these complex comorbid diseases. SUBJECTS AND METHODS The study was based on the Cardiovascular Risk in Young Finns Study cohort from the 2007 follow-up (n = 1494, aged 30-45 years, women: 57%). Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used to analyse the serum lipidome, involving 437 molecular lipid species. The subclinical osteoporotic markers included indices of bone mineral density and content, measured using peripheral quantitative computer tomography from the distal and shaft sites of both the tibia and the radius. The subclinical atherosclerotic markers included carotid and bulbus intima media thickness measured with high-resolution ultrasound. Weighted co-expression network analysis was performed to identify networks of densely interconnected lipid species (i.e. lipid modules) associated with subclinical markers of both osteoporosis and atherosclerosis. The levels of lipid species (lipid profiles) of each of the lipid modules were summarized by the first principal component termed as module eigenlipid. Then, Pearson's correlation (r) was calculated between the module eigenlipids and the markers. Lipid modules that were significantly and jointly correlated with subclinical markers of both osteoporosis and atherosclerosis were considered to be related to the comorbidities. The hypothesis that the eigenlipids and profiles of the constituent lipid species in the modules have joint effects on the markers was tested with multivariate analysis of variance (MANOVA). RESULTS Among twelve studied molecular lipid modules, we identified one module with 105 lipid species significantly and jointly associated with both subclinical markers of both osteoporosis (r = 0.24, p-value = 2 × 10-20) and atherosclerosis (r = 0.16, p-value = 2 × 10-10). The majority of the lipid species in this module belonged to the glycerolipid (n = 60), glycerophospholipid (n = 13) and sphingolipid (n = 29) classes. The module was also enriched with ceramides (n = 20), confirming their significance in cardiovascular outcomes and suggesting their joint role in the comorbidities. The top three of the 37 statistically significant (adjusted p-value < 0.05) lipid species jointly associated with subclinical markers of both osteoporosis and atherosclerosis within the module were all triacylglycerols (TAGs) - TAG(18:0/18:0/18:1) with an adjusted p-value of 8.6 × 10-8, TAG(18:0/18:1/18:1) with an adjusted p-value of 3.7 × 10-6, and TAG(16:0/18:0/18:1) with an adjusted p-value of 8.5 × 10-6. CONCLUSION This study identified a novel lipid module associated with both surrogate markers of both subclinical osteoporosis and subclinical atherosclerosis. Alterations in the metabolism of the identified lipid module and, more specifically, the TAG related molecular lipids within the module may provide potential new biomarkers for testing the comorbidities, opening avenues for the emergence of dual-purpose prevention measures.
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Affiliation(s)
- Binisha H Mishra
- Department of Clinical Chemistry, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Finnish Cardiovascular Research Centre, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland.
| | - Pashupati P Mishra
- Department of Clinical Chemistry, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Finnish Cardiovascular Research Centre, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
| | - Nina Mononen
- Department of Clinical Chemistry, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Finnish Cardiovascular Research Centre, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
| | | | | | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland; Research centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | | | - Nina Hutri-Kähönen
- Department of Paediatrics, Tampere University Hospital, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jorma Viikari
- Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland
| | - Mika Kähönen
- Finnish Cardiovascular Research Centre, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Clinical Physiology, Tampere University Hospital, Tampere Finland
| | - Olli T Raitakari
- Research centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku Finland
| | - Reijo Laaksonen
- Department of Clinical Chemistry, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland; Zora Biosciences Oy, Espoo, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Finnish Cardiovascular Research Centre, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
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13
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Abstract
Vitamin D is necessary for bone health but may also have many extra-skeletal effects. The vitamin D endocrine system has major effects on gene and protein expression in many cells and tissues related to the cardiovascular system. In addition, many preclinical studies in animals with vitamin D deficiency or genetically silenced expression of the vitamin D receptor or vitamin D metabolizing enzymes suggest that the absence of vitamin D action may result in cardiovascular events. This includes dysfunctions of endothelial cells, thereby accelerating the process of atherosclerosis, hypertension or abnormal coagulation, ultimately resulting in higher risks for all major cardiovascular or cerebrovascular events. A wealth of observational studies in different parts of the world have fairly consistently found a strong association between a poor vitamin D status and surrogate markers or hard cardiovascular events. A few Mendelian randomization studies did, however, not find a link between genetically lower serum 25OHD concentrations and cardiovascular events. Finally, many RCTs could not demonstrate a consistent effect on surrogate markers, and a limited number of RCTs did so far not find whatever effect on hard cardiovascular endpoints such as myocardial ischemia or infarction, stroke, or cardiovascular death. In conclusion, preclinical data generated a plausible hypothesis of a link between vitamin D status and extra-skeletal events, including cardiovascular endpoints. Whether the vitamin D endocrine system is redundant for the human vascular system or whether the RCTs have not been optimally designed to answer the research question is thus not yet settled.
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Affiliation(s)
- R Bouillon
- Clinical & Experimental Endocrinology, Department Chronic Diseases, Metabolism and Ageing, KU Leuven, Herestraat 49 ON1 box 902, 3000, Leuven, Belgium.
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14
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Nguyen LT, Pham VN, Chau PMN, Ho-Pham LT, Nguyen TV. Association between carotid intima-media thickness and bone mineral density: a cross-sectional study in Vietnamese men and women aged 50 years and older. BMJ Open 2019; 9:e028603. [PMID: 31530594 PMCID: PMC6756441 DOI: 10.1136/bmjopen-2018-028603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES The association between osteoporosis and atherosclerosis remains controversial. We sought to define the relationship between carotid intima-media thickness and bone mineral density (BMD) in individuals of Vietnamese background. DESIGN AND SETTING Cross-sectional study in Ho Chi Minh City, Vietnam. PARTICIPANTS The study involved 1460 individuals (559 men) aged 50 years and older (average age 59 years) who were randomly recruited from the community. OUTCOME MEASURES BMD at the femoral neck and lumbar spine was measured by dual-energy X-ray absorptiometry (Hologic, Waltham, Massachusetts, USA). Carotid intima-media thickness (cIMT) was measured using a Philips Ultrasonography (HD7XE). The presence of atherosclerotic plaque was ascertained for each individual. The association between cIMT and BMD was analysed by a multiple linear regression model. RESULTS In unadjusted analysis, cIMT was positively associated with femoral neck BMD in men (p=0.005), but not in women (p=0.242). After adjusting for age, smoking, diabetes and hypertension, the association remained statistically significant in men (partial R2=0.005; p=0.015) but not in women (partial R2=0.008; p=0.369). When the analysis was limited to individuals aged 60 years and older, the association between cIMT and BMD was no longer statistically significant. There was no statistically significant association between cIMT and lumbar spine BMD in either men or women. CONCLUSIONS In Vietnamese individuals aged 50 years and older, there is a clinically non-significant but statistically significant association between carotid intima-media thickness and BMD in men, not in women.
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Affiliation(s)
- Lich T Nguyen
- Bone and Muscle Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam
- Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| | - Vinh N Pham
- Tam Duc Heart Hospital, Ho Chi Minh City, Vietnam
| | - Phuong M N Chau
- Bone and Muscle Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| | - Lan T Ho-Pham
- Bone and Muscle Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam
- Department of Internal Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Tuan V Nguyen
- Bone Biology Division, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- School of Biomedical Engineering, University of Technology, Sydney, New South Wales, Australia
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15
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Mantovani A, Altomari A, Fassio A, Gatti D, Bonnet F, Targher G. Association between increased carotid intima-media thickness and higher serum C-terminal telopeptide of type 1 collagen levels in post-menopausal women with type 2 diabetes. DIABETES & METABOLISM 2019; 46:409-411. [PMID: 30844448 DOI: 10.1016/j.diabet.2019.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 02/26/2019] [Indexed: 10/27/2022]
Affiliation(s)
- A Mantovani
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
| | - A Altomari
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - A Fassio
- Section of Rheumatology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - D Gatti
- Section of Rheumatology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - F Bonnet
- Groupe Hospitalier Paris Saint-Joseph, 75014 Paris, France
| | - G Targher
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
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16
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Abstract
Cardiovascular (CV) disease and osteoporosis (OP) have become increasing challenges in the aging population and even more in patients with inflammatory rheumatic diseases, such as rheumatoid arthritis, spondyloarthropathies, and systemic lupus erythematosus. In this review, we discuss how the epidemiology and pathogenesis of CV events and OP are overlapping. Smoking, diabetes mellitus, physical inactivity as conventional risk factors as well as systemic inflammation are among the modifiable risk factors for both CV events and bone loss. In rheumatic patients, systemic “high-grade” inflammation may be the primary driver of accelerated atherogenesis and bone resorption. In the general population, in which some individuals might have low-grade systemic inflammation, a holistic approach to drug treatment and lifestyle modifications may have beneficial effects on the bone as well as the vasculature. In rheumatic patients with accelerated inflammatory atherosclerosis and bone loss, the rapid and effective suppression of inflammation in a treat-to-target regime, aiming at clinical remission, is necessary to effectively control comorbidities.
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17
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Jiang Y, Fan Z, Wang Y, Suo C, Cui M, Yuan Z, Tian W, Fan M, Zhang D, Wang X, Jin L, Ye W, Li S, Chen X. Low Bone Mineral Density Is Not Associated with Subclinical Atherosclerosis: A Population-Based Study in Rural China. Cardiology 2018; 141:78-87. [PMID: 30423564 DOI: 10.1159/000493166] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 08/22/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Loss of bone mass may affect the progression of atherosclerosis. We investigated the relationship between low bone mineral density (BMD) and subclinical atherosclerosis in rural China. METHODS In total, 333 men and 421 postmenopausal women aged 55-65 years were enrolled. BMD was measured in the lumbar spine, femoral neck, and total hip using dual-energy X-ray absorptiometry. Subclinical atherosclerosis was defined as increased carotid artery intima-media thickness (CIMT ≥0.9 mm), the presence of carotid plaques, high brachial-ankle pulse wave velocity (baPWV ≥1,400 cm/s), and low ankle-brachial index (ABI ≤1). Binary logistic regression analyses were used to estimate the association between low BMD and subclinical atherosclerosis. RESULTS There was no significant difference in BMD between the normal group and the subclinical atherosclerosis group. After full adjustment for the relevant covariates, a boundary significant association was found between low BMD in the femoral neck and baPWV in postmenopausal women (odds ratio = 1.77, p = 0.049). After full adjustment, neither BMD nor low BMD were significantly associated with subclinical atherosclerosis in men or postmenopausal women. CONCLUSIONS Low BMD is not associated with subclinical atherosclerosis in Chinese individuals aged 55-65 years resident in rural China.
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Affiliation(s)
- Yanfeng Jiang
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China
| | - Zehan Fan
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Yingzhe Wang
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chen Suo
- Fudan University Taizhou Institute of Health Sciences, Taizhou, China.,Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Mei Cui
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ziyu Yuan
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China
| | | | - Min Fan
- Taixing Disease Control and Prevention Center, Taizhou, China
| | - Dekun Zhang
- Taizhou Disease Control and Prevention Center, Taizhou, China
| | - Xiaofeng Wang
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China
| | - Li Jin
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China
| | - Weimin Ye
- Fudan University Taizhou Institute of Health Sciences, Taizhou, China.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Shuyuan Li
- Fudan University Taizhou Institute of Health Sciences, Taizhou, China.,Institute of Embryo-Fetal Original Adult Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xingdong Chen
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China, .,Fudan University Taizhou Institute of Health Sciences, Taizhou, China,
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18
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Barzilay JI, Buzkova P, Cauley JA, Robbins JA, Fink HA, Mukamal KJ. The associations of subclinical atherosclerotic cardiovascular disease with hip fracture risk and bone mineral density in elderly adults. Osteoporos Int 2018; 29:2219-2230. [PMID: 30132027 PMCID: PMC6487649 DOI: 10.1007/s00198-018-4611-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 06/18/2018] [Indexed: 01/27/2023]
Abstract
UNLABELLED In the absence of clinically recognized cardiovascular disease, increased carotid artery intimal medial thickness was associated with higher hip fracture risk in older adults, despite its association with higher bone mineral density (BMD). Low ankle brachial index and aortic wall thickness were not associated with fracture risk or BMD. INTRODUCTION Clinically recognized cardiovascular disease (CVD) is associated with osteoporosis and hip fracture risk, but the relationship of subclinical atherosclerosis to bone health is not certain. METHODS We followed 3385 participants from the Cardiovascular Health Study (mean age 74.7 ± 5.3 years) with a median time to fracture of 12.1 years who underwent baseline carotid artery and aortic wall ultrasound scanning and ankle brachial blood pressure index (ABI) determinations. A subset underwent bone mineral density (BMD) testing. RESULTS There were 494 hip fractures during follow-up. Among persons without clinical CVD, an average standard-deviation increase in a composite score of maximal common and internal carotid artery intimal medial thickness (cIMT) was associated with increased risk of hip fracture [(HR 1.18 [1.04, 1.35]), even though cIMT was positively associated with BMD. Neither aortic wall thickness nor ABI were associated with hip fracture risk or BMD. Among participants with clinical CVD, cIMT and aortic wall thickness, but not ABI, were associated with increased hip fracture risk. CONCLUSION Subclinical cIMT is associated with an increased risk of hip fractures despite being associated with increased BMD. This finding suggests that vascular health, even in its early stages, is linked to bone health, by pathways other than BMD.
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Affiliation(s)
- J I Barzilay
- Kaiser Permanente of Georgia, Division of Endocrinology and the Division of Endocrinology, Emory University School of Medicine, 3650 Steve Reynolds Blvd, Duluth, GA, 30096, USA.
| | - P Buzkova
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - J A Cauley
- Department of Epidemiology, Graduate School, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - J A Robbins
- Department of Medicine, University of California at Davis, Modesto, CA, USA
| | - H A Fink
- Geriatric Research Education and Clinical Center, VA Health Care System, Minneapolis, MN, USA
| | - K J Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Center, Brookline, MA, USA
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19
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Apolipoprotein E plays crucial roles in maintaining bone mass by promoting osteoblast differentiation via ERK1/2 pathway and by suppressing osteoclast differentiation via c-Fos, NFATc1, and NF-κB pathway. Biochem Biophys Res Commun 2018; 503:644-650. [DOI: 10.1016/j.bbrc.2018.06.055] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 06/11/2018] [Indexed: 12/27/2022]
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20
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UPLC/Q-TOF-MS-based metabolomics study of the anti-osteoporosis effects of Achyranthes bidentata polysaccharides in ovariectomized rats. Int J Biol Macromol 2018; 112:433-441. [DOI: 10.1016/j.ijbiomac.2018.01.204] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/29/2018] [Accepted: 01/30/2018] [Indexed: 12/30/2022]
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21
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van den Bos F, Emmelot-Vonk MH, Verhaar HJ, van der Schouw YT. Links between Atherosclerosis and Osteoporosis in Middle Aged and Elderly Men. J Nutr Health Aging 2018; 22:639-644. [PMID: 29806852 DOI: 10.1007/s12603-018-1039-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although the incidences of osteoporosis and atherosclerosis increase with age, there is growing evidence that the coincidental occurrence of both diseases may be independent of age. In general, studies in men are scarce and results are inconsistent. OBJECTIVE to investigate the relationship between atherosclerosis and bone mineral density, and the influence of insulin sensitivity and low grade inflammation on this relationship in 332 men without CVD. METHODS Aortic Pulse wave velocity (PWV), augmentation index (AIX) and measurements of carotid intima media thickness (CIMT) were assessed. BMD measurements were performed with dual-X-ray absorptiometry (DEXA), subcutaneous fat by ultrasonography. Serum concentrations of lipids, hsCRP, glucose and insulin were measured. Insulin sensitivity was calculated by use of the quantitative insulin sensitivity (QUICKI). We used multivariate linear regression models to examine the association of hsCRP, insulin sensitivity, PWV, Aix, CIMT with BMD. RESULTS A higher CIMT was significantly associated with higher BMD after multivariate adjustment (ß 99.7; p=0.02). Further adjustment for weight attenuated the estimates towards non-significant. No association was found between PWV or AIX and BMD. Lower insulin sensitivity was associated with higher BMD (ß -645.1; p<0.01). After adjustment for weight this association was no longer significant. A similar effect was seen for the association between hsCRP and BMD. CONCLUSION In this population of healthy, non-obese, men without a history of cardiovascular disease the positively association between cardiovascular parameters and BMD was mainly explained by weight, suggesting that in this population weight plays a protective role in the development of osteoporosis.
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Affiliation(s)
- F van den Bos
- Frederiek van den Bos, HagaHospital, department of internal medicine. Leyweg 275, 2545 CH, The Haque, The Netherlands, 0031-70-2102917.
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22
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23
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Idoate F, Cadore EL, Casas-Herrero A, Zambom-Ferraresi F, Martínez-Velilla N, Rodriguez-Mañas L, Azcárate PM, Bottaro M, Ramírez-Vélez R, Izquierdo M. Noncoronary Vascular Calcification, Bone Mineral Density, and Muscle Mass in Institutionalized Frail Nonagenarians. Rejuvenation Res 2017; 20:298-308. [PMID: 28193134 DOI: 10.1089/rej.2016.1868] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The purpose of this study was to compare the vascular calcification in thoracic aorta (TAC), abdominal aorta (AAC), iliac arteries (IAC), and femoral arteries (FAC) and bone mineral density (BMD) of the lumbar vertebrae between frail and robust nonagenarians, as well as to verify the associations between vascular calcification with BMD, muscle tissue quality, and quantity in both groups. Forty-two elderly subjects participated in this study: 29 institutionalized frail (92.0 ± 3.2 years) and 13 robust (89.0 ± 4.0 years) elderly participants. All patients underwent nonenhanced helical thoracic, abdominal, and thigh computed tomography. The frail group presented significantly greater FAC as well as less lumbar BMD than the robust group (p < 0.05). In the frail group, significant negative relationships were observed between the individual values of FAC with the individual values of BMD (r = -0.35 to -0.43, p < 0.05) and with the individual values of the quadriceps muscle quantity and quality (r = -0.52, p < 0.01), whereas no significant relationships were observed in the robust group. The robust group presented less vascular calcification and more BMD in the vertebral bodies than the frail group. In the frail group, femoral artery calcification was significantly negatively correlated with BMD, leg muscle quality, and muscle mass volume.
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Affiliation(s)
- Fernando Idoate
- 1 Department of Radiology, Clínica San Miguel , Pamplona, Spain
| | - Eduardo L Cadore
- 2 Exercise Research Laboratory, Federal University of Rio Grande do Sul , Porto Alegre, Brazil
| | - Alvaro Casas-Herrero
- 3 Division of Geriatric Medicine, Complejo Hospitalario de Navarra , CIBER de Fragilidad y Envejecimiento Saludable (CB16/10/00315) Pamplona, Navarra, Spain
| | - Fabricio Zambom-Ferraresi
- 4 Department of Health Sciences, Public University of Navarre , CIBER de Fragilidad y Envejecimiento Saludable (CB16/10/00315), Tudela, Navarre, Spain
| | - Nicolas Martínez-Velilla
- 3 Division of Geriatric Medicine, Complejo Hospitalario de Navarra , CIBER de Fragilidad y Envejecimiento Saludable (CB16/10/00315) Pamplona, Navarra, Spain
| | - Leocadio Rodriguez-Mañas
- 5 Division of Geriatric Medicine, University Hospital of Getafe , CIBER de Fragilidad y Envejecimiento Saludable (CB16/10/00464), Madrid, Spain
| | | | - Martim Bottaro
- 7 College of Physical Education, University of Brasília , Brasília, Brazil
| | - Robinson Ramírez-Vélez
- 8 Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario , Bogotá, Colombia
| | - Mikel Izquierdo
- 4 Department of Health Sciences, Public University of Navarre , CIBER de Fragilidad y Envejecimiento Saludable (CB16/10/00315), Tudela, Navarre, Spain
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24
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Shin J, Park JH, Song YM, Lee K, Sung J. Association between Lumbar Bone Mineral Density and Carotid Intima-Media Thickness in Korean Adults: a Cross-sectional Study of Healthy Twin Study. J Korean Med Sci 2017; 32:70-76. [PMID: 27914134 PMCID: PMC5143301 DOI: 10.3346/jkms.2017.32.1.70] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 10/08/2016] [Indexed: 11/30/2022] Open
Abstract
Bone mineral density (BMD) has been suggested to be associated with atherosclerosis. In the present study, we evaluated the association between lumbar BMD and the segments of carotid intima-media thickness (CIMT), a surrogate marker of subclinical atherosclerosis, in Korean adults, with consideration of sex and menopause status. Among 1,679 Korean adults who enrolled in a Healthy Twin Study, 723 men, 690 premenopausal women, and 266 postmenopausal women measured the CIMT at the common carotid artery intima-media thickness (CCA-IMT), carotid bifurcation intima-media thickness (BIF-IMT), internal carotid artery intima-media thickness (ICA-IMT) using B-mode ultrasound and lumbar BMD using dual-energy X-ray absorptiometry. The composite CIMT was calculated as the mean value of three CIMTs. The association was evaluated using linear mixed models. In premenopausal women, lumbar BMD was positively associated with composite CIMT and with CCA-IMT (P = 0.008 and 0.002, respectively). However, no association was observed between BMD and CIMT in men or in postmenopausal women. Stratified analysis revealed the effect of body mass index (BMI) on the association between BMD and CIME. The positive association in premenopausal women persisted only in low BMI (< 25 kg/m²) group, whereas a positive association appeared at high BMI (≥ 25 kg/m²) group in men. A high lumbar BMD may indicate an elevated risk of subclinical atherosclerosis in premenopausal women and men with high BMI.
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Affiliation(s)
- Jinyoung Shin
- Department of Family Medicine, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joo Hyun Park
- Department of Family Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Yun Mi Song
- Department of Family Medicine, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Kayoung Lee
- Department of Family Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Joohon Sung
- Department of Epidemiology, School of Public Health, Seoul National University, Seoul, Korea
- Institute of Health and Environment, Seoul National University, Seoul, Korea
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25
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Lange V, Dörr M, Schminke U, Völzke H, Nauck M, Wallaschofski H, Hannemann A. The Association between Bone Quality and Atherosclerosis: Results from Two Large Population-Based Studies. Int J Endocrinol 2017; 2017:3946569. [PMID: 28852407 PMCID: PMC5568612 DOI: 10.1155/2017/3946569] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 07/03/2017] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE It is highly debated whether associations between osteoporosis and atherosclerosis are independent of cardiovascular risk factors. We aimed to explore the associations between quantitative ultrasound (QUS) parameters at the heel with the carotid artery intima-media thickness (IMT), the presence of carotid artery plaques, and the ankle-brachial index (ABI). METHODS The study population comprised 5680 men and women aged 20-93 years from two population-based cohort studies: Study of Health in Pomerania (SHIP) and SHIP-Trend. QUS measurements were performed at the heel. The extracranial carotid arteries were examined with B-mode ultrasonography. ABI was measured in a subgroup of 3853 participants. Analyses of variance and linear and logistic regression models were calculated and adjusted for major cardiovascular risk factors. RESULTS Men but not women had significantly increased odds for carotid artery plaques with decreasing QUS parameters independent of diabetes mellitus, dyslipidemia, and hypertension. Beyond this, the QUS parameters were not significantly associated with IMT or ABI in fully adjusted models. CONCLUSIONS Our data argue against an independent role of bone metabolism in atherosclerotic changes in women. Yet, in men, associations with advanced atherosclerosis, exist. Thus, men presenting with clinical signs of osteoporosis may be at increased risk for atherosclerotic disease.
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Affiliation(s)
- V. Lange
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - M. Dörr
- Department for Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research, Partner Site Greifswald, Greifswald, Germany
| | - U. Schminke
- Department for Neurology, University Medicine Greifswald, Greifswald, Germany
| | - H. Völzke
- German Centre for Cardiovascular Research, Partner Site Greifswald, Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - M. Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research, Partner Site Greifswald, Greifswald, Germany
| | - H. Wallaschofski
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research, Partner Site Greifswald, Greifswald, Germany
| | - A. Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- *A. Hannemann:
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26
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Frysz M, Deere K, Lawlor DA, Benfield L, Tobias JH, Gregson CL. Bone Mineral Density Is Positively Related to Carotid Intima-Media Thickness: Findings From a Population-Based Study in Adolescents and Premenopausal Women. J Bone Miner Res 2016; 31:2139-2148. [PMID: 27357175 PMCID: PMC5244498 DOI: 10.1002/jbmr.2903] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 06/22/2016] [Accepted: 06/28/2016] [Indexed: 12/28/2022]
Abstract
Osteoporosis 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 American Society for Bone and Mineral Research.
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Affiliation(s)
- Monika Frysz
- School of Social and Community Medicine, University of Bristol, MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Kevin Deere
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol, UK
| | - Debbie A Lawlor
- School of Social and Community Medicine, University of Bristol, MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Li Benfield
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Jon H Tobias
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol, UK
| | - Celia L Gregson
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol, UK
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27
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Ye C, Xu M, Wang S, Jiang S, Chen X, Zhou X, He R. Decreased Bone Mineral Density Is an Independent Predictor for the Development of Atherosclerosis: A Systematic Review and Meta-Analysis. PLoS One 2016; 11:e0154740. [PMID: 27149062 PMCID: PMC4858264 DOI: 10.1371/journal.pone.0154740] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 04/18/2016] [Indexed: 01/11/2023] Open
Abstract
Background There is conflicting evidence regarding the association between decreased bone mineral density (BMD) and atherosclerosis. To this end, we performed a systematic review and meta-analysis to clarify the association. Methods To identify relevant studies, PubMed, Embase, and the Cochrane Library were systematically searched up to November 2015. All observational and comparative studies directly investigating the relationship between decreased BMD and clinical consequences of atherosclerotic vascular abnormalities, including carotid artery calcification (CAC), cardiovascular disease (CAD), and coronary artery disease (CAD) were obtained, without limitation of language or publication year. Results A total of 25 studies involving 10,299 patients were included. The incidence of atherosclerotic vascular abnormalities was significantly increased in low BMD patients, compared to patients with normal BMD (OR, 1.81, 95% CI [1.01, 2.19], p<0.00001)). Similar results were also observed for postmenopausal women (OR, 2.23, 95% CI [1.72, 2.89], p<0.00001). Subgroup analyses of osteopenia, osteoporosis, and normal BMD also revealed that the combined ORs for the incidence of atherosclerotic vascular abnormalities increased as BMD decreased. Of note, after adjusting for age, sex, body mass index (BMI) and other vascular risk factors, decreased BMD remained significantly associated with the incidence of atherosclerotic vascular abnormalities (OR, 2.96, 95% CI [2.25, 3.88], p < 0.00001). Conclusions Based on the results of this study, decreased BMD is an independent predictor for the development of atherosclerosis in elderly individuals. Moreover, the risk of atherosclerotic vascular abnormalities increased as BMD decreased. Future studies focusing on individuals with different severities of atherosclerosis and comorbidities are of interest.
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Affiliation(s)
- Chenyi Ye
- Department of Orthopedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - Mingyuan Xu
- Department of Plastic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - Shengdong Wang
- Department of Orthopedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - Shuai Jiang
- Department of Orthopedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - Xi Chen
- Department of Orthopedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - Xiaoyu Zhou
- Department of Orthopedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - Rongxin He
- Department of Orthopedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
- * E-mail:
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28
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Kang K. Low bone mineral density is associated with intracranial posterior circulation atherosclerosis in women. Bone 2015; 81:669-674. [PMID: 26431918 DOI: 10.1016/j.bone.2015.09.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 08/14/2015] [Accepted: 09/28/2015] [Indexed: 10/23/2022]
Abstract
Low bone mineral density (BMD) is associated with carotid atherosclerosis and the incidence of stroke. However, there are no data on the association of BMD with intracranial atherosclerosis. The study population consisted of 357 participants who underwent dual energy x-ray absorptiometric scanning of the lumbar spine and brain 3D time of flight magnetic resonance angiography as part of their voluntary health checks. The basilar, middle cerebral, intracranial internal carotid and intracranial vertebral arteries were evaluated. Low BMD was defined as a T-score of less than -1. All analyses were stratified by sex and intracranial atherosclerosis location. One hundred seventy-six women (53 years; 66.9% postmenopausal; 33.5% low BMD; 60.2% intracranial atherosclerosis in the anterior circulation (AC); 60.2% intracranial atherosclerosis in the posterior circulation (PC)) and 181 men (51 years; 28.7% low BMD; 61.9% intracranial atherosclerosis in the AC; 55.8% intracranial atherosclerosis in the PC) were included. In women, low BMD was significantly associated with intracranial atherosclerosis in the PC with the odds ratio of 2.57 (95% confidence interval 1.11-5.99). However, intracranial atherosclerosis in the AC was not associated with BMD in women. In men, there were no significant associations between BMD and intracranial atherosclerosis. In conclusion, this study shows that low BMD is associated with subclinical intracranial PC atherosclerosis in women but not in men.
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Affiliation(s)
- K Kang
- Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea; Department of Neurology, Gyeongsang National University Hospital, Jinju, Republic of Korea.
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Li LL, Li Y, Liu T, Wang RT. Bone Mineral Density is Negatively Associated with Arterial Stiffness in Men with Silent Brain Infarction. Int J Stroke 2015; 10:E74. [PMID: 26404882 DOI: 10.1111/ijs.12561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Lu-lu Li
- Department of Geriatrics, the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Ying Li
- Department of Geriatrics, the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
- International Physical Examination and Healthy Center, the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Tiemin Liu
- Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, USA
| | - Rui-tao Wang
- Department of Geriatrics, the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
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30
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Kim SN, Lee HS, Nam HS, Lee HR, Kim JM, Han SW, Park JH, Baik JS, Kim JY, Park JH. Carotid Intima-Media Thickness is Inversely Related to Bone Density in Female but not in Male Patients with Acute Stroke. J Neuroimaging 2015; 26:83-8. [DOI: 10.1111/jon.12284] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 06/05/2015] [Accepted: 06/30/2015] [Indexed: 11/26/2022] Open
Affiliation(s)
- Shi Nae Kim
- Department of Neurology, Sanggye Paik Hospital; Inje University College of Medicine; Seoul Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs; Seoul Korea
| | - Hyo Suk Nam
- Department of Neurology, Severance Hospital; Yonsei University College of Medicine; Seoul Korea
| | - Hwa Reung Lee
- Department of Neurology, Sanggye Paik Hospital; Inje University College of Medicine; Seoul Korea
| | - Jung Min Kim
- Department of Internal Medicine, Sanggye Paik Hospital; Inje University College of Medicine; Seoul Korea
| | - Sang Won Han
- Department of Neurology, Sanggye Paik Hospital; Inje University College of Medicine; Seoul Korea
| | - Joong Hyun Park
- Department of Neurology, Sanggye Paik Hospital; Inje University College of Medicine; Seoul Korea
| | - Jong Sam Baik
- Department of Neurology, Sanggye Paik Hospital; Inje University College of Medicine; Seoul Korea
| | - Jeong Yeon Kim
- Department of Neurology, Sanggye Paik Hospital; Inje University College of Medicine; Seoul Korea
| | - Jae Hyeon Park
- Department of Neurology, Sanggye Paik Hospital; Inje University College of Medicine; Seoul Korea
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31
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Noguchi T, Ebina K, Hirao M, Kawase R, Ohama T, Yamashita S, Morimoto T, Koizumi K, Kitaguchi K, Matsuoka H, Kaneshiro S, Yoshikawa H. Progranulin plays crucial roles in preserving bone mass by inhibiting TNF-α-induced osteoclastogenesis and promoting osteoblastic differentiation in mice. Biochem Biophys Res Commun 2015; 465:638-43. [PMID: 26297947 DOI: 10.1016/j.bbrc.2015.08.077] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 08/17/2015] [Indexed: 11/26/2022]
Abstract
A close correlation between atherosclerosis, inflammation, and osteoporosis has been recognized, although the precise mechanism remains unclear. The growth factor progranulin (PGRN) is expressed in various cells such as macrophages, leukocytes, and chondrocytes. PGRN plays critical roles in a variety of diseases, such as atherosclerosis and arthritis by inhibiting Tumor Necrosis Factor-α (TNF-α) signaling. The purpose of this study was to investigate the effect of PGRN on bone metabolism. Forty-eight-week old female homozygous PGRN knockout mice (PGRN-KO) (n = 8) demonstrated severe low bone mass in the distal femur compared to age- and sex-matched wild type C57BL/6J mice (WT) (n = 8) [BV/TV (%): 5.8 vs. 16.6; p < 0.001, trabecular number (1/mm): 1.6 vs. 3.8; p < 0.001]. In vitro, PGRN inhibited TNF-α-induced osteoclastogenesis from spleen cells of PGRN-KO mice. Moreover, PGRN significantly promoted ALP activity, osteoblast-related mRNA (ALP, osteocalcin) expression in a dose-dependent manner and up-regulated osteoblastic differentiation by down-regulating phosphorylation of ERK1/2 in mouse calvarial cells. In conclusion, PGRN may be a promising treatment target for both atherosclerosis and inflammation-related osteoporosis.
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Affiliation(s)
- Takaaki Noguchi
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Kosuke Ebina
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Makoto Hirao
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Ryota Kawase
- Department of Cardiovascular Medicine, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Tohru Ohama
- Department of Cardiovascular Medicine, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan; Department of Dental Anesthesiology, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Shizuya Yamashita
- Department of Cardiovascular Medicine, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan; Department of Community Medicine, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Tokimitsu Morimoto
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Kota Koizumi
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Kazuma Kitaguchi
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hozo Matsuoka
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Shoichi Kaneshiro
- Department of Orthopaedic Surgery, Japan Community Health Care Organization, Osaka Hospital, 4-2-78 Fukushima Ward, Osaka 586-8521, Japan
| | - Hideki Yoshikawa
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
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Wang YQ, Yang PT, Yuan H, Cao X, Zhu XL, Xu G, Mo ZH, Chen ZH. Low bone mineral density is associated with increased arterial stiffness in participants of a health records based study. J Thorac Dis 2015; 7:790-8. [PMID: 26101634 DOI: 10.3978/j.issn.2072-1439.2015.04.47] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 04/10/2015] [Indexed: 11/14/2022]
Abstract
AIMS Many epidemiological studies have shown that low bone mineral density (BMD) and atherosclerosis appear to be related. However, their precise correlation is not completely understood after full adjustment the shared confounders of atherosclerosis and bone metabolism. The aim of this cross-sectional study was to investigate the relationship between BMD and subclinical atherosclerosis in a healthy Chinese population and the difference in gender. METHODS The study population consisted of 2,487 subjects (1,467 men, 1,020 women) who participated in health check-up programs and were selected to be free of major diseases which might affect atherosclerosis and bone metabolism. Bone status was assessed by BMD in lumbar spine. The brachial-ankle PWV (baPWV) was assessed as a functional marker of atherosclerosis. The ankle-brachial index (ABI), carotid artery intima-media thickness (CIMT), estimated glomerular filtration rate (eGRF) and microalbuminuria were evaluated as indexes of structural markers of atherosclerosis. RESULTS After adjustment for risk factors, significant association was shown between baPWV and BMD in both genders (male: r=-0.084, P=0.035; female: r=-0.088, P=0.014). The correlation was stronger in females than in males, and in females, the correlation was stronger after menopause. Similarly, mean baPWV differed significantly according to the decreased BMD (normal BMD, Osteopenia, Osteoporosis). In contrast, no significant differences were observed for ABI, CIMT, eGFR or microalbuminuria with BMD. CONCLUSIONS Independent of confounding factors, low BMD is associated with the functional marker of subclinical atherosclerosis (increased baPWV), but not with structural markers (ABI, CIMT, eGFR or microalbuminuria) among healthy females and males.
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Affiliation(s)
- Ya-Qin Wang
- 1 Department of Healthy Management Center, 2 Department of Cardiology, 3 Department of Endocrinology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Ping-Ting Yang
- 1 Department of Healthy Management Center, 2 Department of Cardiology, 3 Department of Endocrinology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Hong Yuan
- 1 Department of Healthy Management Center, 2 Department of Cardiology, 3 Department of Endocrinology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Xia Cao
- 1 Department of Healthy Management Center, 2 Department of Cardiology, 3 Department of Endocrinology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Xiao-Ling Zhu
- 1 Department of Healthy Management Center, 2 Department of Cardiology, 3 Department of Endocrinology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Guo Xu
- 1 Department of Healthy Management Center, 2 Department of Cardiology, 3 Department of Endocrinology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Zhao-Hui Mo
- 1 Department of Healthy Management Center, 2 Department of Cardiology, 3 Department of Endocrinology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Zhi-Heng Chen
- 1 Department of Healthy Management Center, 2 Department of Cardiology, 3 Department of Endocrinology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
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Kim DH, Rogers JR, Fulchino LA, Kim CA, Solomon DH, Kim SC. Bisphosphonates and risk of cardiovascular events: a meta-analysis. PLoS One 2015; 10:e0122646. [PMID: 25884398 PMCID: PMC4401508 DOI: 10.1371/journal.pone.0122646] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 02/23/2015] [Indexed: 11/23/2022] Open
Abstract
Background and Objectives Some evidence suggests that bisphosphonates may reduce atherosclerosis, while concerns have been raised about atrial fibrillation. We conducted a meta-analysis to determine the effects of bisphosphonates on total adverse cardiovascular (CV) events, atrial fibrillation, myocardial infarction (MI), stroke, and CV death in adults with or at risk for low bone mass. Methods A systematic search of MEDLINE and EMBASE through July 2014 identified 58 randomized controlled trials with longer than 6 months in duration that reported CV events. Absolute risks and the Mantel-Haenszel fixed-effects odds ratios (ORs) and 95% confidence intervals (CIs) of total CV events, atrial fibrillation, MI, stroke, and CV death were estimated. Subgroup analyses by follow-up duration, population characteristics, bisphosphonate types, and route were performed. Results Absolute risks over 25–36 months in bisphosphonate-treated versus control patients were 6.5% versus 6.2% for total CV events; 1.4% versus 1.5% for atrial fibrillation; 1.0% versus 1.2% for MI; 1.6% versus 1.9% for stroke; and 1.5% versus 1.4% for CV death. Bisphosphonate treatment up to 36 months did not have any significant effects on total CV events (14 trials; ORs [95% CI]: 0.98 [0.84–1.14]; I2 = 0.0%), atrial fibrillation (41 trials; 1.08 [0.92–1.25]; I2 = 0.0%), MI (10 trials; 0.96 [0.69–1.34]; I2 = 0.0%), stroke (10 trials; 0.99 [0.82–1.19]; I2 = 5.8%), and CV death (14 trials; 0.88 [0.72–1.07]; I2 = 0.0%) with little between-study heterogeneity. The risk of atrial fibrillation appears to be modestly elevated for zoledronic acid (6 trials; 1.24 [0.96–1.61]; I2 = 0.0%), not for oral bisphosphonates (26 trials; 1.02 [0.83–1.24]; I2 = 0.0%). The CV effects did not vary by subgroups or study quality. Conclusions Bisphosphonates do not have beneficial or harmful effects on atherosclerotic CV events, but zoledronic acid may modestly increase the risk of atrial fibrillation. Given the large reduction in fractures with bisphosphonates, changes in osteoporosis treatment decision due to CV risk are not justified.
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Affiliation(s)
- Dae Hyun Kim
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
| | - James R. Rogers
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Lisa A. Fulchino
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Caroline A. Kim
- Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Daniel H. Solomon
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Seoyoung C. Kim
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
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Yu XY, Li XS, Li Y, Liu T, Wang RT. Neutrophil-lymphocyte ratio is associated with arterial stiffness in postmenopausal women with osteoporosis. Arch Gerontol Geriatr 2015; 61:76-80. [PMID: 25882272 DOI: 10.1016/j.archger.2015.03.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 03/22/2015] [Accepted: 03/25/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Systemic inflammation may be a common mechanism for the development of osteoporosis (OP) and atherosclerosis. Elevated arterial stiffness is an index of subclinical atherosclerosis. Recent studies found that neutrophil/lymphocyte ratio (NLR), is a useful marker of cardiovascular disease and a more powerful predictor than any other leukocyte subtypes. However, little research has been conducted to investigate the relationship between NLR and arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV). METHODS In this cross-sectional study, we examined the relationship between NLR and baPWV in 512 subjects. RESULTS Compared to the control subjects, NLR and baPWV increased in patients with OP. Partial correlation analysis revealed that there was a significant correlation between NLR and baPWV after adjusting for confounding factors in OP. Multivariate linear regression analysis showed that NLR was a significant factor for increased baPWV in patients with OP (β=0.249, p<0.001). However, there was no association between NLR and baPWV in control subjects. CONCLUSION NLR and baPWV are elevated in OP. Moreover, NLR is independently associated with baPWV. Further studies are warranted to investigate whether anti-inflammatory treatment could improve arterial stiffness in postmenopausal women with OP.
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Affiliation(s)
- Xin-yang Yu
- Harbin Medical University, Harbin, Heilongjiang, China
| | - Xue-song Li
- Department of Orthopedics, the First Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Ying Li
- Department of Geriatrics, the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Tiemin Liu
- Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - Rui-tao Wang
- Department of Geriatrics, the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China.
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Mendoza-Pinto C, García-Carrasco M, Jiménez-Hernández M, Sánchez-Pérez R, Escárcega RO, Nava-Zavala A, Munguía-Realpozo P, López-Colombo A, Jara LJ, Cervera R. Carotid atherosclerosis is not associated with lower bone mineral density and vertebral fractures in patients with systemic lupus erythematosus. Lupus 2014; 24:25-31. [DOI: 10.1177/0961203314548247] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Low bone mineral density (BMD) and vertebral fractures (VF) have been associated with atherosclerosis in the general population. We sought to investigate the relationship between BMD and VF and carotid atherosclerosis in women with systemic lupus erythematosus (SLE). Methods We studied 122 women with SLE. All patients had BMD, carotid intima-media thickness (IMT), and carotid artery atherosclerotic plaque assessment by ultrasound. Results Mean age at study entry was 44 years and mean disease duration was 11 years. Carotid plaque was found in 13 (11%) patients (9 postmenopausal and 4 premenopausal). Patients in the highest IMT quartile were more likely to be older ( p = 0.001), have a higher body mass index ( p = 0.008), and exhibit dyslipidemia at study entry ( p = 0.041), compared with the lower three quartiles. BMD at the lumbar spine was lower in patients in the highest IMT quartile compared with the lower quartiles in the multivariate logistic analysis, however, there was no association between lumbar or total hip BMD and IMT ( p = 0.91 and p = 0.6, respectively). IMT measurements did not differ according to the presence or absence of VF (0.08 ± 0.12 vs. 0.06 ± 0.03 mm, p = 0.11). A trend towards higher incidence of VF was found in patients with carotid plaque compared with those without (33% vs. 21%; p = 0.2). Conclusions In patients with SLE, the presence of carotid atherosclerosis is not associated with low BMD or VF.
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Affiliation(s)
- C Mendoza-Pinto
- Systemic Autoimmune Diseases Research Unit, IMSS, Puebla, Mexico
- Department of Rheumatology and Immunology, Benemérita Universidad Autónoma de Puebla, Mexico
| | - M García-Carrasco
- Systemic Autoimmune Diseases Research Unit, IMSS, Puebla, Mexico
- Department of Rheumatology and Immunology, Benemérita Universidad Autónoma de Puebla, Mexico
| | | | | | - R O Escárcega
- Division of Interventional Cardiology, Medstar Hospital Center, Washington, USA
| | - A Nava-Zavala
- Clinical Epidemiology Research Unit, IMSS, Guadalajara, Mexico
| | | | - A López-Colombo
- State Research Department, Research Unit, IMSS, Puebla, Mexico
| | - L J Jara
- Clinical Research Department, UMAE, Centro Médico Nacional IMSS, Mexico
| | - R Cervera
- Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Catalonia, Spain
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Relationship between serum total cholesterol level and serum biochemical bone turnover markers in healthy pre- and postmenopausal women. BIOMED RESEARCH INTERNATIONAL 2014; 2014:398397. [PMID: 24949440 PMCID: PMC4052088 DOI: 10.1155/2014/398397] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 05/02/2014] [Accepted: 05/05/2014] [Indexed: 11/18/2022]
Abstract
Background. The presence of common risk factors suggests that there is a relationship between osteoporosis and cardiovascular disease, possibly via dyslipidemia and inflammation. We investigated the relationships among the lipid profile, the inflammation marker high-sensitivity C-reactive protein (hsCRP), bone turnover markers, and bone mineral density (BMD) to assess the correlation between osteoporosis and cardiovascular disease and identify factors predicting osteoporosis. Methods. The study included 759 Korean women older than 20 years of age. The BMD, serum lipid profile, and levels of hsCRP, cross-linked C-terminal peptide (CTX), and osteocalcin were measured. We compared the serum biomarkers between groups with normal and low BMD and assessed the correlations between the levels of bone turnover markers and the lipid profile and hsCRP level. Results. The concentrations of CTX, osteocalcin, and total cholesterol were significantly higher in the low BMD group than in the normal BMD group in premenopausal women group. However, hsCRP was not correlated with these parameters. Multivariate logistic regression analysis revealed that TC (OR, 1.647; 95% CI, 1.190–2.279) and osteocalcin (OR, 1.044; 95% CI, 1.002–1.088) had an increased risk of low BMD in premenopausal women. Conclusions. These results indicate that total cholesterol concentration is correlated with the levels of bone turnover markers, suggesting that it might predict osteoporosis in premenopausal women.
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Park J, Omi N. The effects of different exercise modes for preventing endothelial dysfunction of arteries and bone loss in ovariectomized rats. J Exerc Nutrition Biochem 2014; 18:133-9. [PMID: 25566448 PMCID: PMC4241919 DOI: 10.5717/jenb.2014.18.2.133] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 04/17/2014] [Accepted: 05/15/2014] [Indexed: 11/04/2022] Open
Abstract
[Purpose] Several epidemiological studies have demonstrated that there are positive correlations between vascular disorders and bone loss in postmenopausal women. The aim of the present study was to examine the effect of different types of exercise (e.g., climbing and swimming) for preventing endothelial dysfunction of arteries and bone loss in ovariectomized rats. [Methods] Twenty Sprague-Dawley female rats were randomly divided into three groups: ovariectomy (OVX) plus treatment with vitamin D3 and nicotine (VDN) (control rats [Con], n = 7), which is an animal model for endothelial dysfunction and bone loss; voluntary climbing resistance exercise with OVX plus VDN (climbing rats [Clim], n = 6), and swimming exercise with OVX plus VDN (swimming rats [Swim], n = 7). The period of exercise training was 8 weeks. [Results] The endothelin-1 (ET-1) protein levels were significantly lower in the Clim and Swim groups than in the Con. The endothelial nitric oxide synthase protein levels were significantly higher in the Swim group than in the Con, but they did not differ between the Clim and Con groups. The cortical bone mineral density in the tibia and breaking energy of the femur were significantly higher in the Clim group than in the Con, but this positive effect was not seen in the Swim group. [Conclusion] Voluntary climbing exercise decreased arterial ET-1 protein levels and prevented bone loss in a postmenopause-model rat combining OVX and VDN. Conversely, swimming suppressed endothelial dysfunction of the arteries but did not prevent bone loss. Thus, the type of exercise should be cautiously chosen for enhancing vascular function and bone status, especially in females after menopause.
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Affiliation(s)
- Jonghoon Park
- Department of Physical Education, Konkuk University, Seoul, Korea
| | - Naomi Omi
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
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Canepa M, Ameri P, AlGhatrif M, Pestelli G, Milaneschi Y, Strait JB, Giallauria F, Ghigliotti G, Brunelli C, Lakatta EG, Ferrucci L. Role of bone mineral density in the inverse relationship between body size and aortic calcification: results from the Baltimore Longitudinal Study of Aging. Atherosclerosis 2014; 235:169-75. [PMID: 24842457 DOI: 10.1016/j.atherosclerosis.2014.04.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 04/01/2014] [Accepted: 04/12/2014] [Indexed: 01/06/2023]
Abstract
OBJECTIVE There is a J-shaped relationship between body mass index (BMI) and cardiovascular outcomes in elderly patients (obesity paradox). Whether low BMI correlates with aortic calcification (AC) and whether this association is accounted for by bone demineralization is uncertain. METHODS Presence of AC was evaluated in 687 community-dwelling individuals (49% male, mean age 67 ± 13 years) using CT images of the thoracic, upper and lower abdominal aorta, and scored from 0 to 3 according to number of sites that showed any calcification. Whole-body bone mineral density (BMD) was evaluated by dual-energy X-ray absorptiometry. Predictors of AC were assessed by logistic regression, and the role of BMD using mediation analysis. RESULTS Age and cardiovascular risk factors were positively associated while both BMI (r = -0.11, p < 0.01) and BMD (r = -0.17, p < 0.0001) were negatively associated with AC severity. In multivariate models, lower BMI (OR 0.96, 95%CI 0.92-0.99, p = 0.01), older age, higher systolic blood pressure, use of lipid-lowering drugs and smoking were independent predictors of AC. A nonlinear relationship between BMI and AC was noticed (p = 0.03), with decreased AC severity among overweight participants. After adjusting for BMD, the coefficient relating BMI to AC was reduced by 14% and was no longer significant, whereas BMD remained negatively associated with AC (OR 0.82, 95%CI 0.069-0.96, p = 0.01), with a trend for a stronger relationship in older participants. CONCLUSION Low BMI is associated with increased AC, possibly through calcium mobilization from bone, resulting in low BMD. Prevention of weight loss and bone demineralization with aging may help reducing AC.
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Affiliation(s)
- Marco Canepa
- Longitudinal Studies Section, Translational Gerontology Branch, NIA/NIH, Baltimore, MD, USA; Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, NIA/NIH, Baltimore, MD, USA; Department of Internal Medicine, University of Genova, Genova, Italy.
| | - Pietro Ameri
- Department of Internal Medicine, University of Genova, Genova, Italy
| | - Majd AlGhatrif
- Longitudinal Studies Section, Translational Gerontology Branch, NIA/NIH, Baltimore, MD, USA; Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, NIA/NIH, Baltimore, MD, USA; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Gabriele Pestelli
- Department of Internal Medicine, University of Genova, Genova, Italy
| | - Yuri Milaneschi
- Longitudinal Studies Section, Translational Gerontology Branch, NIA/NIH, Baltimore, MD, USA; Department of Psychiatry, VU University Medical Center/GGZ inGeest, Amsterdam, The Netherlands
| | - James B Strait
- Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, NIA/NIH, Baltimore, MD, USA
| | - Francesco Giallauria
- Longitudinal Studies Section, Translational Gerontology Branch, NIA/NIH, Baltimore, MD, USA
| | | | - Claudio Brunelli
- Department of Internal Medicine, University of Genova, Genova, Italy
| | - Edward G Lakatta
- Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, NIA/NIH, Baltimore, MD, USA
| | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, NIA/NIH, Baltimore, MD, USA
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Teng ZY, Pei LC, Zhang Y, Li Y, Wang RT. Whole blood viscosity is negatively associated with bone mineral density in postmenopausal women with osteoporosis. Bone 2013; 56:343-6. [PMID: 23845324 DOI: 10.1016/j.bone.2013.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Revised: 06/14/2013] [Accepted: 07/01/2013] [Indexed: 11/28/2022]
Abstract
Osteoporosis (OP) is associated with cardiovascular disease. Moreover, osteoporosis has been shown to be an independent predictor of cardiovascular mortality. Recent studies revealed that altered blood rheology plays a critical role in atherosclerosis. A study confirmed that whole blood viscosity (WBV) is a predictor of cardiovascular events. However, little research has been conducted to investigate the relationship between blood viscosity and osteoporosis. In this cross-sectional study, we investigated the relationship between the rheological parameters and bone mineral density (BMD) in 481 subjects in the International Physical Examination and Healthy Center of the Second Affiliated Hospital, Harbin, China. Different biochemical stress and physical activity are correlated to lumbar spine BMD. Stepwise multivariate linear regression analysis revealed that WBV was a significant factor for decreased BMD (β=-0.513; P<0.001 for lumbar spine L2-4 BMD; β=-0.157; P=0.003 for femoral neck BMD). In conclusion, The findings show that WBV is elevated in osteoporosis and negatively correlated with BMD. Further studies are warranted to investigate whether antiosteoporosis medication could normalize whole blood viscosity in postmenopausal women with osteoporosis.
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Affiliation(s)
- Zong-yan Teng
- Department of Geriatrics, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
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Kuipers AL, Miljkovic I, Kammerer CM, Evans RW, Bunker CH, Patrick AL, Wheeler VW, Sutton-Tyrrell K, Zmuda JM. Evidence for a genetic link between bone and vascular measures in African ancestry families. J Bone Miner Res 2013; 28:1804-10. [PMID: 23505032 PMCID: PMC3720825 DOI: 10.1002/jbmr.1922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 02/20/2013] [Accepted: 03/04/2013] [Indexed: 11/07/2022]
Abstract
Bone mineral density (BMD) has been inversely associated with subclinical and clinical cardiovascular disease (CVD) in population studies, but the potential mechanisms underlying this relationship are unclear. To test if there is a genetic basis underlying this association, we determined the phenotypic and genetic correlations between BMD and carotid artery ultrasound measures in families. Dual-energy X-ray absorptiometry and peripheral quantitative computed tomography were used to measure BMD in 461 individuals with African ancestry belonging to seven large, multigenerational families (mean family size 66; 3414 total relative pairs). Carotid artery ultrasound was used to measure adventitial diameter (AD) and intima-media thickness (IMT). Phenotypic and genetic correlations between BMD and carotid measures were determined using pedigree-based maximum likelihood methods. We adjusted for potential confounding factors, including age, sex, body weight, height, menopausal status, smoking, alcohol intake, walking for exercise, diabetes, hypertension, serum lipid and lipoprotein levels, inflammation markers, and kidney function. We found statistically significant phenotypic (ρ = -0.19) and genetic (ρG = -0.70) correlations (p < 0.05 for both) between lumbar spine BMD and AD in fully adjusted models. There was also a significant genetic correlation between trabecular BMD at the radius and IMT in fully adjusted models (ρG = -0.398; p < 0.05). Our findings indicate that the previously observed association between osteoporosis and CVD in population-based studies may be partly mediated by genetic factors and that the pleiotropic effects of these genes may operate independently of traditional risk pathways.
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Affiliation(s)
- Allison L Kuipers
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15261, USA.
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Dangas GD, Maehara A, Evrard SM, Sartori S, Li JR, Chirumamilla AP, Nomura-Kitabayashi A, Gukathasan N, Hassanin A, Baber U, Fahy M, Fuster V, Mintz GS, Kovacic JC. Coronary artery calcification is inversely related to body morphology in patients with significant coronary artery disease: a three-dimensional intravascular ultrasound study. Eur Heart J Cardiovasc Imaging 2013; 15:201-9. [PMID: 23904334 DOI: 10.1093/ehjci/jet139] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
AIMS Emerging data have indicated unexpected complexity in the regulation of vascular and bone calcification. In particular, several recent studies have challenged the concept of a universally positive relationship between body morphology [weight, height, body mass index (BMI), body surface area (BSA)] and the extent of vascular calcification. We sought to clarify these discrepancies and investigated the relationship between index lesion coronary artery calcification (CAC) and body morphology in patients undergoing percutaneous coronary intervention (PCI) using three-dimensional intravascular ultrasound (IVUS). METHODS AND RESULTS We analysed CAC in patients who underwent PCI with pre-intervention IVUS imaging. The main outcome measure was the calcium index (CalcIndex); a three-dimensional IVUS-derived measure of total calcification per obstructive coronary lesion. A total of 346 patients (65.3 ± 10.6 years; 29.5% females) underwent PCI with IVUS-based CAC assessment. CalcIndex was categorized as zero-low (0-0.1399; n = 152) or intermediate-high (0.1400-1.2541; n = 194). All measures of body morphology were lower in patients with intermediate-high CalcIndex (height, P = 0.024; weight, P = 0.008; BMI, P = 0.064; BSA, P = 0.005). In adjusted multivariable models, weight and BSA were independent inverse predictors of intermediate-high CalcIndex [weight: odds ratio (OR) 0.986, P = 0.017; BSA: OR 0.323, P = 0.012] while CalcIndex also trended towards an inverse association with both height (P = 0.068) and BMI (P = 0.064). These independent inverse associations were consistent across multiple clinical subgroups, including stratification by age, race, gender, diabetes, and renal impairment. CONCLUSION Using three-dimensional IVUS to assess vascular calcification, these data confirm an independent, inverse relationship between body size and index lesion CAC in patients with obstructive coronary artery disease.
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Issever AS, Kentenich M, Köhlitz T, Diederichs G, Zimmermann E. Osteoporosis and atherosclerosis: a post-mortem MDCT study of an elderly cohort. Eur Radiol 2013; 23:2823-9. [PMID: 23722898 DOI: 10.1007/s00330-013-2903-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 04/07/2013] [Accepted: 04/11/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To evaluate how far fracture status and bone mineral density (BMD) correlate with the vascular calcification score (CS). METHODS On 29 complete human cadavers (17 female, 12 male; mean age at death was 85.57 years), multi-detector computed tomography was performed to assess the spine fracture status (fracture vs non-fracture [FX vs non-FX]) and CS of the coronary arteries (Coro-CS), the aorta (Aorta-CS) and the pelvic vessels (Iliac-CS). Quantitative computed tomography of the lumbar spine was performed to estimate overall BMD (osteoporotic [BMD <80 mg/cm(3)] vs non-osteoporotic [BMD ≥ 80 mg/cm(3)]). RESULTS Gender-specific differences in statistical significance were only observed for Aorta-CS and Iliac-CS but not for Coro-CS. When comparing the osteoporotic with the non-osteoporotic group, statistically significant differences were only found for Iliac-CS (P < 0.05); however, linear regression analysis showed none of the CSs to significantly correlate with BMD. CONCLUSIONS In our small post-mortem elderly population, statistically significant associations of fracture status and BMD with CS were only observed between the osteoporotic and non-osteoporotic groups for the pelvic vessels but not for the coronary arteries and the aorta. KEY POINTS • Gender-specific differences were observed for aortic and iliac calcification score (CS). • There was no difference in coronary CS between females and males. • Only iliac CS was different in osteoporotic and non-osteoporotic subjects. • In linear regression analysis, CS showed no correlation with BMD. • In univariate analysis, gender was a BMD and iliac CS confounder.
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Affiliation(s)
- A S Issever
- Department of Radiology, Charité Campus Mitte, Charité - Universitaetsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany,
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McFarlane SI, Qureshi G, Singh G, Venner-Jones K, Salciccioli L, Lazar J. Bone Mineral Density as a Predictor of Atherosclerosis and Arterial Wall Stiffness in Obese African-American Women. Cardiorenal Med 2012; 2:328-334. [PMID: 23381741 DOI: 10.1159/000345461] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Accepted: 09/10/2012] [Indexed: 11/19/2022] Open
Abstract
Bone demineralization is associated with higher cardiovascular event rates, possibly due to vascular calcification and accelerated atherosclerosis. African-Americans have less bone loss and less calcium content within atherosclerotic plaques. However, whether loss of bone mass is related to atherosclerosis has not been examined in African-Americans. The objective of this study was to evaluate possible associations between bone mineral density (BMD), carotid intimal-medial thickness (CIMT), and arterial stiffness. We studied 100 obese African-American women (BMI: 26.6 ± 6.2; age: 63 ± 14 years) referred for BMD estimation by dual-energy X-ray absorptiometry scan. BMD (g/cm(2)) was obtained at the lumbar spine (L1-L4), femoral neck, and total hip. Arterial stiffness was evaluated by the heart rate-corrected augmentation index (AI@75) and pulse wave velocity (PWV) using applanation tonometry. CIMT was measured by vascular ultrasound. Mean CIMT, AI@75, and PWV were 0.72 ± 0.14 mm, 28.8 ± 9.0%, and 8.9 ± 1.6 m/s, respectively. Mean BMD values at the lumbar spine, femoral neck, and hip were 0.96 ± 0.19, 0.80 ± 0.16, and 0.91 ± 0.17 g/cm(2). Older subjects had higher CIMT (r = 0.61, p < 0.001) and AI@75 (r = 0.42, p < 0.001). There was a significant correlation between AI@75 and CIMT (r = 0.45, p < 0.001). BMD was negatively correlated with AI@75 (lumbar: r = -0.22, p = 0.03; femoral neck: r = -0.24, p = 0.01; hip: r = -0.21, p = 0.03). BMD was unrelated to CIMT (lumbar: r = -0.09, p = 0.42; femoral neck: r = -0.15, p = 0.17; hip: r = -0.13, p = 0.23). On multivariate analysis, age (p < 0.001), hypertension (p = 0.02), and lumbar BMD (p = 0.01, R(2) = 0.30) were independent predictors of increased AI@75 after adjusting for age, height, and cardiovascular risk factors. These findings were unchanged upon substitution of femoral neck BMD (p = 0.05, R(2) = 0.28) into the model. There was a trend with hip BMD (p = 0.06, R(2) = 0.28) in the regression model. Age-matched comparison between normal BMD (n = 25) and osteoporotic patients (n = 34) demonstrated a significant difference in AI@75 (26.6 ± 8.9 vs. 31.6 ± 9.1%, p = 0.04). In summary, women with lower BMD had increased arterial stiffness. There was no relationship between BMD and atherosclerosis. In conclusion, age, hypertension, and BMD are independent predictors of higher arterial stiffness. Vascular changes are related to bone mineral loss, suggesting lower BMD may increase cardiovascular risk in African-Americans.
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Affiliation(s)
- Samy I McFarlane
- Division of Cardiology, State University of New York Downstate Medical Center, Brooklyn, N.Y., USA
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Li XS, Zhang JR, Meng SY, Li Y, Wang RT. Mean platelet volume is negatively associated with bone mineral density in postmenopausal women. J Bone Miner Metab 2012; 30:660-5. [PMID: 22684618 DOI: 10.1007/s00774-012-0362-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Accepted: 04/23/2012] [Indexed: 11/24/2022]
Abstract
Osteoporosis (OP) has been associated with cardiovascular disease. More specifically, osteoporosis was found to be an independent predictor of cardiovascular mortality. Recent studies revealed that platelets play a critical role in bone remodeling. Mean platelet volume (MPV) is an early marker of platelet activation, which is involved in the pathophysiology of coronary heart disease. However, little research has been conducted to investigate the relationship between MPV and OP. In this cross-sectional study, we investigated the relationship between platelet count, MPV, and bone mineral density (BMD) in 410 subjects in the geriatric department of the Second Affiliated Hospital, Harbin, China. Different biochemical parameters, platelet count, and MPV were determined, and bone mineral density (BMD) (g/cm(2)) was measured in the osteoporosis, osteopenia, and normal BMD groups. Mean age, systolic blood pressure (SBP), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), and MPV increased gradually, and body mass index (BMI), decreased as BMD decreased. A negative correlation was present between MPV and the lumbar spine (L2-L4) and femoral neck BMD after adjusting other risk factors. Univariate analysis and multivariate analysis showed that MPV was significantly associated with lumbar spine L2-L4 BMD and femoral neck BMD (β = -0.285, P < 0.001 for lumbar spine L2-L4 BMD; β = -0.207, P < 0.001 for femoral neck BMD in multivariate model). The findings show that MPV is negatively correlated with BMD. Further studies on the involvement of MPV in osteoporosis may contribute to the evaluation of thrombotic risk in elderly patients with osteoporosis.
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Affiliation(s)
- Xue-song Li
- Department of Orthopedics, The First Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
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Kovacic JC, Lee P, Baber U, Karajgikar R, Evrard SM, Moreno P, Mehran R, Fuster V, Dangas G, Sharma SK, Kini AS. Inverse relationship between body mass index and coronary artery calcification in patients with clinically significant coronary lesions. Atherosclerosis 2011; 221:176-82. [PMID: 22204865 DOI: 10.1016/j.atherosclerosis.2011.11.020] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2011] [Revised: 10/12/2011] [Accepted: 11/07/2011] [Indexed: 01/07/2023]
Abstract
AIMS Mounting data support a 'calcification paradox', whereby reduced bone mineral density is associated with increased vascular calcification. Furthermore, reduced bone mineral density is prevalent in older persons with lower body mass index (BMI). Therefore, although BMI and coronary artery calcification (CAC) exhibit a positive relationship in younger persons, it is predicted that in older persons and/or those at risk for osteoporosis, an inverse relationship between BMI and CAC may apply. We sought to explore this hypothesis in a large group of patients with coronary artery disease undergoing percutaneous coronary intervention (PCI). METHODS AND RESULTS We accessed our single-center registry for 07/01/1999 to 06/30/2009, extracting data on all patients that underwent PCI. To minimize bias we excluded those at the extremes of age or BMI and non-Black/Hispanic/Caucasians, leaving 9993 study subjects (age 66.6±9.9 years). Index lesion calcification (ILC) was analyzed with respect to BMI. Comparing index lesions with no angiographic calcification to those with the most severe, mean BMI decreased by 1.11 kgm(-2); a reduction of 3.9% (P<0.0001). By multivariable modeling, BMI was an independent inverse predictor of moderate-severe ILC (m-sILC; odds ratio [OR] 0.967, 95% CI 0.953-0.980, P<0.0001). Additional fully adjusted models identified that, compared to those with normal BMI, obese patients had an OR of 0.702 for m-sILC (95% CI 0.596-0.827, P<0.0001). CONCLUSIONS In a large group of PCI patients, we identified an inverse correlation between BMI and index lesion calcification. These associations are consistent with established paradigms and suggest a complex interrelationship between BMI, body size and vascular calcification.
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Affiliation(s)
- Jason C Kovacic
- The Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, NY, United States.
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Konishi M, Uno K, Yoshimoto E, Kasahara K, Maeda K, Mikasa K. [Correlation between osteoporosis and atherosclerosis in those with HIV-infection]. ACTA ACUST UNITED AC 2011; 85:384-5. [PMID: 21861444 DOI: 10.11150/kansenshogakuzasshi.85.384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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den Uyl D, Nurmohamed MT, van Tuyl LH, Raterman HG, Lems WF. (Sub)clinical cardiovascular disease is associated with increased bone loss and fracture risk; a systematic review of the association between cardiovascular disease and osteoporosis. Arthritis Res Ther 2011; 13:R5. [PMID: 21241491 PMCID: PMC3241350 DOI: 10.1186/ar3224] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Revised: 11/12/2010] [Accepted: 01/17/2011] [Indexed: 02/06/2023] Open
Abstract
Introduction Both cardiovascular disease and osteoporosis are important causes of morbidity and mortality in the elderly. The co-occurrence of cardiovascular disease and osteoporosis prompted us to review the evidence of an association between cardiovascular (CV) disease and osteoporosis and potential shared common pathophysiological mechanisms. Methods A systematic literature search (Medline, Pubmed and Embase) was conducted to identify all clinical studies that investigated the association between cardiovascular disease and osteoporosis. Relevant studies were screened for quality according to guidelines as proposed by the Dutch Cochrane Centre and evidence was summarized. Results Seventy studies were included in this review. Due to a large heterogeneity in study population, design and outcome measures a formal meta-analysis was not possible. Six of the highest ranked studies (mean n = 2,000) showed that individuals with prevalent subclinical CV disease had higher risk for increased bone loss and fractures during follow-up compared to persons without CV disease (range of reported risk: hazard ratio (HR) 1.5; odds ratio (OR) 2.3 to 3.0). The largest study (n = 31,936) reported a more than four times higher risk in women and more than six times higher risk in men. There is moderate evidence that individuals with low bone mass had higher CV mortality rates and incident CV events than subjects with normal bone mass (risk rates 1.2 to 1.4). Although the shared common pathophysiological mechanisms are not fully elucidated, the most important factors that might explain this association appear to be, besides age, estrogen deficiency and inflammation. Conclusions The current evidence indicates that individuals with prevalent subclinical CV disease are at increased risk for bone loss and subsequent fractures. Presently no firm conclusions can be drawn as to what extent low bone mineral density might be associated with increased cardiovascular risk.
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Affiliation(s)
- Debby den Uyl
- Department of Rheumatology, VU Medical Centre, De Boelelaan 1117, 1081 NV Amsterdam, The Netherlands
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Eastell R, Newman C, Crossman DC. Cardiovascular disease and bone. Arch Biochem Biophys 2010; 503:78-83. [DOI: 10.1016/j.abb.2010.06.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2010] [Revised: 06/05/2010] [Accepted: 06/08/2010] [Indexed: 11/15/2022]
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Anagnostis P, Karagiannis A, Kakafika AI, Tziomalos K, Athyros VG, Mikhailidis DP. Atherosclerosis and osteoporosis: age-dependent degenerative processes or related entities? Osteoporos Int 2009; 20:197-207. [PMID: 18509713 DOI: 10.1007/s00198-008-0648-5] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2008] [Accepted: 04/30/2008] [Indexed: 11/26/2022]
Abstract
Osteoporosis and atherosclerosis, two multifactorial and degenerative entities, are major public health problems. These diseases accompany the aging process and share common risk factors. Furthermore, several common pathophysiological factors have been suggested. These include similar molecular pathways involving bone and vascular mineralization, estrogen deficiency, parathyroid hormone, homocysteine, lipid oxidation products, inflammatory process, as well as vitamin D and K. Moreover, the use of statins, biphosphonates, beta-blockers and experimental dual-purpose therapies based on the biological linkage of the above entities may simultaneously benefit bone loss and vascular disease. This review considers a potential link between osteoporosis and atherosclerosis beyond aging. These common factors may lead to appropriate treatment strategies.
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Affiliation(s)
- P Anagnostis
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Greece
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Lee JH, O'Keefe JH, Bell D, Hensrud DD, Holick MF. Vitamin D deficiency an important, common, and easily treatable cardiovascular risk factor? J Am Coll Cardiol 2009; 52:1949-56. [PMID: 19055985 DOI: 10.1016/j.jacc.2008.08.050] [Citation(s) in RCA: 464] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2008] [Revised: 08/06/2008] [Accepted: 08/13/2008] [Indexed: 02/06/2023]
Abstract
Vitamin D deficiency is a highly prevalent condition, present in approximately 30% to 50% of the general population. A growing body of data suggests that low 25-hydroxyvitamin D levels may adversely affect cardiovascular health. Vitamin D deficiency activates the renin-angiotensin-aldosterone system and can predispose to hypertension and left ventricular hypertrophy. Additionally, vitamin D deficiency causes an increase in parathyroid hormone, which increases insulin resistance and is associated with diabetes, hypertension, inflammation, and increased cardiovascular risk. Epidemiologic studies have associated low 25-hydroxyvitamin D levels with coronary risk factors and adverse cardiovascular outcomes. Vitamin D supplementation is simple, safe, and inexpensive. Large randomized controlled trials are needed to firmly establish the relevance of vitamin D status to cardiovascular health. In the meanwhile, monitoring serum 25-hydroxyvitamin D levels and correction of vitamin D deficiency is indicated for optimization of musculoskeletal and general health.
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Affiliation(s)
- John H Lee
- Mid America Heart Institute and University of Missouri, Kansas City, Missouri, USA
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