Ranatunga Shasheni, Kulkarni Bharati, Kinra Sanjay, Ebeling Peter R, Zengin Ayse
Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, VIC, Australia.
Clinical Division, ICMR-National Institute of Nutrition, Jamai Osmania PO, Hyderabad, India.
Bone. 2023 Apr;169:116686. doi: 10.1016/j.bone.2023.116686. Epub 2023 Jan 28.
Osteoporosis and cardiovascular disease (CVD) share common risk factors, yet both are usually underdiagnosed in the absence of major complications. We investigated associations between arterial stiffness, cardiac workload, carotid intima media thickness (CIMT) and areal bone mineral density (aBMD) in Indian adults.
Men and women aged >45 years from the Andhra Pradesh Children and Parents Study (APCAPS) were included for cross-sectional analysis (521 women and 696 men). Dual energy x-ray absorptiometry (DXA) measured aBMD at the whole body, total hip and lumbar spine. Supine blood pressure and heart rate were measured and used to calculate rate pressure product and pulse pressure; augmentation index, pulse wave velocity and CIMT were measured. Sex-interactions were tested (denoted as p-int); adjustments were made for confounders. Data were expressed as SD differences with 95 % confidence intervals.
There were significant negative associations between pulse pressure and aBMD at all sites in women only. In unadjusted analyses, for every 1SD increase in pulse pressure, women had greater negative differences in aBMD at the whole body (-0.13 vs 0.007), total hip (-0.20 vs -0.05) and lumbar spine (-0.12 vs 0.05) compared with men. After adjustments, sex differences remained. Similar negative associations were seen between pulse wave velocity and augmentation index with aBMD in women only. There were no sex differences between CIMT and rate pressure product with aBMD.
Markers of arterial stiffness are associated with poorer bone health in Indian women, but not in men. There is a need to identify the shared risk factors and markers of arterial stiffness and poor bone health to detect those who require co-management of these diseases to prevent cardiovascular events and fractures.
骨质疏松症和心血管疾病（CVD）有共同的风险因素，但在没有重大并发症的情况下，这两种疾病通常都未得到充分诊断。我们调查了印度成年人动脉僵硬度、心脏负荷、颈动脉内膜中层厚度（CIMT）与骨密度（aBMD）之间的关联。
纳入来自安得拉邦儿童与父母研究（APCAPS）的45岁以上男性和女性进行横断面分析（521名女性和696名男性）。采用双能X线吸收法（DXA）测量全身、全髋和腰椎的骨密度。测量仰卧位血压和心率，并用于计算心率血压乘积和脉压；测量增强指数、脉搏波速度和CIMT。检验性别交互作用（表示为p-int）；对混杂因素进行校正。数据以标准差差异及95%置信区间表示。
仅在女性中，脉压与所有部位的骨密度之间存在显著负相关。在未经校正的分析中，脉压每增加1个标准差，与男性相比，女性在全身（-0.13对0.007）、全髋（-0.20对-0.05）和腰椎（-0.12对0.05）的骨密度负差异更大。校正后，性别差异仍然存在。仅在女性中，脉搏波速度和增强指数与骨密度之间也存在类似的负相关。CIMT和心率血压乘积与骨密度之间不存在性别差异。
动脉僵硬度指标与印度女性较差的骨骼健康相关，但与男性无关。有必要确定动脉僵硬度和骨骼健康不佳的共同风险因素和指标，以发现那些需要对这些疾病进行联合管理以预防心血管事件和骨折的人群。
