Campos-Obando Natalia, Kavousi Maryam, Roeters van Lennep Jeanine E, Rivadeneira Fernando, Hofman Albert, Uitterlinden André G, Franco Oscar H, Zillikens M Carola
Department of Internal Medicine, Erasmus MC, 3000 CA Rotterdam, The Netherlands.
Department of Epidemiology, Erasmus MC, 3000 CA Rotterdam, The Netherlands.
Atherosclerosis. 2015 Jul;241(1):278-83. doi: 10.1016/j.atherosclerosis.2015.02.013. Epub 2015 Feb 9.
Vascular calcification has been associated inconsistently to low bone mineral density and fractures. The aims of the present study were to investigate the associations between coronary artery calcification (CAC) and BMD change, BMD and fracture risk in elderly subjects of the population-based Rotterdam Study.
BMD was assessed through dual-energy X-ray absorptiometry and CAC through Electron-Beam Computed Tomography in 582 men and 694 women. We investigated the associations between BMD change (6.4 years follow-up) and CAC at follow-up and between BMD and CAC (measured simultaneously). In sensitivity analyses we stratified analyses for estradiol levels in women. The association between CAC and fracture risk (9 years follow-up) was tested through competing-risks models. Models were sex-stratified and adjusted for age, body mass index, smoking, bisphosphonate use and age at menopause.
There was no association between BMD change and CAC in men. In women, each 1% increase in annual BMD loss was significantly associated with higher follow-up CAC [β = 0.22 (0.06-0.38), p=0.006; prevalence ratio: 4%]. Stratified analyses showed significant associations between BMD loss and follow-up CAC only in women with lower estradiol levels. We found no association between CAC and fracture risk and no association between BMD and CAC cross-sectionally.
BMD loss was associated with higher follow-up CAC in women, which might be related to low estrogen levels. No association between CAC and BMD or fracture risk was found. Further studies are required to elucidate the mechanisms that might underlie the association between BMD change and coronary calcification in women.
血管钙化与低骨矿物质密度及骨折之间的关联并不一致。本研究的目的是在基于人群的鹿特丹研究的老年受试者中，调查冠状动脉钙化（CAC）与骨密度变化、骨密度和骨折风险之间的关联。
对582名男性和694名女性进行了双能X线吸收法评估骨密度，通过电子束计算机断层扫描评估CAC。我们调查了骨密度变化（6.4年随访）与随访时的CAC之间以及骨密度与CAC（同时测量）之间的关联。在敏感性分析中，我们对女性的雌二醇水平进行了分层分析。通过竞争风险模型测试了CAC与骨折风险（9年随访）之间的关联。模型按性别分层，并对年龄、体重指数、吸烟、双膦酸盐使用情况和绝经年龄进行了调整。
男性的骨密度变化与CAC之间无关联。在女性中，每年骨密度损失每增加1%，与更高的随访CAC显著相关[β = 0.22（0.06 - 0.38），p = 0.006；患病率比：4%]。分层分析显示，仅在雌二醇水平较低的女性中，骨密度损失与随访CAC之间存在显著关联。我们发现CAC与骨折风险之间无关联，且骨密度与CAC横断面之间也无关联。
女性的骨密度损失与更高的随访CAC相关，这可能与低雌激素水平有关。未发现CAC与骨密度或骨折风险之间存在关联。需要进一步研究以阐明女性骨密度变化与冠状动脉钙化之间关联可能的潜在机制。
