Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Nanjing Medical University, Nanjing, China.
Osteoporos Int. 2020 Jun;31(6):1135-1143. doi: 10.1007/s00198-020-05374-4. Epub 2020 Mar 10.
It is unknown whether a relationship exists between bone mineral density (BMD) and atherosclerosis with or without vascular calcification. In our study, a negative correlation between carotid atherosclerosis and BMD was found in female T2DM patients with vascular calcification, but not in those without calcification and males.
Atherosclerosis is considered associated with low bone mineral density (BMD). However, most previous studies focus on patients with arterial atherosclerosis with vascular calcification. It is still unknown whether a relationship exists between atherosclerosis and BMD in patients without calcification. It is also unknown if sex plays a role in this relationship.
We performed a retrospective cross-sectional study, which included 1459 type 2 diabetes mellitus (T2DM) patients (648 males ≥ 50 years old, and 811 postmenopausal females). They were assigned to three groups: group 1 (patients without carotid plaques and without carotid calcification), group 2 (patients with carotid plaques but without carotid calcification), and group 3 (patients with carotid plaques and with carotid calcification). Clinical characteristics and BMD were compared. The relationship between atherosclerosis and BMD was determined by binary logistic regression analysis. Statistical analysis was performed using SPSS 25.0.
Significant differences were only observed in women. The percentage of osteoporosis was higher in group 3 (43.64%) than in groups 1 (34.82%) and 2 (32.14%) (P = 0.016). Low BMD was found in the lumbar (P = 0.032), hip (P < 0.001), and femoral neck (P < 0.001). The odds ratio for osteoporosis increased significantly in a score-dependent manner in postmenopausal female patients with calcified atherosclerosis, but not in uncalcified patients. In men, no differences or relationships were identified.
A negative correlation between carotid atherosclerosis and BMD was found in female T2DM patients with vascular calcification, but not in those without calcification. A similar relationship was not observed in male patients with or without calcification. Thus, the relationship between atherosclerosis and bone mineral density in patients with type 2 diabetes depends on vascular calcifications and sex.
尚不清楚伴或不伴血管钙化的动脉粥样硬化与骨密度（BMD）之间是否存在关系。在本研究中，我们发现伴血管钙化的女性 2 型糖尿病（T2DM）患者的颈动脉粥样硬化与 BMD 呈负相关，但在无钙化患者和男性中未发现这种相关性。
动脉粥样硬化被认为与低骨密度（BMD）有关。然而，大多数先前的研究都集中在伴有血管钙化的动脉粥样硬化患者上。尚不清楚在无钙化的患者中，动脉粥样硬化与 BMD 是否存在关系。也不清楚性别是否在此关系中起作用。
我们进行了一项回顾性的横断面研究，纳入了 1459 例 2 型糖尿病（T2DM）患者（648 名男性≥50 岁，811 名绝经后女性）。他们被分为三组：组 1（无颈动脉斑块且无颈动脉钙化的患者）、组 2（有颈动脉斑块但无颈动脉钙化的患者）和组 3（有颈动脉斑块且有颈动脉钙化的患者）。比较了各组的临床特征和 BMD。采用二元逻辑回归分析确定动脉粥样硬化与 BMD 的关系。采用 SPSS 25.0 进行统计分析。
仅在女性中观察到显著差异。组 3（43.64%）的骨质疏松症发生率高于组 1（34.82%）和组 2（32.14%）（P=0.016）。绝经后女性患者的腰椎（P=0.032）、髋部（P<0.001）和股骨颈（P<0.001）的 BMD 较低。在有钙化性动脉粥样硬化的绝经后女性患者中，骨质疏松症的比值比随着评分的增加而显著增加，但在无钙化的患者中则没有差异或关系。在男性患者中，未发现差异或关系。
在伴血管钙化的女性 T2DM 患者中，颈动脉粥样硬化与 BMD 呈负相关，但在无钙化的患者中则无相关性。在有或无钙化的男性患者中未观察到类似的关系。因此，2 型糖尿病患者的动脉粥样硬化与骨密度之间的关系取决于血管钙化和性别。
