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Associations between bone mineral density in different measurement locations and coronary artery disease: a
Yaoling Wang1, Ruiyun Wang1, Yun Liu1
1Department of Geriatrics, Union Hospital of Tongji Medical College Huazhong University of Science & Technology, Wuhan, 430022, China.
Insights
Low bone mineral density (BMD) in the femoral neck, particularly below -1.70, is a significant indicator of coronary heart disease (CAD) risk. This finding highlights the importance of BMD measurements for cardiovascular health assessment.
Area of Science:
- Orthopedics and Cardiology
- Bone Metabolism and Cardiovascular Health
Background:
- Low bone mineral density (BMD) is increasingly recognized as a risk factor for coronary artery disease (CAD).
- However, the specific skeletal sites and BMD thresholds most effective for identifying CAD risk require further elucidation.
Purpose of the Study:
- To evaluate the efficacy of BMD measurements at various skeletal locations in identifying coronary artery disease (CAD).
- To determine the optimal measurement site and BMD cut-off value for predicting CAD risk.
Main Methods:
- A cross-sectional study involving 817 participants, with 180 diagnosed with CAD.
- BMD was measured using dual-energy X-ray absorptiometry (DEXA) at the lumbar spine, femoral neck, and total proximal femur.
- Logistic regression and receiver operating characteristic (ROC) curve analysis were employed to assess the association between BMD and CAD and identify optimal prediction parameters.
Main Results:
- BMD measurements at the femoral neck and total proximal femur showed a stronger protective association against CAD (ORs = 0.47–0.66) compared to the lumbar spine (ORs = 0.74–0.79).
- The femoral neck demonstrated the highest predictive ability for CAD risk, with an area under the ROC curve (AUC) of 0.72.
- An average femoral neck BMD of -1.70 was identified as the optimal cut-off value for indicating CAD risk.
Conclusions:
- Femoral neck BMD measurements, especially when below a threshold of -1.70, hold significant value for identifying individuals at risk of coronary artery disease (CAD).
- These findings suggest that BMD assessment at the femoral neck may be a valuable tool in cardiovascular risk stratification.
Abstract:
The bone mineral density (BMD) loss is closely related to coronary heart disease (CAD). The BMD measured at different locations differ in BMD values, the risk to CAD, and the capability to identify CAD. An average BMD of the right and left femoral neck being below - 1.70 has the ability to indicate risk of CAD.
Purpose:
Previous studies have reported that low bone mineral density (BMD) is closely related to coronary artery disease (CAD); however, it is not clear that the BMD loss at which location to what extent has the greatest effect in identifying risk of CAD. This study aimed to evaluate the ability of different measurement sites of BMD in identifying CAD and analyze the best measurement sites and the optimal cut-off of BMD for CAD.
Methods:
This was a cross-sectional study in which 180 of 817 participants were diagnosed with CAD. All participants in the study were measured by dual-energy X-ray absorptiometry (DEXA) for BMD at 8 locations, and following measurements were derived: the average BMD of lumbar spine (L1-L4), femoral neck (left and right), and total proximal femur (left and right). The association between BMD at different locations and CAD was analyzed using logistic regression. The receiver operating characteristic (ROC) curve was used to select the optimal measurement location and cut-off value of the BMD for identifying CAD.
Results:
There were significant differences in BMD at 3 different measurement locations. Higher BMD is a protective factor against CAD, which is more pronounced in the femoral neck and total proximal femur (ORs = 0.47 ~ 0.66, P < 0.001) than in the lumbar spine (ORs = 0.74 ~ 0.79, P < 0.001). The optimal site for predicting the risk of CAD by BMD is the femoral neck, with the AUC (area under the ROC curve) is 0.72 (95% CI: 0.67 ~ 0.76) and the cut-off is - 1.70.
Conclusion:
The BMD below particular cut-off of the femoral neck rather than of the lumbar spine may have certain further research value for revealing the risk of CAD.
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