Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicne, Seoul, Korea.
Korean Circ J. 2013 Jul;43(7):453-61. doi: 10.4070/kcj.2013.43.7.453. Epub 2013 Jul 31.
It is widely known that both bone loss and vascular calcification are age-related processes. The purpose of this study was to investigate the relationship between coronary artery calcium (CAC) score or bone mineral density (BMD) with age and whether there is a gender difference factoring in the two conditions among healthy subjects.
Between March 2009 and August 2011, participants included 1727 subjects (mean age: 55±10 years, M : F=914 : 813) with routine health check-ups. After being categorized into three groups (normal, osteopenia, and osteoporosis) according to the World Health Organization (WHO) diagnostic classification, we estimated BMD by dual energy X-ray absorptiometry (DEXA) and CAC score by dual-source CT (DSCT).
There was a significant gender difference among the risk factors, including total-lumbar spine (1.213±0.176 g/cm(2) : 1.087±0.168 g/cm(2), p<0.001) and femur (1.024±0.131 g/cm(2) : 0.910±0.127 g/cm(2), p<0.001) in BMD by DEXA, and CAC score (68±227 : 27±116, p<0.001) in coronary artery calcification by DSCT. Age in male [odds ratio (OR): 1.138 {95% confidence interval (CI): 1.088-1.190}, p<0.001] and menopause in female subjects {OR: 12.370 (95% CI: 3.120-49.047), p<0.001} were, respectively, independently associated with osteopenia.
Although our results do not demonstrate a direct association between CAC score and BMD in both genders, there is a gender difference of CAC score in normal and osteopenia groups according to the WHO diagnostic classification. Additionally, we suggest that more specific therapeutic strategies be considered during any early bone loss period, especially in female subjects.
众所周知,骨质流失和血管钙化都是与年龄相关的过程。本研究旨在调查冠状动脉钙(CAC)评分或骨密度(BMD)与年龄之间的关系,以及在健康受试者中,这两种情况是否存在性别差异。
在 2009 年 3 月至 2011 年 8 月期间,我们纳入了 1727 名接受常规健康检查的受试者(平均年龄:55±10 岁,男性:914 名,女性:813 名)。根据世界卫生组织(WHO)的诊断分类,我们将受试者分为三组(正常、骨质疏松前期和骨质疏松),通过双能 X 射线吸收仪(DEXA)估计 BMD,通过双源 CT(DSCT)估计 CAC 评分。
在危险因素方面存在显著的性别差异,包括 DEXA 测量的全腰椎(1.213±0.176 g/cm(2):1.087±0.168 g/cm(2),p<0.001)和股骨(1.024±0.131 g/cm(2):0.910±0.127 g/cm(2),p<0.001)BMD,以及 DSCT 测量的 CAC 评分(68±227:27±116,p<0.001)。男性的年龄[比值比(OR):1.138(95%置信区间(CI):1.088-1.190),p<0.001]和女性的绝经[OR:12.370(95%CI:3.120-49.047),p<0.001]分别与骨质疏松前期独立相关。
尽管我们的结果并未显示 CAC 评分与两性 BMD 之间存在直接关联,但根据 WHO 诊断分类,在正常和骨质疏松前期组中,CAC 评分存在性别差异。此外,我们建议在任何早期骨质流失期间考虑更具体的治疗策略,尤其是在女性受试者中。