根据代谢综合征状况评估患者冠状动脉钙化与骨密度之间的关系。
The relationship between coronary artery calcification and bone mineral density in patients according to their metabolic syndrome status.
机构信息
Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
出版信息
Korean Circ J. 2011 Feb;41(2):76-82. doi: 10.4070/kcj.2011.41.2.76. Epub 2011 Feb 28.
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.
背景与目的
冠状动脉钙化（CAC）的程度与总动脉粥样硬化斑块负担密切相关。然而，CAC 的发病机制尚不清楚。糖尿病、肾衰竭、吸烟和慢性炎症等情况被认为与血管钙化和骨丢失有关。在本研究中，我们假设在伴有代谢综合征（MetS）的慢性炎症状态下，骨丢失可能导致 CAC 的发病机制。本研究的目的是通过冠状动脉多层螺旋 CT（MDCT）探讨 MetS 患者和非 MetS 患者 CAC 与骨密度（BMD）之间的关系。
对象和方法
回顾性分析了 395 例连续患者的数据。从 MDCT 数据库中，仅选择在一个月内同时接受冠状动脉 MDCT 和双能 X 线吸收法检查的患者。MetS 的存在通过美国国家胆固醇教育计划成人治疗专家组第三版更新标准确定。
结果
在 MetS 患者中，CAC 与年龄呈显著正相关{比值比（OR）=1.139，95%置信区间（CI）为 1.080 至 1.201，p<0.001}，CAC 与男性（OR=3.762，95%CI 为 1.339 至 10.569，p=0.012），CAC 与 L 脊柱 T 评分呈显著负相关（OR=0.740，95%CI 为 0.550 至 0.996，p=0.047），使用包括性别、年龄、血脂谱、体重指数、糖尿病、高血压、吸烟和 BMD 等临床变量的正向多元逻辑回归分析模型。但是在没有 MetS 的患者中，BMD 本身并没有导致 CAC。
结论
只有在 MetS 患者中，BMD 与 CAC 呈负相关。这一发现表明，伴有 MetS 的低 BMD 可能具有重要的临床意义。
Zotero 插件