Association Between Low Bone Mass and Aortic Valve Sclerosis in Koreans

Background: Osteoporosis or low bone mass has been associated with cardiovascular disease and calcification in several clinical studies. However, few studies have assessed the relationship between bone mass and valvular calcification. The aim of this study was to evaluate the relationship between low bone mass and aortic valve sclerosis in Korean men and women.

Methods: A total of 211 men and 117 women were included in this study. Each subject's bone mineral density (BMD) was measured with dual-energy X-ray absorptiometry, and aortic valve sclerosis was assessed using transthoracic echocardiography. Association between low bone mass and aortic valve sclerosis was assessed with multivariate logistic regression analysis in this cross-sectional study.

Results: Of 328 total subjects enrolled in this study, 50 men (23.7%) and 18 women (15.4%) were found to have aortic valve sclerosis. The mean (+/-SD) BMD T-scores were -0.5 (+/-0.8) in men and -0.9 (+/-1.0) in women. After adjusting for covariates, only women with aortic valve sclerosis had significantly lower BMD T-scores than those without it. Multivariate logistic regression analysis showed that age, smoking and hypertension were independently associated with increased risk of aortic valve sclerosis in men. In women, however, logistic regression analysis showed that BMD T-score, as well as age, was an independent variable for aortic valve sclerosis. We also found that a T-score of less than -1.5 was significantly associated with increased risk of aortic valve sclerosis in women compared to normal T-scores.

Conclusion: Low bone mass might be independently associated with increased risk of aortic valve sclerosis in women, but not in men. Women with low bone mass should be further evaluated for the presence of aortic valve sclerosis and related cardiovascular diseases.