Hyder Joseph A, Allison Matthew A, Wong Nathan, Papa Agnes, Lang Thomas F, Sirlin Claude, Gapstur Susan M, Ouyang Pamela, Carr J Jeffrey, Criqui Michael H
Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Am J Epidemiol. 2009 Jan 15;169(2):186-94. doi: 10.1093/aje/kwn303. Epub 2008 Dec 8.
Atherosclerosis and osteoporosis share many risk factors, but their independent association is unclear. The authors investigated the independent associations between volumetric trabecular bone mineral density (vBMD) of the lumbar spine and coronary artery calcium (CAC) and abdominal aortic calcium (AAC). During 2002-2005, they used quantitative computed tomography to assess vBMD and the presence and extent of CAC and AAC among 946 women (mean age = 65.5 years) and 963 men (mean age = 64.1 years) in a substudy of the Multi-Ethnic Study of Atherosclerosis. Prevalences of CAC were 47% and 68% in women and men, respectively, and AAC prevalences were 70% and 73%. Sequential, sex-specific regression models included adjustment for age, ethnicity, body mass index, hypertension, dyslipidemia, diabetes mellitus, smoking, alcohol consumption, physical activity, interleukin-6, C-reactive protein, homocysteine, and sex hormones. After full adjustment, lower vBMD was associated with greater CAC score among women (P < 0.002) and greater AAC score among women (P = 0.004) and men (P < 0.001). After adjustment, vBMD quartile was inversely associated with CAC prevalence (P-trend = 0.05) in women and AAC prevalence (P-trend < 0.01) in men. Partially and fully adjusted models showed similar results. Though modest, these significant, independent associations suggest that atherosclerosis and bone loss may be related.
动脉粥样硬化和骨质疏松症有许多共同的风险因素,但其独立关联尚不清楚。作者研究了腰椎骨小梁体积骨密度(vBMD)与冠状动脉钙化(CAC)及腹主动脉钙化(AAC)之间的独立关联。在2002年至2005年期间,他们在动脉粥样硬化多族裔研究的一项子研究中,使用定量计算机断层扫描评估了946名女性(平均年龄 = 65.5岁)和963名男性(平均年龄 = 64.1岁)的vBMD以及CAC和AAC的存在情况及范围。女性和男性的CAC患病率分别为47%和68%,AAC患病率分别为70%和73%。按性别依次进行的回归模型对年龄、种族、体重指数、高血压、血脂异常、糖尿病、吸烟、饮酒、身体活动、白细胞介素-6、C反应蛋白、同型半胱氨酸和性激素进行了调整。经过全面调整后,较低的vBMD与女性较高的CAC评分相关(P < 0.002),与女性较高的AAC评分相关(P = 0.004),与男性较高的AAC评分相关(P < 0.001)。调整后,vBMD四分位数与女性的CAC患病率呈负相关(P趋势 = 0.05),与男性的AAC患病率呈负相关(P趋势 < 0.01)。部分调整和全面调整模型显示了相似的结果。尽管这种关联程度不大,但这些显著的独立关联表明动脉粥样硬化和骨质流失可能相关。