The Relationship Between Coronary Artery Calcification and Bone Mineral Density in Patients According to Their Metabolic Syndrome Status

Overview

Journal Korean Circ J

Date 2011 Mar 25

PMID 21430992

Citations 9

Authors

Hyung Tak Lee

Jinho Shin

Young-Hyo Lim

Bae Keun Kim

Young Taek Kim

Jae Ung Lee

Sangmo Hong

Soon Young Song

Sam Hyun Cho

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: The extent of coronary artery calcification (CAC) is closely related to total atherosclerotic plaque burden. However, the pathogenesis of CAC is still unclear. Conditions such as diabetes mellitus, renal failure, smoking, and chronic inflammation have been suggested to link vascular calcification and bone loss. In the present study, we hypothesized that bone loss can contribute to the pathogenesis of CAC in patients with the chronic inflammatory condition that accompanies metabolic syndrome (MetS). The objective of this study was to investigate the relationship between CAC and bone mineral density (BMD) in patients with MetS and in patients without MetS, by using coronary multidetector-row computed tomography (MDCT).

Subjects And Methods: Data from 395 consecutive patients was analyzed retrospectively. From the MDCT database, only those patients who underwent both coronary MDCT and dual-energy X-ray absorptiometry within an interval of one month, were selected. The presence of MetS was determined by the updated criteria as defined by the Third Adult Treatment Panel Report of the National Cholesterol Education Program.

Results: In patients with MetS, a significant correlation was found between CAC and age {odds ratio (OR)=1.139, 95% confidence interval (CI) 1.080 to 1.201, p<0.001}, CAC and male sex (OR=3.762, 95% CI 1.339 to 10.569, p=0.012), and CAC and T-score of L-spine (OR=0.740, 95% CI 0.550 to 0.996, p=0.047) using a forward multiple logistic regression analysis model including clinical variables of gender, age, lipid profile, body mass index, diabetes mellitus, hypertension, smoking, and BMD. But in patients without MetS, BMD by itself was not found to contribute to CAC.

Conclusion: BMD was inversely correlated with CAC only in patients with MetS. This finding suggests that low BMD accompanied by MetS, may have significant clinical implications.

Citing Articles

Association Between Coronary Artery Calcium Score and Bone Mineral Density in Type 2 Diabetes Mellitus with Different Visceral Fat Area.

Yang Y, Li L, Zhang Y, Yang H, Bai J, Lv H Diabetes Metab Syndr Obes. 2022; 15:3949-3960.

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Correlation of Arterial Stiffness and Bone Mineral Density by Measuring Brachial-Ankle Pulse Wave Velocity in Healthy Korean Women.

Kim N, Suh H Korean J Fam Med. 2015; 36(6):323-7.

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High Parathyroid Hormone Level and Osteoporosis Predict Progression of Coronary Artery Calcification in Patients on Dialysis.

Malluche H, Blomquist G, Monier-Faugere M, Cantor T, Davenport D J Am Soc Nephrol. 2015; 26(10):2534-44.

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Association of arterial stiffness and osteoporosis in healthy men undergoing screening medical examination.

Kim N, Jang H, Kim S, Ko K, Hwang I, Suh H J Bone Metab. 2014; 21(2):133-41.

PMID: 25006570 PMC: 4075267. DOI: 10.11005/jbm.2014.21.2.133.

Gender difference in bone loss and vascular calcification associated with age.

Lee D, Youn H, Yi J, Chin J, Kim T, Jung H Korean Circ J. 2013; 43(7):453-61.

PMID: 23964291 PMC: 3744732. DOI: 10.4070/kcj.2013.43.7.453.

References

Grundy S, Cleeman J, Daniels S, Donato K, Eckel R, Franklin B . Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Curr Opin Cardiol. 2005; 21(1):1-6. DOI: 10.1097/01.hco.0000200416.65370.a0. View

Barengolts E, Berman M, Kukreja S, Kouznetsova T, Lin C, Chomka E . Osteoporosis and coronary atherosclerosis in asymptomatic postmenopausal women. Calcif Tissue Int. 1998; 62(3):209-13. DOI: 10.1007/s002239900419. View

Hofbauer L, Brueck C, Shanahan C, Schoppet M, Dobnig H . Vascular calcification and osteoporosis--from clinical observation towards molecular understanding. Osteoporos Int. 2006; 18(3):251-9. DOI: 10.1007/s00198-006-0282-z. View

Abedin M, Tintut Y, Demer L . Vascular calcification: mechanisms and clinical ramifications. Arterioscler Thromb Vasc Biol. 2004; 24(7):1161-70. DOI: 10.1161/01.ATV.0000133194.94939.42. View

Festa A, DAgostino Jr R, Howard G, Mykkanen L, Tracy R, Haffner S . Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). Circulation. 2000; 102(1):42-7. DOI: 10.1161/01.cir.102.1.42. View

Agatston A, Janowitz W, HILDNER F, Zusmer N, VIAMONTE Jr M, Detrano R . Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol. 1990; 15(4):827-32. DOI: 10.1016/0735-1097(90)90282-t. View

Farhat G, Strotmeyer E, Newman A, Sutton-Tyrrell K, Bauer D, Harris T . Volumetric and areal bone mineral density measures are associated with cardiovascular disease in older men and women: the health, aging, and body composition study. Calcif Tissue Int. 2006; 79(2):102-11. DOI: 10.1007/s00223-006-0052-0. View

Christian R, Harrington S, Edwards W, Oberg A, Fitzpatrick L . Estrogen status correlates with the calcium content of coronary atherosclerotic plaques in women. J Clin Endocrinol Metab. 2002; 87(3):1062-7. DOI: 10.1210/jcem.87.3.8354. View

Lee W, Park J, Noh S, Rhee E, Kim S, Zimmet P . Prevalence of the metabolic syndrome among 40,698 Korean metropolitan subjects. Diabetes Res Clin Pract. 2004; 65(2):143-9. DOI: 10.1016/j.diabres.2003.12.007. View

10.

Moe S, Chen N . Inflammation and vascular calcification. Blood Purif. 2005; 23(1):64-71. DOI: 10.1159/000082013. View

11.

Sakkinen P, Wahl P, Cushman M, Lewis M, Tracy R . Clustering of procoagulation, inflammation, and fibrinolysis variables with metabolic factors in insulin resistance syndrome. Am J Epidemiol. 2000; 152(10):897-907. DOI: 10.1093/aje/152.10.897. View

12.

Choi S, An J, Lim S, Koo B, Park S, Chang H . Lower bone mineral density is associated with higher coronary calcification and coronary plaque burdens by multidetector row coronary computed tomography in pre- and postmenopausal women. Clin Endocrinol (Oxf). 2009; 71(5):644-51. DOI: 10.1111/j.1365-2265.2009.03535.x. View

13.

Wong N, Sciammarella M, Polk D, Gallagher A, Miranda-Peats L, Whitcomb B . The metabolic syndrome, diabetes, and subclinical atherosclerosis assessed by coronary calcium. J Am Coll Cardiol. 2003; 41(9):1547-53. DOI: 10.1016/s0735-1097(03)00193-1. View

14.

Farhat G, Cauley J, Matthews K, Newman A, Johnston J, Mackey R . Volumetric BMD and vascular calcification in middle-aged women: the Study of Women's Health Across the Nation. J Bone Miner Res. 2006; 21(12):1839-46. DOI: 10.1359/jbmr.060903. View

15.

Rumberger J, Simons D, Fitzpatrick L, Sheedy P, Schwartz R . Coronary artery calcium area by electron-beam computed tomography and coronary atherosclerotic plaque area. A histopathologic correlative study. Circulation. 1995; 92(8):2157-62. DOI: 10.1161/01.cir.92.8.2157. View

16.

Fernandez-Real J, Ricart W . Insulin resistance and inflammation in an evolutionary perspective: the contribution of cytokine genotype/phenotype to thriftiness. Diabetologia. 1999; 42(11):1367-74. DOI: 10.1007/s001250051451. View

17.

Mazzini M, Schulze P . Proatherogenic pathways leading to vascular calcification. Eur J Radiol. 2006; 57(3):384-9. DOI: 10.1016/j.ejrad.2005.12.025. View

18.

Reilly M, Wolfe M, Rhodes T, Girman C, Mehta N, Rader D . Measures of insulin resistance add incremental value to the clinical diagnosis of metabolic syndrome in association with coronary atherosclerosis. Circulation. 2004; 110(7):803-9. DOI: 10.1161/01.CIR.0000138740.84883.9C. View

19.

Sinnott B, Syed I, Sevrukov A, Barengolts E . Coronary calcification and osteoporosis in men and postmenopausal women are independent processes associated with aging. Calcif Tissue Int. 2006; 78(4):195-202. DOI: 10.1007/s00223-005-0244-z. View