Sinnott B, Syed I, Sevrukov A, Barengolts E
Department of Endocrinology, University of Illinois, Chicago, IL 60612, USA.
Calcif Tissue Int. 2006 Apr;78(4):195-202. doi: 10.1007/s00223-005-0244-z. Epub 2006 Apr 13.
The objective of this study was to investigate whether low bone mass is directly associated with the severity of coronary atherosclerosis in men and postmenopausal women self-referred for evaluation of coronary atherosclerosis and osteoporosis. Low bone mass was evaluated by measurement of bone mineral density (BMD) using quantitative computerized tomography (QCT). Coronary atherosclerosis was evaluated by measurement of coronary calcium (CC) burden using electron beam computerized tomography (EBCT). Using a cross-sectional design, we tested the hypothesis that osteoporosis and coronary atherosclerosis are correlated, age-dependent processes. Study variables were BMD, CC scores, and other known risk factors for osteoporosis and atherosclerosis. Qualifying for the study were 313 postmenopausal women and 167 men. Men had higher baseline CC scores and higher body mass indexes compared to women. In females, those patients with coronary calcification were older and had significantly lower BMD compared to those without calcification. In males, those patients with coronary calcification were older. By univariate correlation analysis, the degree of coronary calcification was inversely associated with BMD in postmenopausal women (P < 0.0001) but not in men. However, after controlling for age, this association was absent for both men and postmenopausal women. Using multivariate logistic regression analysis in women and men separately, age was the only significant predictor of positive CC status and low BMD. Our study suggests that in postmenopausal women and in men, after controlling for age, osteoporosis and coronary atherosclerosis are independent processes.
本研究的目的是调查在因冠状动脉粥样硬化和骨质疏松症前来接受评估的男性及绝经后女性中，低骨量是否与冠状动脉粥样硬化的严重程度直接相关。通过使用定量计算机断层扫描（QCT）测量骨矿物质密度（BMD）来评估低骨量。通过使用电子束计算机断层扫描（EBCT）测量冠状动脉钙化（CC）负荷来评估冠状动脉粥样硬化。采用横断面设计，我们检验了骨质疏松症和冠状动脉粥样硬化是相关的、年龄依赖性过程这一假设。研究变量包括BMD、CC评分以及其他已知的骨质疏松症和动脉粥样硬化风险因素。313名绝经后女性和167名男性符合本研究条件。与女性相比，男性的基线CC评分和体重指数更高。在女性中，与无冠状动脉钙化的患者相比，有冠状动脉钙化的患者年龄更大且BMD显著更低。在男性中，有冠状动脉钙化的患者年龄更大。通过单变量相关分析，绝经后女性冠状动脉钙化程度与BMD呈负相关（P < 0.0001），而在男性中则不然。然而，在控制年龄后，男性和绝经后女性的这种关联均不存在。分别对女性和男性进行多变量逻辑回归分析，年龄是CC阳性状态和低BMD的唯一显著预测因素。我们的研究表明，在绝经后女性和男性中，控制年龄后，骨质疏松症和冠状动脉粥样硬化是独立的过程。
