Danilevicius C F, Lopes J B, Pereira R M R
Laboratório de Metabolismo Osseo (LIM-17), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
Braz J Med Biol Res. 2007 Apr;40(4):435-42. doi: 10.1590/s0100-879x2007000400001.
Osteoporosis and atherosclerosis are chronic degenerative diseases which have been considered to be independent and whose common characteristic is increasing incidence with age. At present, growing evidence indicates the existence of a correlation between cardiovascular disease and osteoporosis, irrespective of age. The morbidity and mortality of osteoporosis is mainly related to the occurrence of fractures. Atherosclerosis shows a high rate of morbidity and especially mortality because of its clinical repercussions such as angina pectoris, acute myocardial infarction, stroke, and peripheral vascular insufficiency. Atherosclerotic disease is characterized by the accumulation of lipid material in the arterial wall resulting from autoimmune and inflammatory mechanisms. More than 90% of these fatty plaques undergo calcification. The correlation between osteoporosis and atherosclerosis is being established by studies of the underlying physiopathological mechanisms, which seem to coincide in many biochemical pathways, and of the risk factors for vascular disease, which have also been associated with a higher incidence of low-bone mineral density. In addition, there is evidence indicating an action of antiresorptive drugs on the reduction of cardiovascular risks and the effect of statins, antihypertensives and insulin on bone mass increase. The mechanism of arterial calcification resembles the process of osteogenesis, involving various cells, proteins and cytokines that lead to tissue mineralization. The authors review the factors responsible for atherosclerotic disease that correlate with low-bone mineral density.
骨质疏松症和动脉粥样硬化是慢性退行性疾病，过去一直被认为是独立的疾病，其共同特征是发病率随年龄增长而增加。目前，越来越多的证据表明，无论年龄大小，心血管疾病与骨质疏松症之间都存在关联。骨质疏松症的发病率和死亡率主要与骨折的发生有关。动脉粥样硬化的发病率很高，尤其是死亡率，因为它会引发心绞痛、急性心肌梗死、中风和外周血管功能不全等临床后果。动脉粥样硬化疾病的特征是由于自身免疫和炎症机制导致脂质物质在动脉壁堆积。这些脂肪斑块中超过90%会发生钙化。骨质疏松症与动脉粥样硬化之间的关联正通过对潜在生理病理机制的研究得以确立，这些机制在许多生化途径中似乎是一致的，同时也通过对血管疾病风险因素的研究得以确立，这些因素也与低骨密度的较高发病率相关。此外，有证据表明抗吸收药物对降低心血管风险有作用，而他汀类药物、抗高血压药物和胰岛素对增加骨量有作用。动脉钙化的机制类似于骨生成过程，涉及多种导致组织矿化的细胞、蛋白质和细胞因子。作者回顾了与低骨密度相关的动脉粥样硬化疾病的相关因素。
