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

Overview

Journal Diabetes Metab Syndr Obes

Publisher Dove Medical Press

Specialty Endocrinology

Date 2022 Dec 23

PMID 36561919

Authors

Ying Yang

Lingling Li

Yangyang Zhang

Hong Yang

Jia Bai

Haihong Lv

Songbo Fu

Affiliations

Soon will be listed here.

Abstract

Purpose: The relationship between coronary artery calcification and bone mineral density (BMD) in T2DM is still unclear. The aim of this study is to analyze the association between coronary artery calcium score (CACs) and BMD in T2DM with different visceral fat area (VFA), and further to explore the clinical significance of CACs in predicting osteoporosis in T2DM patients.

Patients And Methods: A total of 479 T2DM patients aged ≥50 years were included. Agatston was applied to calculate CACs to evaluate the degree of coronary artery calcification. Dual-energy X-ray absorptiometry (DXA) was used to measure BMD. According to VFA, all subjects were divided into VFA <100cm and VFA ≥100cm group. Adjusted regression analysis was performed to analyze the association between CACs and BMD. ROC curve was used to analyze the optimal cut-off value of CACs for screening osteoporosis.

Results: The baseline showed that in VFA ≥100cm group, CACs increased significantly than that in VFA <100cm group (212.1±195.9 vs 139.3±141.8, <0.001) and total hip BMD decreased obviously (0.968±0.19 vs 1.021±0.184, =0.01). After multivariable adjustment, CACs was not significantly associated with BMD in all patients (>0.05). However, CACs was negatively associated with BMD of total hip and lumbar spine in patients with VFA ≥100cm (total hip β=-0.087 =0.01; lumbar spine β=-0.052 =0.005), but not VFA <100cm. ROC curve analysis showed that the optimal cut-off value of CACs for screening osteoporosis was 191.505.

Conclusion: The present study implied that associations between CACs and BMD varied by the visceral fat deposition. It is critical to evaluate the condition of visceral fat accumulation for exploring the complex interplay of coronary artery calcification and BMD in T2DM patients. It may be of some clinical value for CACs in predicting osteoporosis in T2DM with visceral obesity.

Citing Articles

Association between visceral fat and bone mineral density in perimenopausal women.

Tang X, Tang L, Li X, Cao J, Wang H, Liu S PeerJ. 2025; 13:e18957.

PMID: 39959823 PMC: 11830370. DOI: 10.7717/peerj.18957.

Nonlinear association between liver fat content and lumbar bone mineral density in overweight and obese individuals: evidence from a large-scale health screening data in China.

Liu A, Sun Y, Qi X, Zhou Y, Zhou J, Li Z Endocrine. 2025; .

PMID: 39869295 DOI: 10.1007/s12020-025-04168-0.

References

Chuang T, Wang Y, Koo M, Chuang M . Association of Trabecular Bone Score-Adjusted Fracture Risk Assessment Tool with Coronary Artery Calcification in Women. Diagnostics (Basel). 2022; 12(1). PMC: 8775109. DOI: 10.3390/diagnostics12010178. View

Iwai S, Watanabe M, Okamura A, Kyodo A, Nogi K, Kamon D . Prognostic Impact of Calcified Plaque Morphology After Drug Eluting Stent Implantation　- An Optical Coherence Tomography Study. Circ J. 2021; 85(11):2019-2028. DOI: 10.1253/circj.CJ-20-1233. View

Nagai M, Komiya H, Mori Y, Ohta T, Kasahara Y, Ikeda Y . Development of a new method for estimating visceral fat area with multi-frequency bioelectrical impedance. Tohoku J Exp Med. 2008; 214(2):105-12. DOI: 10.1620/tjem.214.105. View

Lee H, Shin J, Lim Y, Kim B, Kim Y, Lee J . The relationship between coronary artery calcification and bone mineral density in patients according to their metabolic syndrome status. Korean Circ J. 2011; 41(2):76-82. PMC: 3053564. DOI: 10.4070/kcj.2011.41.2.76. View

Sasaki M, Hasegawa T, Yamada T, Hongo H, Freitas P, Suzuki R . Altered distribution of bone matrix proteins and defective bone mineralization in klotho-deficient mice. Bone. 2013; 57(1):206-19. DOI: 10.1016/j.bone.2013.08.008. View

Nicolaisen P, Obling M, Winther K, Hansen S, Hermann A, Hegedus L . Consequences of Hyperthyroidism and Its Treatment for Bone Microarchitecture Assessed by High-Resolution Peripheral Quantitative Computed Tomography. Thyroid. 2020; 31(2):208-216. DOI: 10.1089/thy.2020.0084. View

Hong T, Yan Z, Li L, Tang W, Qi L, Ye J . The Prevalence of Cardiovascular Disease in Adults with Type 2 Diabetes in China: Results from the Cross-Sectional CAPTURE Study. Diabetes Ther. 2022; 13(5):969-981. PMC: 9076769. DOI: 10.1007/s13300-022-01243-x. View

Zhu J, Guo F, Zhang J, Mu C . Relationship between carotid or coronary artery calcification and osteoporosis in the elderly. Minerva Med. 2018; 110(1):12-17. DOI: 10.23736/S0026-4806.18.05632-X. View

Deng L, Yao F, Tian F, Luo X, Yu S, Wen Z . Influence of Iguratimod on Bone Metabolism in Patients with Rheumatoid Arthritis: A Meta-analysis. Int J Clin Pract. 2022; 2022:5684293. PMC: 9334038. DOI: 10.1155/2022/5684293. View

10.

. New criteria for 'obesity disease' in Japan. Circ J. 2002; 66(11):987-92. DOI: 10.1253/circj.66.987. View

11.

Hum J, OBryan L, Tatiparthi A, Cass T, Clinkenbeard E, Cramer M . Chronic Hyperphosphatemia and Vascular Calcification Are Reduced by Stable Delivery of Soluble Klotho. J Am Soc Nephrol. 2016; 28(4):1162-1174. PMC: 5373441. DOI: 10.1681/ASN.2015111266. View

12.

Aras M, Tchang B, Pape J . Obesity and Diabetes. Nurs Clin North Am. 2021; 56(4):527-541. DOI: 10.1016/j.cnur.2021.07.008. View

13.

Silva B, Bilezikian J . Skeletal abnormalities in Hypoparathyroidism and in Primary Hyperparathyroidism. Rev Endocr Metab Disord. 2020; 22(4):789-802. DOI: 10.1007/s11154-020-09614-0. View

14.

Wallin R, Wajih N, Greenwood G, Sane D . Arterial calcification: a review of mechanisms, animal models, and the prospects for therapy. Med Res Rev. 2001; 21(4):274-301. DOI: 10.1002/med.1010. View

15.

Kurabayashi M . [Vascular Calcification - Pathological Mechanism and Clinical Application - . Role of vascular smooth muscle cells in vascular calcification]. Clin Calcium. 2015; 25(5):661-9. DOI: CliCa1505661669. View

16.

Bourne L, Wheeler-Jones C, Orriss I . Regulation of mineralisation in bone and vascular tissue: a comparative review. J Endocrinol. 2020; 248(2):R51-R65. DOI: 10.1530/JOE-20-0428. View

17.

Zhang P, Yang L, Xu Q, Zeng Y, Yu Y, Peng Q . Associations between bone mineral density and coronary artery calcification: a systematic review and meta-analysis. Ther Adv Chronic Dis. 2022; 13:20406223221086998. PMC: 8972925. DOI: 10.1177/20406223221086998. View

18.

Nakama C, Kadowaki T, Choo J, El-Saed A, Kadota A, Willcox B . Cross-sectional association of bone mineral density with coronary artery calcification in an international multi-ethnic population-based cohort of men aged 40-49: ERA JUMP study. Int J Cardiol Heart Vasc. 2020; 30:100618. PMC: 7452517. DOI: 10.1016/j.ijcha.2020.100618. View

19.

van den Hoogen I, Stuijfzand W, Gianni U, van Rosendael A, Bax A, Lu Y . Early versus late acute coronary syndrome risk patterns of coronary atherosclerotic plaque. Eur Heart J Cardiovasc Imaging. 2022; 23(10):1314-1323. DOI: 10.1093/ehjci/jeac114. View

20.

Rochette L, Meloux A, Rigal E, Zeller M, Malka G, Cottin Y . The Role of Osteoprotegerin in Vascular Calcification and Bone Metabolism: The Basis for Developing New Therapeutics. Calcif Tissue Int. 2019; 105(3):239-251. DOI: 10.1007/s00223-019-00573-6. View