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Associations between bone mineral density and coronary artery disease: a meta-analysis of cross-sectional studies
Yonghui Zhang1, Bing He1, Haijiao Wang1
1Orthopaedics Department, Luohe Central Hospital, Luohe, 462000, Henan, People's Republic of China.
Insights
This meta-analysis found no association between low bone mineral density (BMD) and the prevalence of coronary artery disease (CAD). However, individuals with CAD showed significantly lower BMD, particularly in the femoral neck and calcaneus.
Area of Science:
- Gerontology and Cardiovascular Health
- Bone Metabolism and Atherosclerosis
Background:
- The relationship between coronary artery disease (CAD) and bone mineral density (BMD) is complex and findings in existing literature are conflicting.
- Both CAD and low BMD are common age-related conditions, prompting investigation into their potential interrelation.
Purpose of the Study:
- To conduct a meta-analysis to comprehensively evaluate the association between CAD and BMD.
- To clarify the conflicting findings regarding the relationship between these two prevalent age-related conditions.
Main Methods:
- A systematic literature search was conducted across PubMed, Embase, and Cochrane Library databases.
- Meta-analysis techniques were employed, pooling odds ratios (OR) for prevalence and standardized mean differences (SMD) for BMD comparisons.
- Subgroup and meta-regression analyses were performed to investigate heterogeneity and potential confounding factors, including age.
Main Results:
- The meta-analysis included 11 studies with 4170 participants.
- No statistically significant association was found between low BMD and the prevalence of CAD (OR = 1.58, P = 0.06).
- However, individuals with CAD exhibited significantly lower BMD compared to non-CAD individuals, particularly in the femoral neck (SMD = -0.28, P = 0.004) and overall (SMD = -0.25, P < 0.001).
- A significant negative correlation was observed between BMD and the Gensini score, indicating more severe CAD lesions in individuals with lower BMD (COR = -0.4435, P = 0.004).
Conclusions:
- Low bone mineral density is not associated with the prevalence of coronary artery disease.
- Despite the lack of association with prevalence, individuals with CAD demonstrate significantly lower bone mineral density.
- The observed lower BMD in CAD patients may be influenced by age, but also suggests a potential link between reduced bone density and the severity of coronary artery lesions.
Abstract:
A meta-analysis was performed to explore the association of coronary artery disease (CAD) with bone mineral density (BMD). Low BMD was not found to be associated with prevalence of CAD. Though the BMD of CADs is significantly lower than that of non-CADs, the confounding effect of aging could not be excluded as CADs might be more prevalent in older patients.
Purpose/Introduction:
The clinical association of coronary artery disease (CAD) with bone mineral density (BMD) has been increasingly reported, but findings on the relationship between the two age-related processes are conflicting. The aim of our study was to conduct a meta-analysis to evaluate the associations between CAD and BMD.
Methods:
We searched PubMed, Embase, and Cochrane Library. Odds ratio (OR) and 95% confidence interval (CI) were pooled to assess the association between low BMD and the prevalence of CAD. For continuous data, standardized mean difference (SMD) with its 95% CI was pooled. Correlation coefficients of BMD and Gensini score were pooled after being transformed by Fischer z-transformation. Subgroup and meta-regression analyses were performed to explore the sources of heterogeneity.
Results:
The meta-analysis involved 4170 participants from 11 studies. Pooled ORs for the incidence of CAD in patients with low BMD versus patients with normal BMD was 1.58 (95% CI 0.99-2.52, P = 0.06), and no statistical difference was found in men and women subgroups. After confounding age, the combined OR was 1.60 (95% OR 0.69-3.72, P = 0.27). Pooling data for comparing BMD of CADs and non-CADs were - 0.28 (95% CI - 0.47 to - 0.09, P = 0.004) in femoral neck and calcaneus, - 0.42 (95% CI - 0.89-0.05, P = 0.08) in lumbar spine, and - 0.25 (95% CI - 0.40 to - 0.11, P = 0.000) in the overall. A significance was detected in pooled correlation analysis between CAG Gensini score and BMD (COR = - 0.4435 [- 0.6647; - 0.1508], P = 0.004). No sources of heterogeneity were acquired, and no publication bias was identified.
Conclusions:
Low BMD was not associated with the prevalence of CAD. Without age adjustment, the BMD of CADs is significantly lower than that of non-CADs, and the patients with lower BMD are inclined to more severe coronary artery lesions.
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