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Erden E, Turk AC, Fidan N, Erden E. Relationship Between Blood Monocyte-HDL Ratio and Carotid Intima Media Thickness in with Postmenopausal Women. J Clin Densitom 2023; 26:101428. [PMID: 37549600 DOI: 10.1016/j.jocd.2023.101428] [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: 06/14/2023] [Accepted: 07/26/2023] [Indexed: 08/09/2023]
Abstract
INTRODUCTION/BACKGROUND The monocyte-to-high-density lipoprotein (HDL) ratio (MHR) and carotid intima media thickness may be used as a marker of inflammation and oxidative stres. This study is aimed to investigate the role of MHR in etiopathogenesis and to determine the association between MHR and carotid intima media thickness, fracture risk, and quality of life (QoL) in postmenopausal osteoporosis patients without comorbidities. METHODOLOGY Sixty osteoporosis, sixty osteopenia and sixty control groups were included in the prospective study evaluating postmenapausal women. The monocyte, HDL, and MHR values of all patients were evaluated. The bone mineral density of the participants was determined using the dual energy X-ray absorptiometry device. The fracture risk was assessed using the Turkish model of the Fracture Risk Assessment Tool. The QoL was determined using the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41) scale, and carotid intima media thickness ultrasonography was used. RESULTS The age, body mass index, duration of menopause, monocyte, HDL, and MHR were similar in all three groups. carotid intima media thickness was higher in the osteoporosis group than in the normal group (p=0.015). A positive correlation was found between L1-4 total T score and monocytes, major osteoporotic fracture risk and physical function from QUALEFFO-41 sub-headings, MHR and QUALEFFO-41 total score (p<0.05). When all participants were evaluated, a positive correlation was found between femoral neck T score and MHR, L1-4 total T score and monocytes, while a negative correlation was found between L1-4 total T score and CIMT (p<0.05). CONCLUSION Among postmenopausal women without comorbidities, MHR in the osteoporosis group was similar to that of the osteopenia and normal groups. Monocyte and MHR correlate with femoral neck T score and L1-4 total T score. CIMT was associated with a decreased L1-4 total T-score and an increased fracture risk, but not with MHR.
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Affiliation(s)
- Ender Erden
- Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Hitit University, Corum 19200, Turkey.
| | - Ayla Cagliyan Turk
- Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Hitit University, Corum 19200, Turkey
| | - Nurdan Fidan
- Faculty of Medicine, Department of Radiology, Hitit University Faculty of Medicine, Hitit University, Corum, Turkey
| | - Ebru Erden
- Department of Physical Medicine and Rehabilitation, Hitit University Erol Olçok Education and Research Hospital, Corum, Turkey
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Kim KM, Yoon YE, La Yun B, Suh JW. Association between Bone Mineral Density and Coronary Atherosclerotic Plaque According to Plaque Composition: Registry for the Women Health Cohort for Bone, Breast, and Coronary Artery Disease Study. J Bone Metab 2022; 29:123-131. [PMID: 35718929 PMCID: PMC9208904 DOI: 10.11005/jbm.2022.29.2.123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Indexed: 11/16/2022] Open
Abstract
Background Although biological links are unclear, low bone density and atherosclerosis are inversely associated. This study evaluated the association between bone mineral density (BMD) and coronary computed tomographic angiography (CCTA) findings, including coronary artery calcification (CAC) score and the presence, extent, and composition of coronary atherosclerotic plaque (CAP) in asymptomatic women. Methods A symptomatic women aged ≥40 years (N=2, 100; median age, 52 years; range, 40–80 years) were selected from a retrospective observational cohort and stratified into normal, osteopenia, and osteoporosis groups according to BMD T-score grades. We evaluated CAC score and assessed the presence, extent, and stenosis severity of CAP on CCTA. Additionally, CAP was categorized as calcified, mixed, or non-calcified according to calcified component valiums (>130 Hounsfield units). Results Osteopenia and osteoporosis were found in 28.8% and 5.3% of participants, respectively. CAC score and CAC severity significantly increased with decreased BMD grades (from normal to osteoporosis). The presence of CAP (overall, 15.6%; normal, 12.6%; osteopenia, 20.2%; osteoporosis, 28.8%; P<0.001) and number of segments with CAP significantly increased with decreased BMD grades. Furthermore, the number of segments with calcified or mixed plaques, excluding non-calcified plaques, increased with decreased BMD grades. Although most associations were attenuated or disappeared after adjusting for age and other covariates, calcified plaques showed a strong and age-independent association with BMD grades. Conclusions The presence and severity of CAC and CAP were significantly associated with BMD severity in asymptomatic women, particularly for the presence of calcified plaques. Further studies are required to determine the association between vascular calcification and bone health status.
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Affiliation(s)
- Kyoung Min Kim
- Division of Endocrinology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Yeonyee E. Yoon
- Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Bo La Yun
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jung-Won Suh
- Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Sitthisombat P, Soontrapa S, Kaewrudee S, Sothornwit J, Eamudomkarn N, Promsorn J, Takong W, Somboonporn W. Carotid plaque and lumbar bone mineral density status in post-menopausal women: An age-matched, analytical cross-sectional study. Post Reprod Health 2020; 26:9-18. [PMID: 31795810 DOI: 10.1177/2053369119890746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
ObjectiveTo explore the association between carotid plaque and lumbar spine osteoporosis in post-menopausal women.Study designAge-matched, cross-sectional study.Main outcome measuresCarotid plaque and carotid intima media thickness were measured with B-mode ultrasound. Lumbar spine bone mineral density was measured with dual-energy X-ray absorptiometry. Prevalence odds ratios and the respective 95% confidence intervals (95%CI) were calculated to determine the association.ResultsSeventy-two post-menopausal women with lumbar spine osteoporosis and 72 post-menopausal women with normal lumbar spine bone mineral density were enrolled. The adjusted prevalence odds ratio of carotid plaque presence in post-menopausal women with lumbar spine osteoporosis was 1.73 (95%CI; 0.60 to 4.94) when compared to post-menopausal women with normal lumbar spine bone mineral density. The presence of vulnerable plaque was greater in post-menopausal women with lumbar spine osteoporosis; however, the difference was not statistically significant after adjusting for other risk factors of cardiovascular disease (odds ratio 1.31; 95%CI; 0.39 to 4.43). There was no significant difference in carotid intima media thickness between the two groups. Multiple logistic regression analysis with backward elimination in assessment of potential risk factors for the presence of carotid plaque showed that the year since menopause, family history of cardiovascular disease and systolic blood pressure were nominally significant associated factors with a respective adjusted odds ratio of 1.06 (95%CI; 1.01 to 1.12), 6.23 (95%CI; 1.65 to 23.46) and 1.03 (95%CI; 1.01 to 1.06).ConclusionsThe current study indicates that lumbar spine osteoporosis is not associated with the presence of carotid plaque, whereas year since menopause, family history of cardiovascular disease and systolic blood pressure are associated factors.
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Affiliation(s)
- Patraporn Sitthisombat
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sukree Soontrapa
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Srinaree Kaewrudee
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Jen Sothornwit
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Nuntasiri Eamudomkarn
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Julaluck Promsorn
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Wittawat Takong
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Woraluk Somboonporn
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Liu D, Chen L, Dong S, Yang H, Li L, Liu J, Zhou H, Zhou R. Low bone mass is associated with carotid calcification plaque in Chinese postmenopausal women: the Chongqing osteoporosis study. Climacteric 2019; 23:237-244. [PMID: 31612731 DOI: 10.1080/13697137.2019.1671818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: The aim of this study was to examine the relationship between low bone mass and the risk of carotid calcification plaques in Chinese postmenopausal women.Methods: We conducted a 5 years prospective study. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA) scanning. Carotid computed tomography angiography (CTA) was conducted using a 64-multidetector row scanner to assess carotid arterial plaque at baseline and during follow-up. Cox proportional hazards analysis was used to evaluate the association of BMD and risk of carotid calcification plaques.Results: Four hundred and eighty-eight women sustained prospective carotid plaques during the follow-up. Women with carotid calcification plaques had low BMD than those with carotid non-calcification plaques. After adjustment for potential confounders, BMD, age, years since menopause, levels of plasma osteoprotegerin and adiponectin, hypertension, diabetes mellitus and hyperlipidemia were independently associated with increased risk of carotid calcification plaques. For carotid calcification plaques, a significant inverse correlation was indicated between BMD and the plaques, and a significant positive correlation was indicated between bone loss and plaques.Conclusions: This study suggested that lower BMD and increased loss rate of BMD were associated with a higher risk of carotid calcification plaques in Chinese postmenopausal women.
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Affiliation(s)
- D Liu
- Trauma Center, Daping Hospital, Army Medical University, Chongqing, China
| | - L Chen
- Postgraduate School, Bengbu Medical College, Anhui, China
| | - S Dong
- Postgraduate School, Bengbu Medical College, Anhui, China
| | - H Yang
- Department of Neurology, Daping hospital, Army Medical University, Chongqing, China
| | - L Li
- Department of Neurology, Daping hospital, Army Medical University, Chongqing, China
| | - J Liu
- Department of Neurology, Daping hospital, Army Medical University, Chongqing, China
| | - H Zhou
- Department of Neurology, Daping hospital, Army Medical University, Chongqing, China
| | - R Zhou
- Department of Orthopedics, The Orthopedic Surgery Center of Chinese PLA, Southwest Hospital, Army Medical University, Chongqing, China
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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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Skripnikova IA, Abirova ES, Alikhanova NA, Kosmatova OV. Vessel stiffness, calcification and osteoporosis. Common pathogenetic components. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2018. [DOI: 10.15829/1728-8800-2018-4-95-102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Atherosclerosis and osteoporosis until recently were regarded as the diseases of modern society, and their simultaneous development was explained just by the increased chances with longevity. Currently, there are studies showing evidence on these diseases in ancient populations, regardless the age and gender. The diseases found in younger age, with the early Egyptian civilization, witness on the common genetic and behavioral risk factors and pathogenetic components, than simple age-related chance. Scientific publications show more and more data on common properties of these diseases and pathogenetic mechanisms. High risk of premature death from atherosclerosis and osteoporosis complications facilitates the search for individual and general predictors of the disorders with the aim of on-time prevention. Treatment of atherosclerosis and osteoporosis presentation events in one patient demands for a range of medications that leads to polypragmasia. The review is focused on common mechanisms of vascular stiffness development, calcification and bone density decrease. Profound understanding might make it to open novel targets for one drug to both diseases, with decreased rate of complications.
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Affiliation(s)
- I. A. Skripnikova
- National Medical Research Centre of Prevention Medicine of the Ministry of Health
| | - E. S. Abirova
- National Medical Research Centre of Prevention Medicine of the Ministry of Health
| | - N. A. Alikhanova
- National Medical Research Centre of Prevention Medicine of the Ministry of Health
| | - O. V. Kosmatova
- National Medical Research Centre of Prevention Medicine of the Ministry of Health
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Deng H, Lu H, Dai Y, Li L, Cao J, Zhu D. Relationship between Serum Osteocalcin and Carotid Atherosclerosis in Middle-Aged Men in China: A Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2018; 2018:1751905. [PMID: 30186852 PMCID: PMC6112087 DOI: 10.1155/2018/1751905] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 05/25/2018] [Accepted: 06/04/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND PURPOSE Numerous investigations found that there exists a close relationship between serum osteocalcin and incurrence of atherosclerosis, but studies investigating the effect of serum osteocalcin on carotid atherosclerosis are very limited. Our study is aimed at investigating the role of osteocalcin in carotid atherosclerosis in middle-aged men in China. METHODS A total of 335 male middle-aged participants (40-60, 52.4 ± 3.87 years averagely) were enrolled from the institute. The carotid intima-media thicknesses (CIMT) of each subject were measured. All subjects were included either in the carotid atherosclerosis (AS) group or the control group according to the CAS diagnosis criteria. Serum osteocalcin and other markers of each patient were assessed following standard laboratory tests protocol. RESULTS 135 subjects were included in AS group, and 199 subjects were included in control group. The average osteocalcin level in AS group was 18.71 ± 6.20 ng/ml and was significantly different from that in control group, which was 20.38 ± 7.19 ng/ml (p=0.039). Logistic regression analysis revealed that OCN (standardized β=-0.024, p=0.013) and FINS (standardized β=-0.065, p=0.010) were independently and inversely associated with the carotid atherosclerosis, while FPG (standardized β=0.538, p=0.006) was independently and positively associated with the carotid atherosclerosis. CONCLUSION Our study suggests that OCN is independently related to carotid atherosclerosis in middle-aged male individuals.
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Affiliation(s)
- Hui Deng
- Department of Geriatrics, Drum Tower Clinical Medical College of Nanjing Medical University, China
| | - Hao Lu
- Department of Geriatrics, Drum Tower Clinical Medical College of Nanjing Medical University, China
| | - Yang Dai
- Department of Geriatrics, Drum Tower Clinical Medical College of Nanjing Medical University, China
| | - Lingling Li
- Department of Geriatrics, Drum Tower Clinical Medical College of Nanjing Medical University, China
| | - Juan Cao
- Department of Geriatrics, Drum Tower Clinical Medical College of Nanjing Medical University, China
| | - Dalong Zhu
- Department of Endocrinology, Drum Tower Clinical Medical College of Nanjing Medical University, China
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Sothornwit J, Somboonporn W, Soontrapa S, Kaewrudee S, Wongwiwatchai J, Soontrapa S. Carotid intima-media thickness and osteoporosis in postmenopausal women: a cross-sectional study. Climacteric 2018. [DOI: 10.1080/13697137.2018.1439916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- J. Sothornwit
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - W. Somboonporn
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - S. Soontrapa
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - S. Kaewrudee
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - J. Wongwiwatchai
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - S. Soontrapa
- Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Bischetti S, Scimeca M, Bonanno E, Federici M, Anemona L, Menghini R, Casella S, Cardellini M, Ippoliti A, Mauriello A. Carotid plaque instability is not related to quantity but to elemental composition of calcification. Nutr Metab Cardiovasc Dis 2017; 27:768-774. [PMID: 28739184 DOI: 10.1016/j.numecd.2017.05.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 05/10/2017] [Accepted: 05/22/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Recent studies highlighted the role of calcification processes in the clinical progression of chronic cardiovascular diseases. In this study we investigated the relationship between the chemical composition of calcification and atherosclerotic plaque stability in carotid arteries. METHODS AND RESULTS To this end, we characterized the calcification on 229 carotid plaques, by morphology, immunohistochemistry, transmission electron microscopy and energy dispersive X-ray microanalysis. Plaques were classified into two categories: unstable and stable. No significant differences were found in the incidence of the various risk factors between patients with and without carotid calcification, with the exception of diabetes. The energy dispersive X-ray microanalysis allowed us to identify two types of calcium salts in the atheromatous plaques, hydroxyapatite (HA) and calcium oxalate (CO). Our results showed that calcification is a common finding in carotid plaques, being present in 77.3% of cases, and the amount of calcium is not a factor of vulnerability. Noteworthy, we observed an association between HA calcification and unstable plaques. On the contrary, CO calcifications were mainly detected in stable plaques. CONCLUSIONS The presence of different types of calcification in atheromatous plaques may open new perspectives in understanding the molecular mechanisms of atheroma formation and plaque instability.
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Affiliation(s)
- S Bischetti
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.
| | - M Scimeca
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy; OrchideaLab S.r.l., Via del Grecale 6, Morlupo, Rome, Italy; IRCCS San Raffaele Pisana, 00166 Rome, Italy.
| | - E Bonanno
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.
| | - M Federici
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; Center for Atherosclerosis, Department of Medicine, Policlinico Tor Vergata, 00133 Rome, Italy.
| | - L Anemona
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.
| | - R Menghini
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; Center for Atherosclerosis, Department of Medicine, Policlinico Tor Vergata, 00133 Rome, Italy.
| | - S Casella
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.
| | - M Cardellini
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; Center for Atherosclerosis, Department of Medicine, Policlinico Tor Vergata, 00133 Rome, Italy.
| | - A Ippoliti
- Vascular Surgery, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.
| | - A Mauriello
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.
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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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Wu CH, Zhang ZH, Wu MK, Wang CH, Lu YY, Lin CL. Increased migraine risk in osteoporosis patients: a nationwide population-based study. SPRINGERPLUS 2016; 5:1378. [PMID: 27610297 PMCID: PMC4993742 DOI: 10.1186/s40064-016-3090-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 08/17/2016] [Indexed: 02/10/2023]
Abstract
BACKGROUND Osteoporosis and migraine are both important public health problems and may have overlapping pathophysiological mechanisms. The aim of this study was to use a Taiwanese population-based dataset to assess migraine risk in osteoporosis patients. METHODS The Taiwan National Health Insurance Research Database was used to analyse data for 40,672 patients aged ≥20 years who had been diagnosed with osteoporosis during 1996-2010. An additional 40,672 age-matched patients without osteoporosis were randomly selected as the non-osteoporosis group. The relationship between osteoporosis and migraine risk was estimated using Cox proportional hazard regression models. RESULTS During the follow-up period, 1110 patients with osteoporosis and 750 patients without osteoporosis developed migraine. After controlling for covariates, the overall incidence of migraine was 1.37-fold higher in the osteoporosis group than in the non-osteoporosis group (3.72 vs. 1.24 per 1000 person-years, respectively). Migraine risk factors included high Charlson Comorbidity Index score, female gender, hypertension, depression, asthma, allergic rhinitis, obesity, and tobacco use disorder. CONCLUSIONS Our results indicate that patients with a history of osteoporosis had a higher risk of migraine.
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Affiliation(s)
- Chieh-Hsin Wu
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Neurosurgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100 Tzyou 1st Road, Kaohsiung, 80708 Taiwan
| | - Zi-Hao Zhang
- Department of Neurosurgery, The No. 7 People's Hospital of Hebei Province, Dingzhou, 073000 Hebei People's Republic of China
| | - Ming-Kung Wu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 807 Taiwan
| | - Chiu-Huan Wang
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100 Tzyou 1st Road, Kaohsiung, 80708 Taiwan
| | - Ying-Yi Lu
- Department of Dermatology, Kaohsiung Veterans General Hospital, No. 386 Dazhong 1st Rd, Kaohsiung, 81362 Taiwan.,Cosmetic Applications and Management Department, Yuh-Ing Junior College of Health Care and Management, Kaohsiung, Taiwan
| | - Chih-Lung Lin
- Department of Neurosurgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100 Tzyou 1st Road, Kaohsiung, 80708 Taiwan.,Department of Neurosurgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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12
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Aypak C, Türedi Ö, Bircan MA, Civelek GM, Araz M. Association between mean platelet volume and bone mineral density in postmenopausal women. J Phys Ther Sci 2016; 28:1753-8. [PMID: 27390409 PMCID: PMC4932050 DOI: 10.1589/jpts.28.1753] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 02/22/2016] [Indexed: 12/11/2022] Open
Abstract
[Purpose] Osteoporosis is an inflammatory disease, and platelets play a critical role in bone remodeling. Mean platelet volume has been shown to be influenced by inflammation. Our aim was to evaluate the relationship between mean platelet volume and bone mineral density in postmenopausal women. [Subjects and Methods] The records of female patients who had been referred to a tertiary hospital for bone mineral density analysis were retrospectively reviewed. [Results] A total of 175 patients (mean age: 61.3 ± 9.0 years) were enrolled. Overall, 72% (126/175) of patients met the criteria for osteoporosis. Mean platelet volume was found to be inversely correlated with body mass index. There was a significant positive correlation between mean platelet volume and femoral neck bone mineral density in our normal weight osteoporotic group, whereas there was a significant negative correlation in our overweight-obese osteoporotic group. The negative correlation between mean platelet volume and femoral neck bone mineral density in the overweight-obese osteoporotic group persisted after adjustment for confounding factors. Multivariate analyses revealed that mean platelet volume was significantly associated with femoral neck bone mineral density in osteoporotic patients in both our normal weight and overweight-obese groups. [Conclusion] Regardless of mechanisms, mean platelet volume might be used as a biomarker for osteoporosis in clinical settings.
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Affiliation(s)
- Cenk Aypak
- Family Medicine Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Turkey
| | - Özlem Türedi
- Family Medicine Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Turkey
| | - Mustafa A Bircan
- Family Medicine Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Turkey
| | - Gul M Civelek
- Physical Medicine and Rehabilitation Clinic, Ankara Children's Hematology Oncology Training and Research Hospital, Turkey
| | - Mine Araz
- Division of Nuclear Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Turkey
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13
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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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14
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Lampropoulos CE, Kalamara P, Konsta M, Papaioannou I, Papadima E, Antoniou Z, Andrianopoulou A, Vlachoyiannopoulos PG. Osteoporosis and vascular calcification in postmenopausal women: a cross-sectional study. Climacteric 2016; 19:303-7. [PMID: 27045323 DOI: 10.3109/13697137.2016.1164134] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objectives To estimate the correlation between osteoporosis and vascular calcification in postmenopausal women and the influence of calcium/vitamin D supplements on vascular calcification. Methods A cross-sectional study was performed including 29 women with osteoporosis (15 not taking supplements) and 18 age-matched, non-osteoporotic women. They were evaluated for cardiovascular risk factors and blood tests, lateral X-ray of lumbar spine (assessment of abdominal aorta calcification, AAC) and carotid ultrasound (increased intima media thickness (iIMT) or calcified plaques) were performed. Results In univariate analysis, osteoporotic women were 16 times more likely to develop AAC (odds ratio (OR) 15.8, 95% confidence interval (CI) 1.9-135.4) and seven times more likely to develop iIMT (OR 6.8, 95% CI 1.8-25.4) compared to normal individuals. The odds of developing AAC and iIMT were increased each year after menopause (OR 1.11, 95% CI 1.01-1.2 and OR 1.18, 95% CI 1.05-1.3, respectively) and with aging (OR 1.27, 95% CI 1.1-1.47 and OR = 1.17, 95% CI 1.04-1.3, respectively). Calcified plaques were significantly correlated with osteoporosis (p = 0.014). In multivariate analysis, osteoporosis was an independent risk factor for AAC (OR 13.3, 95% CI 1.3-134.4) and iIMT (OR 4.7, 95% CI 1.1-19.9). Low doses of supplements did not appear to affect vascular calcification (p = 0.6). Conclusions Osteoporosis is associated with increased calcification of the abdominal aorta and carotids. Low doses of supplements do not appear to cause any increase in vascular calcification in osteoporotic women.
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Affiliation(s)
- C E Lampropoulos
- a Department of Internal Medicine , General Hospital of Argolidos , Argos , Greece
| | - P Kalamara
- b Department of Radiology , General Hospital of Argolidos , Argos , Greece
| | - M Konsta
- a Department of Internal Medicine , General Hospital of Argolidos , Argos , Greece
| | - I Papaioannou
- a Department of Internal Medicine , General Hospital of Argolidos , Argos , Greece
| | - E Papadima
- b Department of Radiology , General Hospital of Argolidos , Argos , Greece
| | - Z Antoniou
- b Department of Radiology , General Hospital of Argolidos , Argos , Greece
| | - A Andrianopoulou
- b Department of Radiology , General Hospital of Argolidos , Argos , Greece
| | - P G Vlachoyiannopoulos
- c Department of Pathophysiology, School of Medicine , National University of Athens , Athens , Greece
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15
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van Dijk SC, de Jongh RT, Enneman AW, Ham AC, Swart KMA, van Wijngaarden JP, van der Zwaluw NL, Brouwer-Brolsma EM, van Schoor NM, Dhonukshe-Rutten RAM, Lips P, de Groot CPGM, Smulders YM, Blom HJ, Feskens EJ, Geleijnse JM, van den Meiracker AH, Mattace Raso FUS, Uitterlinden AG, Zillikens MC, van der Velde N. Arterial stiffness is not associated with bone parameters in an elderly hyperhomocysteinemic population. J Bone Miner Metab 2016; 34:99-108. [PMID: 25804313 DOI: 10.1007/s00774-015-0650-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 12/25/2014] [Indexed: 10/23/2022]
Abstract
Several studies have observed positive associations between bone disease and cardiovascular disease. A potential common pathway is hyperhomocysteinemia; however, to date, there is a lack of data regarding hyperhomocysteinemic populations. Therefore, we examined both cross-sectionally and longitudinally, whether there is an association between bone parameters and arterial stiffness in a hyperhomocysteinemic population, and investigated the potential common role of homocysteine (hcy) level on these associations. Cross-sectional and longitudinal data of the B-PROOF study were used (n = 519). At both baseline and 2-year follow-up we determined bone measures-incident fractures and history of fractures, bone-mineral density (BMD) and quantitative ultrasound (QUS) measurement. We also measured arterial stiffness parameters at baseline-pulse wave velocity, augmentation index and aortic pulse pressure levels with applanation tonometry. Linear regression analysis was used to examine these associations and we tested for potential interaction of hcy level. The mean age of the study population was 72.3 years and 44.3 % were female. Both cross-sectionally and longitudinally there was no association between arterial stiffness measures and BMD or QUS measurements or with incident fractures (n = 16) within the 2-3 years of follow-up. Hcy level did not modify the associations and adjustment for hcy did not change the results. Arterial stiffness was not associated with bone parameters and fractures, and hcy neither acted as a pleiotropic factor nor as a mediator. The potential association between bone and arterial stiffness is therefore not likely to be driven by hyperhomocysteinemia.
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Affiliation(s)
- S C van Dijk
- Section of Geriatrics, Department of Internal Medicine, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - R T de Jongh
- Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - A W Enneman
- Section of Geriatrics, Department of Internal Medicine, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - A C Ham
- Section of Geriatrics, Department of Internal Medicine, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - K M A Swart
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - J P van Wijngaarden
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - N L van der Zwaluw
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - E M Brouwer-Brolsma
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - N M van Schoor
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | | | - P Lips
- Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - C P G M de Groot
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Y M Smulders
- Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
- Institute for Cardiovascular Research ICaR-VU, VU University Medical Center, Amsterdam, The Netherlands
| | - H J Blom
- Institute for Cardiovascular Research ICaR-VU, VU University Medical Center, Amsterdam, The Netherlands
- Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands
| | - E J Feskens
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - J M Geleijnse
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - A H van den Meiracker
- Section of Geriatrics, Department of Internal Medicine, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - F U S Mattace Raso
- Section of Geriatrics, Department of Internal Medicine, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - A G Uitterlinden
- Section of Geriatrics, Department of Internal Medicine, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
- Netherlands Consortium of Healthy Ageing, Rotterdam and Leiden, The Netherlands
| | - M C Zillikens
- Section of Geriatrics, Department of Internal Medicine, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - N van der Velde
- Section of Geriatrics, Department of Internal Medicine, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
- Section of Geriatrics, Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands
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Aypak C, Türedi Ö, Bircan MA, Araz M. Association of haematological parameters with bone mineral density in elderly diabetic women. Acta Clin Belg 2015; 70:339-44. [PMID: 25982378 DOI: 10.1179/2295333715y.0000000030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES In this study, we aimed to evaluate whether an association exists between complete blood count (CBC) parameters and bone mineral density (BMD) in elderly females with type 2 diabetes mellitus (T2DM) and to estimate the differences in BMD in T2DM. METHODS The medical records of female patients who had been referred for BMD analysis to a tertiary hospital in Ankara, Turkey were reviewed. RESULTS A total of 275 women (66 with T2DM, 209 without T2DM; mean age 72.1 ± 5.4 years) were included in study. White blood cell (WBC) counts, lumbar spine BMD (LSBMD) and femoral neck BMD (FNBMD) were found to be significantly higher in T2DM. There was an inverse association between haematocrit (Hct) and LSBMD in diabetic group (r = - 0.330; P = 0.008). CONCLUSION Diabetic patients had higher BMD levels. Regardless of the mechanisms, Hct could be a readily available potential candidate to identify diabetic patients with osteoporosis.
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Affiliation(s)
- C Aypak
- Department of Family Medicine, Diskapi Yildirim Beyazit Training and Research Hospital , Ankara, Turkey
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17
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Ajeganova S, Gustafsson T, Jogestrand T, Frostegård J, Hafström I. Bone mineral density and carotid atherosclerosis in systemic lupus erythematosus: a controlled cross-sectional study. Arthritis Res Ther 2015; 17:84. [PMID: 25885788 PMCID: PMC4407386 DOI: 10.1186/s13075-015-0595-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Accepted: 03/12/2015] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION As osteoporosis is reported to be associated with atherosclerosis in the general population we examined the relationship between bone mass and carotid measurements in patients with systemic lupus erythematosus (SLE) and controls, and possible links between them in SLE. METHODS In a cross-sectional study, 111 SLE-patient were compared with 111 age- and sex-matched controls, mean age 48.7(12.9) years, 89% were women, of which 51% postmenopausal. Carotid intima media thickness (cIMT), carotid plaque occurrence and echogenicity were determined by B-mode ultrasound and bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA). RESULTS BMD and cIMT were inversely associated both in patients and controls. Patients, but not controls, with carotid plaque had higher cIMT at low BMD than at normal BMD, p = 0.010. Logistic regression indicated more than doubled odds ratio (OR) of carotid plaque in patients, particularly in post-menopausal women, than in controls in relation to all BMD measurements. For low BMD at hip, significant increased OR for echolucent plaque was shown for patients compared with controls. In patients, significant impact of age, body mass index, smoking, systolic blood pressure, blood lipids, diabetes mellitus, impaired renal function, low levels of complement C3 and C4, history of nephritis, SLE-damage index and ever use of antimalarial was found for association between BMD and higher cIMT and carotid plaque. In multivariate regression, low C4 was independent contributor to association between total BMD and upper cIMT tertile, accounted for OR (95% confidence interval) of 3.2 (1.03-10.01), and also for association with bilateral carotid plaque, OR of 4.8 (1.03-22.66). The contribution of low C4 for the association between BMD and carotid atherosclerosis was enhanced within the second and third tertiles of total BMD. CONCLUSION This study is the first to demonstrate inverse association between BMD and carotid measurements in both SLE-patients and controls. Our results suggest that SLE-patients may suffer higher burden of (sub)clinical atherosclerotic disease, especially presence of both echolucent and echogenic plaque, than controls with the same bone mineral status. Low complement C4 seems to play an important role in earlier development of carotid atherosclerosis already within (sub)normal ranges of total BMD in patients.
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Affiliation(s)
- Sofia Ajeganova
- Department of Medicine, Unit of Rheumatology, Karolinska Institutet at Karolinska University Hospital Huddinge, Stockholm, 141 86, Sweden.
| | - Thomas Gustafsson
- Department of Clinical Physiology, Karolinska Institutet at Karolinska University Hospital Huddinge, Stockholm, 141 86, Sweden.
| | - Tomas Jogestrand
- Department of Clinical Physiology, Karolinska Institutet at Karolinska University Hospital Huddinge, Stockholm, 141 86, Sweden.
| | - Johan Frostegård
- Section of Immunology and Chronic disease, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, 171 77, Sweden.
| | - Ingiäld Hafström
- Department of Medicine, Unit of Rheumatology, Karolinska Institutet at Karolinska University Hospital Huddinge, Stockholm, 141 86, Sweden.
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Lin CH, Chang WC, Kuo CN, Yu HC, Yang CC, Lin YW, Hung KS, Chang WP. A population-based five-year study on the risk of stroke in patients with osteoporosis in Taiwan. Bone 2015; 72:9-13. [PMID: 25460575 DOI: 10.1016/j.bone.2014.11.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 10/17/2014] [Accepted: 11/13/2014] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Osteoporosis and stroke are common diseases in elder patients. The relationship between these two diseases is unclear. This study was intended to estimate the risk of stroke among elder persons aged ≥ 50 years within five years of being diagnosed with osteoporosis. METHODS We retrieved data from the Longitudinal Health Insurance Database 2005 (LHID2005) in Taiwan to perform a nationwide population-based study. There were 2580 patients with osteoporosis aged 50 years of age and older in the study cohort. All of them had at least 2 ambulatory care claims or at least 1 inpatient service claim. Each osteoporotic patient was matched to 5 non-osteoporotic patients based on gender, age, and the index year. Subjects in both groups were followed up for five years. Risk of developing stroke and 5-year stroke-free survival rates were evaluated. RESULTS The risk of developing stroke was 1.24 times higher in osteoporotic patients within a 5-year follow-up period compared to an age- and gender-matched cohort without osteoporosis (95% confidence interval = 1.11-1.39; p < 0.001). Patients with osteoporosis also had a significantly lower 5-year stroke-free survival rate. CONCLUSIONS Our results indicated that patients with osteoporosis history had higher risk for development of stroke.
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Affiliation(s)
- Chia-Hsien Lin
- Department of Health Industry Management, Kainan University, Taoyuan, Taiwan
| | - Wei-Chiao Chang
- Department of Clinical Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Chun-Nan Kuo
- Department of Clinical Pharmacy, Taipei Medical University, Taipei, Taiwan; Department of Pharmacy, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hann-Chin Yu
- Department of Obstetrics and Gynecology, Branch of Hsinchu, Taipei Veterans General Hospital, Taiwan
| | - Chien-Chang Yang
- Department Human Resource, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Yea-Wen Lin
- Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Kuo-Sheng Hung
- Department of Neurosurgery, Clinical Research Center, Graduate Institute of Injury Prevention and Control, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Wei-Pin Chang
- Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu, Taiwan.
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Cardiovascular risk factor analysis in patients with a recent clinical fracture at the fracture liaison service. BIOMED RESEARCH INTERNATIONAL 2014; 2014:710945. [PMID: 25247184 PMCID: PMC4163435 DOI: 10.1155/2014/710945] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 07/29/2014] [Indexed: 11/17/2022]
Abstract
Patients with a low bone mineral density have an increased risk of cardiovascular diseases (CVD) and venous thromboembolic events (VTE). The aim of our retrospective chart review was to investigate the prevalence of CVD, VTE, hypertension (HT), and diabetes mellitus type 2 (DM2) in patients with a recent clinical fracture visiting the Fracture Liaison Service (FLS). Out of 3057 patients aged 50–90 years, 1359 consecutive patients, who agreed and were able to visit the FLS for fracture risk evaluation, were included (71.7% women; mean age 65.2 yrs). Based on medical history, 29.9% had a history of CVD (13.7%), VTE (1.7%), HT (14.9%), and DM2 (7.1%) or a combination. Their prevalence increased with age (21% in patients aged 50–59 years to 48% in patients aged >80 years) and was higher in men than in women (36% versus 27%), but independent of bone mineral density and fracture type. Careful evaluation of medical history with respect to these risk factors should be performed in patients with a recent clinical fracture before starting treatment with medications that increase the risk of VTE or cardiovascular events, such as raloxifene, strontium ranelate, or NSAIDs.
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Simon SP, Fodor D, Muntean L, Poanta L, Cristea P, Rednic S. Bone mineral density, vertebral fractures and body mass index in postmenopausal women with abdominal aortic calcification. Endocr Res 2014; 39:1-6. [PMID: 23650982 DOI: 10.3109/07435800.2013.794425] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Evidence suggest that there are connections between osteoporosis and cardiovascular diseases. OBJECTIVES The aim of the study was to analyze the relationship between radiological measurements of abdominal aorta calcifications (AAC) and bone mineral density (BMD) in postmenopausal women. METHODS In this cross-sectional study were included 125 postmenopausal women 50-84 years of age. BMD of the spine and hip was measured by dual energy X-ray absorptiometry (DXA). AAC were assessed by lateral radiographs of lumbar spine (L1-L4), using the antero-posterior severity score (0-24). Vertebral fractures were evaluated from T4 to L4 using Genant's semiquantitative method. RESULTS Forty-one (32.8%) patients had osteoporosis and 61 (48.8%) had AAC with a mean score of 3.1. Postmenopausal women with AAC were older and had significantly lower femoral neck and trochanteric BMD than subjects without AAC (all p < 0.01). There were no significant differences in the frequency of fractures between subjects with AAC and those without AAC (p > 0.05). In univariate analysis, age, height, weight, femoral and trochanter BMD were significantly associated with the severity of AAC score. In multiple regression analysis, femoral neck BMD, but not lumbar spine, trochanter BMD or age, was an independent predictor of AAC. CONCLUSIONS Reduced femoral neck BMD is negatively associated with the presence of AAC in postmenopausal women. The association between BMD and AAC seems to be age-independent, which suggests a common pathogenesis for bone loss and vascular calcifications.
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Pedone C, Scarlata S, Napoli N, Lauretani F, Bandinelli S, Ferrucci L, Incalzi RA. Relationship between bone cross-sectional area and indices of peripheral artery disease. Calcif Tissue Int 2013; 93:508-16. [PMID: 23995829 PMCID: PMC6125776 DOI: 10.1007/s00223-013-9782-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 07/17/2013] [Indexed: 11/25/2022]
Abstract
Most studies on the relationship between bone mineral density and atherosclerosis have used dual-energy X-ray absorptiometry, but this method is relatively insensitive to bone geometry. The aim of this study was to investigate the relationship between bone area and indices of carotid and peripheral atherosclerosis. We studied 841 persons aged 65 years or older (women = 444, mean age 73.8 years; men = 397, mean age = 75.3 years) enrolled in the InCHIANTI study and free from active malignancies, chronic use of bisphosphonates or steroids, and estrogen replacement therapy. The tibial cortical and total cross-sectional area (CSA) were measured by peripheral quantitative computed tomography and their ratio was calculated (cortical/total cross-sectional area ratio, cCSA/tCSA); carotid plaques were screened by echography, and peripheral artery disease (PAD) was defined as an ankle/brachial index <0.9 or presence of intermittent claudication. No association between cCSA/tCSA and atherosclerosis was observed in men. In women, lower cCSA/tCSA was associated with both carotid plaques [odds ratio (OR) for lowest vs. best quartile = 2.09, 95 % confidence interval (CI) 1.2-3.68] and PAD (OR = 3.43, 95 % CI 1.58-8.12). After correction for potential confounders (age since menopause, body mass index, Parathyroid hormone, vitamin D, leptin, DHEA-S, testosterone, physical activity, chronic obstructive pulmonary disease, and reduced renal function), the association was not confirmed. According to partial logistic regression, the carotid plaque-cCSA/tCSA association, but not the PAD-cCSA/tCSA association, was mostly dependent on years since menopause. In women the association between osteoporosis and carotid plaques likely reflects hormonal deprivation, whereas that between osteoporosis and PAD seems multifactorial in origin.
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Affiliation(s)
- Claudio Pedone
- Area of Geriatrics, Campus Biomedico University and Teaching Hospital, Via Alvaro del Portillo 200, 00128, Rome, Italy,
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Zhou R, Zhou H, Cui M, Wang Y, Tan J, Sawmiller D, Xu J. Association between aortic calcification and the risk of osteoporosis in a chinese cohort: the Chongqing osteoporosis study. Calcif Tissue Int 2013; 93:419-25. [PMID: 23975213 DOI: 10.1007/s00223-013-9776-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Accepted: 07/23/2013] [Indexed: 10/26/2022]
Abstract
The aim of this study was to examine the relationship between aortic calcification (AC) and the risk of osteoporosis for a community of residents in China. We conducted a 5-year prospective study on 1,729 Chinese elderly subjects. An AC scale (ACS) was determined semiquantitatively from baseline lateral radiographs of the lumbar spine. Dual-energy X-ray absorptiometry was used to determine bone mineral density (BMD). Only subjects who completed the study were included in the final analysis; 432 subjects (25.0 %) developed osteoporosis. The BMD of vertebrae, femoral neck, and the total hip in the Q4 quartile of the ACS (ACS > 6) was lower when compared with the Q1 quartile (ACS = 0, p < 0.05). Cox proportional hazards model analysis showed that ACS (Q4), BMD, CTX, current smoking, and daily drinking were associated with increased risk of osteoporosis. A higher ACS was associated with an increased risk of osteoporosis in both women and men. The present study found that AC carried a higher risk of osteoporosis.
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Affiliation(s)
- Rui Zhou
- Department of Orthopedics, The Orthopedic Surgery Center of Chinese PLA, Southwest Hospital, Third Military Medical University, Chongqing, 400038, People's Republic of 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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Lampropoulos CE, Papaioannou I, D'Cruz DP. Osteoporosis--a risk factor for cardiovascular disease? Nat Rev Rheumatol 2012; 8:587-98. [PMID: 22890244 DOI: 10.1038/nrrheum.2012.120] [Citation(s) in RCA: 133] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Osteoporosis is a serious health problem worldwide that is associated with an increased risk of fractures and mortality. Vascular calcification is a well-defined independent risk factor for cardiovascular disease (CVD) and mortality. Major advances in our understanding of the pathophysiology of osteoporosis and vascular calcification indicate that these two processes share common pathogenetic mechanisms. Multiple factors including proteins (such as bone morphogenetic proteins, receptor activator of nuclear factor κB ligand, osteoprotegerin, matrix Gla protein and cathepsins), parathyroid hormone, phosphate, oxidized lipids and vitamins D and K are implicated in both bone and vascular metabolism, illustrating the interaction of these two, seemingly unrelated, conditions. Many clinical studies have now confirmed the correlation between osteoporosis and vascular calcification as well as the increased risk of CVD in patients with osteoporosis. Here, we explore the proposed mechanistic similarities between osteoporosis and vascular calcification and present an overview of the clinical data that support the interaction between these conditions.
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Affiliation(s)
- Christos E Lampropoulos
- Department of Internal Medicine, General Hospital of Nafplio, Kolokotroni and Asklipiou Streets, 21100 Nafplio, Greece
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25
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The effects of ApoE gene polymorphisms on lumbar spine bone mineral density and carotid atherosclerosis. Clin Biochem 2012; 45:219-22. [DOI: 10.1016/j.clinbiochem.2011.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Revised: 11/18/2011] [Accepted: 11/28/2011] [Indexed: 11/22/2022]
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26
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Osteoprotegerin, but not osteopontin, as a potential predictor of vascular calcification in normotensive subjects. Hypertens Res 2012; 35:531-8. [PMID: 22278625 DOI: 10.1038/hr.2011.231] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We conducted a cross-sectional observation study that included 500 asymptomatic subjects to investigate the relationship between bone metabolism and coronary artery calcification (CAC) in hypertensive conditions. Osteoprotegerin (OPG) and osteopontin (OPN) levels and their associations with hypertension were analyzed to predict CAC in 316 subjects. Multislice computed tomography was used to quantify CAC. Multivariate analysis of variance was used to test the non-interactive effects of hypertension, CAC severity and biomarker levels, and the logistic regression model was applied to predict the risk of CAC. OPG and OPN concentrations were significantly higher in the hypertensive than the normotensive subjects, at 3.0 (2.3-4.0) pmol l(-1) and 51 (21-136) ng ml(-1) vs. 2.4 (2.0-3.0) pmol l(-1) and 41 (13-63) ng ml(-1), respectively. The OPG level, but not OPN level, increased with age (r = 0.29; P = 0.0001). Zero or minimal CAC (<10 Agatston units (AU)) was observed in 63% of the subjects, mild (11-100 AU) in 17%, moderate (101-400 AU) in 12% and severe (401-1000 AU)-to-extensive (>1000 AU) in 8%. In hypertensive subjects, only glomerular filtration rate (GFR) (β = -0.67) and gender (β = 0.52) were significant predictors for CAC (R = 0.68). In normotensive patients, GFR (β = -0.81), gender (β = 0.48) and log-transformed OPG levels (β = 0.15) were significant predictors for CAC. OPG levels were associated with an increased risk of CAC in normotensive subjects only (odds ratio: 3.37; 95% confidence interval (1.63-6.57); P = 0.0002). OPG predicted a premature state of vascular calcification in asymptomatic normotensive individuals, and renal function significantly contributed to this process in both hypertensive and normotensive subjects.
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Wada H, Hirano F, Kuroda T, Shiraki M. Breast arterial calcification and hypertension associated with vertebral fracture. Geriatr Gerontol Int 2011; 12:330-5. [DOI: 10.1111/j.1447-0594.2011.00775.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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28
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Fodor D, Bondor C, Albu A, Muntean L, Simon SP, Poanta L, Craciun A. Relation between intima-media thickness and bone mineral density in postmenopausal women: a cross-sectional study. SAO PAULO MED J 2011; 129:139-45. [PMID: 21755248 PMCID: PMC10866315 DOI: 10.1590/s1516-31802011000300004] [Citation(s) in RCA: 11] [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: 06/17/2010] [Revised: 06/17/2010] [Accepted: 02/21/2011] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVES Controversy exists regarding the relationship between atherosclerosis and osteoporosis. The aim of this study was to determine the relationship between intima-media thickness (IMT) of the common carotid artery (CCA), presence of calcified atherosclerotic plaques and bone mineral density (BMD) evaluated by dual energy X-ray absorptiometry (DXA), in postmenopausal women. DESIGN AND SETTING Cross-sectional study at Second Internal Medicine Clinic, Cluj-Napoca, Romania. METHODS We studied the IMT (left and right CCA and mean IMT) and T-score (lumbar spine L2-L4, femoral neck and total hip) in 100 postmenopausal women (mean age 64.5 years). The presence of calcified atherosclerotic plaque and osteoporotic vertebral fractures was also noted. RESULTS IMT in the left and right CCA and mean IMT were significantly associated with T-score measured for the lumbar spine L2-L4, femoral neck and total hip, with lower T-score, in the osteoporotic group than in the normal and osteopenic groups (P < 0.05). IMT had a significantly negative correlation with the lumbar spine T-score and femoral neck T-score; and mean IMT with lowest T-score. Mean IMT (P < 0.001), high blood pressure (P = 0.005) and osteoporotic vertebral fractures (P = 0.048) showed statistical significance regarding the likelihood of developing atherosclerotic plaque. CONCLUSIONS In women referred for routine osteoporosis screening, the relationship between CCA, atherosclerosis and osteoporosis can be demonstrated using either cortical or trabecular BMD. Vertebral fractures may be considered to be a likelihood factor for atherosclerotic plaque development.
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Affiliation(s)
- Daniela Fodor
- "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
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Affiliation(s)
- James F Griffith
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Hong Kong.
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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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Leli C, Pasqualini L, Vaudo G, Gaggioli S, Scarponi AM, Mannarino E. Carotid intima-media thickness and bone turnover: the role of C-terminal telopeptide of type I collagen. Intern Emerg Med 2010; 5:127-34. [PMID: 20182821 DOI: 10.1007/s11739-010-0356-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2009] [Accepted: 01/08/2010] [Indexed: 10/19/2022]
Abstract
Osteoporosis and vascular disease are commonly found together in elderly people. Several common mechanisms and risk factors have been suggested to contribute to the development of osteoporosis and atherosclerosis. The present cross-sectional study was performed to determine whether the degree of bone turnover is correlated to carotid intima-media thickness (CCA-IMT), as a marker of subclinical atherosclerosis. We selected 50 outpatients (mean age 71.7 +/- 12.3), underwent to eco-Doppler evaluation of extracranial carotid tract, without history of calcium and/or vitamin D supplementation, or antireabsorptive therapy. CCA-IMT was measured by high-resolution B-mode ultrasonography. Bone turnover was evaluated by analysing serum levels of C-terminal telopeptide of type I collagen (sCTX), and bone-specific alkaline phosphatase. We also evaluated the vitamin D status by determination of the serum concentration of 25-hydroxyvitamin D [25(OH)D]. We found a prevalence of hypovitaminosis D [serum 25(OH)D levels <30 ng/mL, mean value 10.7 +/- 5.8] of 91.8%, and an increased bone resorption, with mean sCTX levels higher than reference values (mean 1.18 +/- 0.57 ng/mL). A significant positive correlation was found between CCA-IMT and age (r = 0.480, P = 0.001), erythrocyte sedimentation rate (ESR: r = 0.438, P = 0.001), high-sensitivity C-Reactive Protein (HsCRP: r = 0.482, P = 0.011), serum creatinine (r = 0.305, P = 0.031), and sCTX (r = 0.389, P = 0.006). In a multivariate linear regression, CCA-IMT was independently predicted by age (beta = 0.34, P = 0.001), ESR (beta = 0.37, P = 0.005), and sCTX (beta = 0.32, P = 0.006). The preliminary results of our study seem to indicate that after adjustment for established cardiovascular risk factors, sCTX independently predict an increased CCA-IMT in the elderly population.
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Affiliation(s)
- Christian Leli
- Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, University of Perugia, Perugia, Italy.
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32
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Sumino H, Ichikawa S, Kasama S, Takahashi T, Sakamoto H, Koizumi A, Kanai H, Araki Y, Itoh T, Iwasaki T, Sawada Y, Saito Y, Kumakura H, Takayama Y, Kanda T, Murakami M, Sakamaki T, Kurabayashi M. Effects of Raloxifene on Brachial Arterial Endothelial Function, Carotid Wall Thickness, and Arterial Stiffness in Osteoporotic Postmenopausal Women. Int Heart J 2010; 51:60-7. [DOI: 10.1536/ihj.51.60] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Hiroyuki Sumino
- Department of Nursing, Faculty of Nursing, Takasaki University of Health and Welfare
| | - Shuichi Ichikawa
- Department of Internal Medicine, Cardiovascular Hospital of Central Japan
| | - Shu Kasama
- Department of Internal Medicine, Cardiovascular Hospital of Central Japan
| | | | - Hironosuke Sakamoto
- Department of Nursing, Faculty of Nursing, Takasaki University of Health and Welfare
| | - Akira Koizumi
- Department of Internal Medicine, Cardiovascular Hospital of Central Japan
| | - Hiroyoshi Kanai
- Department of Internal Medicine, Cardiovascular Hospital of Central Japan
| | - Yoshihiro Araki
- Department of Internal Medicine, Cardiovascular Hospital of Central Japan
| | - Toshio Itoh
- Department of Internal Medicine, Cardiovascular Hospital of Central Japan
| | - Toshiya Iwasaki
- Department of Internal Medicine, Cardiovascular Hospital of Central Japan
| | - Yoshie Sawada
- Department of Internal Medicine, Cardiovascular Hospital of Central Japan
| | - Yuichiro Saito
- Department of Medicine and Biological Science, Gunma University Graduate School of Medicine
| | - Hisao Kumakura
- Department of Internal Medicine, Cardiovascular Hospital of Central Japan
| | - Yoshiaki Takayama
- Department of Internal Medicine, Cardiovascular Hospital of Central Japan
| | | | - Masami Murakami
- Departments of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine
| | - Tetsuo Sakamaki
- Medical Informatics and Decision Sciences, Gunma University Graduate School of Medicine
| | - Masahiko Kurabayashi
- Department of Medicine and Biological Science, Gunma University Graduate School of Medicine
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