The Association between Bone Quality and Atherosclerosis: Results from Two Large Population-Based Studies

Area of Science:

• Cardiovascular Health
• Bone Metabolism
• Geriatric Medicine

Background:

• The relationship between osteoporosis and atherosclerosis is debated, particularly concerning independence from cardiovascular risk factors.
• Quantitative ultrasound (QUS) parameters offer a non-invasive method to assess bone health.
• Carotid artery intima-media thickness (IMT) and ankle-brachial index (ABI) are established markers of atherosclerosis.

Purpose of the Study:

• To investigate associations between heel QUS parameters and carotid artery atherosclerosis (IMT, plaque presence, ABI).
• To determine if these associations persist independently of major cardiovascular risk factors.

Main Methods:

• Utilized data from 5680 participants (aged 20-93) from the Study of Health in Pomerania (SHIP) and SHIP-Trend cohorts.
• Performed heel QUS measurements and extracranial carotid artery B-mode ultrasonography.
• Measured ABI in 3853 participants and employed adjusted regression models for analysis.

Main Results:

• Decreasing QUS parameters were associated with increased odds of carotid artery plaques in men, independent of diabetes, dyslipidemia, and hypertension.
• No significant associations were found between QUS parameters and IMT or ABI in fully adjusted models for either sex.
• Women did not show significant associations between QUS parameters and carotid artery plaque presence.

Conclusions:

• Bone metabolism's independent role in atherosclerotic changes appears limited in women.
• In men, associations between QUS parameters and advanced atherosclerosis (plaque presence) were observed.
• Men with clinical signs of osteoporosis may represent a higher-risk group for developing atherosclerotic disease.