Tasić Ivan, Popović Marina Rašić, Stojanović Sonja, Stamenković Bojana, Kostić Svetlana, Popović Dejan, Lazarević Gordana, Bogdanović Dragan, Stefanović Vladisav
Srp Arh Celok Lek. 2015 Jan-Feb;143(1-2):28-34. doi: 10.2298/sarh1502028t.
Cardiovascular (CV) diseases and bone fractures due to osteoporosis are the leading causes of death in the elderly.
The aim of this study was to demonstrate a correlation between the overall risk for CV events, and low bone density in postmenopausal women, and its impact on the incidence of serious CV events.
Our prospective study involved 300 postmenopausal women. All the examinees were divided into three groups based on their measured bone density: Group I--84 examinees with osteoporosis; Group II--115 examinees with osteopenia; and Group III--101 examinees with normal bone density. In all examinees the overall ten-year risk for a fatal CV event was calculated using the SCORE system tables.
After a 36-month follow-up, CV events occurred in 19 (6.3%) examinees. Significant differences in the incidence of CV events were demonstrated between the patients with osteoporosis, osteopenia, and normal bone density (χ2 = 28.7; p < 0.001), as well as between those with a high and low CV risk (χ2 = 22.6; p < 0.001). Multivariate logistic regression analysis showed that smoking (OR: 2.23; 95% CI: 1.02 to 6.19; p = 0.035), and increase of overall CV score (OR: 1.36; 95% CI: 1.17 to 1.58; p < 0.001) are associated with increased CV event risk, while the increase of T score value is associated with decreased risk of CV event (OR: 0.42; 95% CI: 0.25 to 0.73; p = 0.002).
Measurement of bone density with a standard assessment of the total CV risk could be useful for selecting women who need intensive prevention and treatment of atherosclerosis.
心血管（CV）疾病和骨质疏松导致的骨折是老年人的主要死因。
本研究的目的是证明绝经后女性心血管事件的总体风险与低骨密度之间的相关性，以及其对严重心血管事件发生率的影响。
我们的前瞻性研究纳入了300名绝经后女性。所有受检者根据其测量的骨密度分为三组：第一组——84名患有骨质疏松症的受检者；第二组——115名患有骨质减少症的受检者；第三组——101名骨密度正常的受检者。在所有受检者中，使用SCORE系统表计算致命心血管事件的总体十年风险。
经过36个月的随访，19名（6.3%）受检者发生了心血管事件。骨质疏松症、骨质减少症和骨密度正常的患者之间心血管事件发生率存在显著差异（χ2 = 28.7；p < 0.001），心血管风险高和低的患者之间也存在显著差异（χ2 = 22.6；p < 0.001）。多因素逻辑回归分析表明，吸烟（比值比：2.23；95%置信区间：1.02至6.19；p = 0.035）和总体心血管评分增加（比值比：1.36；95%置信区间：1.17至1.58；p < 0.001）与心血管事件风险增加相关，而T评分值增加与心血管事件风险降低相关（比值比：0.42；95%置信区间：0.25至0.73；p = 0.002）。
通过标准评估总体心血管风险来测量骨密度，可能有助于选择需要强化预防和治疗动脉粥样硬化的女性。
