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绝经后女性的妊娠史、冠状动脉钙化与骨密度

Pregnancy history, coronary artery calcification and bone mineral density in menopausal women.

作者信息

Beckman J P, Camp J J, Lahr B D, Bailey K R, Kearns A E, Garovic V D, Jayachandran M, Miller V M, Holmes D R

机构信息

a Department of Surgery , Mayo Clinic , Rochester , MN , USA.

b Department of Physiology and Biomedical Engineering , Mayo Clinic , Rochester , MN , USA.

出版信息

Climacteric. 2018 Feb;21(1):53-59. doi: 10.1080/13697137.2017.1406910. Epub 2017 Nov 30.

Abstract

OBJECTIVE

This study examined relationships, by pregnancy histories, between bone mineral density (BMD) and coronary artery calcification (CAC) in postmenopausal women.

METHODS

Forty women identified from their medical record as having pre-eclampsia (PE) were age/parity-matched with 40 women having a normotensive pregnancy (NP). Vertebral (T4-9) BMD and CAC were assessed by quantitative computed tomography in 73 (37 with PE and 36 with NP) of the 80 women. Analyses included linear regression using generalized estimating equations.

RESULTS

Women averaged 59 years of age and 35 years from the index pregnancy. There were no significant differences in cortical, trabecular or central BMD between groups. CAC was significantly greater in the PE group (p = 0.026). In multivariable analysis, CAC was positively associated with cortical BMD (p = 0.001) and negatively associated with central BMD (p = 0.036). There was a borderline difference in the association between CAC and central BMD by pregnancy history (interaction, p = 0.057).

CONCLUSIONS

Although CAC was greater in women with a history of PE, vertebral BMD did not differ between groups. However, both cortical and central BMD were associated with CAC. The central BMD association was marginally different by pregnancy history, suggesting perhaps differences in underlying mechanisms of soft tissue calcification.

摘要

目的

本研究按妊娠史调查绝经后女性骨矿物质密度(BMD)与冠状动脉钙化(CAC)之间的关系。

方法

从病历中确定40名患有先兆子痫(PE)的女性,将其年龄/产次与40名血压正常妊娠(NP)的女性进行匹配。80名女性中的73名(37名患有PE,36名患有NP)通过定量计算机断层扫描评估椎体(T4 - 9)BMD和CAC。分析包括使用广义估计方程的线性回归。

结果

女性平均年龄59岁,距本次妊娠平均35年。两组之间皮质骨、小梁骨或中央骨的BMD无显著差异。PE组的CAC显著更高(p = 0.026)。在多变量分析中,CAC与皮质骨BMD呈正相关(p = 0.001),与中央骨BMD呈负相关(p = 0.036)。按妊娠史,CAC与中央骨BMD之间的关联存在临界差异(交互作用,p = 0.057)。

结论

尽管有PE病史的女性CAC更高,但两组之间椎体BMD无差异。然而,皮质骨和中央骨BMD均与CAC相关。按妊娠史,中央骨BMD的关联略有不同,这可能表明软组织钙化的潜在机制存在差异。

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