Paccou J, Edwards M H, Ward K A, Jameson K A, Moss C L, Harvey N C, Dennison E M, Cooper C
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.
Osteoporos Int. 2015 Jul;26(7):1893-901. doi: 10.1007/s00198-015-3132-z. Epub 2015 Apr 24.
In this study, high-resolution peripheral quantitative computed tomography (HR-pQCT) was used to investigate geometric, volumetric and microstructural parameters at the distal radius and at the distal tibia in participants with ischaemic heart disease. We found that, compared with participants without ischaemic heart disease, they had substantially lower cortical volumetric bone mineral density (BMD) at the distal radius.
HR-pQCT captures novel aspects of bone geometry and volumetric bone mineral density (vBMD) and offers the ability to measure bone microarchitecture, but data relating measures obtained from this technique in patients with ischemic heart disease (IHD) are lacking.
Here, we report an analysis from the Hertfordshire Cohort Study, where we were able to study associations between measures obtained from HR-pQCT of distal radius and distal tibia in 350 participants (184 men and 166 women) aged 71.5-80.5 years with or without IHD (e.g. heart attack, angina or heart failure; n = 75 and n = 275, respectively).
Analyses for all participants (men and women together) revealed that cortical vBMD (Ct.vBMD) was lower (p < 0.001) and cortical thickness (Ct.th) was not different (p = 0.519), whereas cortical porosity (Ct.Po) was higher (p = 0.016) in participants with IHD at the distal radius. Moreover, trabecular microarchitectural parameters were not significantly different in patients with IHD (p > 0.05 for all). Adjustment for a priori confounders (age, gender, body mass index, smoking status, alcohol consumption, high blood pressure and diabetes mellitus) did not materially affect the relationship described for Ct.vBMD (p = 0.002), but differences in Ct.Po were attenuated. Analyses in men alone revealed that only Ct.vBMD was lower at the distal radius in participants with IHD with and without adjustment for a priori confounders (p = 0.0002 and p = 0.004, respectively), whereas no statistical differences were found in women, although patterns of differences were similar in both sexes. Moreover, no association was found between IHD and bone parameters at the distal tibia either in men or women.
We have demonstrated that IHD is associated with lower Ct.vBMD of the distal radius.
在本研究中，高分辨率外周定量计算机断层扫描（HR-pQCT）被用于研究缺血性心脏病患者桡骨远端和胫骨远端的几何、体积和微观结构参数。我们发现，与无缺血性心脏病的参与者相比，他们桡骨远端的皮质骨体积骨密度（BMD）显著更低。
HR-pQCT能够捕捉骨几何结构和体积骨密度（vBMD）的新情况，并具备测量骨微结构的能力，但缺乏关于缺血性心脏病（IHD）患者通过该技术获得的测量数据的相关信息。
在此，我们报告了来自赫特福德郡队列研究的一项分析，在该研究中，我们能够研究350名年龄在71.5 - 80.5岁、患有或未患有IHD（例如心脏病发作、心绞痛或心力衰竭；分别为n = 75和n = 275）的参与者桡骨远端和胫骨远端HR-pQCT测量值之间的关联。
对所有参与者（男性和女性一起）的分析显示，在桡骨远端，IHD参与者的皮质vBMD（Ct.vBMD）更低（p < 0.001），皮质厚度（Ct.th）无差异（p = 0.519），而皮质孔隙率（Ct.Po）更高（p = 0.016）。此外，IHD患者的小梁微结构参数无显著差异（所有p > 0.05）。对先验混杂因素（年龄、性别、体重指数、吸烟状况、饮酒量、高血压和糖尿病）进行调整后，对Ct.vBMD描述的关系没有实质性影响（p = 0.002），但Ct.Po的差异有所减弱。仅对男性进行分析发现，无论是否对先验混杂因素进行调整，IHD男性参与者桡骨远端的Ct.vBMD均更低（分别为p = 0.0002和p = 0.004），而女性未发现统计学差异，尽管两性的差异模式相似。此外，无论男性还是女性，IHD与胫骨远端的骨参数均无关联。
我们已经证明，IHD与桡骨远端较低的Ct.vBMD相关。
