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Low bone mineral density and coronary artery disease: A systematic review and meta-analysis
Chinmay Khandkar1,2, Kaivan Vaidya1,2, Keyvan Karimi Galougahi1,2,3
1Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia.
Insights
Low bone mineral density (BMD) is linked to coronary artery disease (CAD) in adults, according to a meta-analysis. Further research is needed to confirm this association and explore potential confounding factors.
Area of Science:
- Cardiovascular Medicine
- Bone Metabolism
- Inflammation
Background:
- Coronary artery disease (CAD) and osteoporosis are significant causes of morbidity and mortality.
- Emerging research highlights inflammation and the bone-vascular axis, suggesting a potential mechanistic link between these conditions.
Purpose of the Study:
- To conduct a systematic review and meta-analysis examining the association between low bone mineral density (BMD) and CAD in adults.
Main Methods:
- A comprehensive literature search identified studies investigating the link between low BMD and CAD.
- Ten studies were included after screening 2258 unique records.
- Risk of bias was assessed using the modified Newcastle Ottawa score.
Main Results:
- Pooled analysis revealed a significant association between low BMD and CAD (OR 1.65, 95%CI 1.37-2.39, p < 0.01).
- Subgroup analyses by sex, geographic location, and coronary imaging modality did not yield significant differences.
- Analysis of studies with adjusted odds ratios (ORs) showed a trend towards significance (OR 3.01, 95%CI 0.91-9.99, p = 0.07).
Conclusions:
- Low BMD is associated with an increased risk of CAD.
- The association's independence from common risk factors remains uncertain due to study heterogeneity.
- Large-scale epidemiological studies are warranted to further elucidate this relationship.
Abstract:
Coronary artery disease (CAD) and osteoporosis both cause significant morbidity and mortality. Recent interest in inflammation and the bone-vascular axis suggests a mechanistic link between the two conditions. This review and meta-analysis was conducted to examine the potential association between low bone mineral density (BMD) and CAD in adults. Two authors searched for studies that examined the association between low BMD and CAD. Risk of bias assessment was conducted using the modified Newcastle Ottawa score. Ten studies were selected from the 2258 unique records identified. Pooled analysis showed a significant association between low BMD and CAD (OR 1.65, 95%CI 1.37-2.39, p < 0.01). Subgroup analysis investigating males and females separately was not significant. The subgroup analyses looking for any differences across geographic locations and differences between coronary imaging modalities were also negative. Studies with adjusted ORs (n = 4) were also pooled (OR 3.01, 95%CI 0.91-9.99, p = 0.07). Low BMD is associated with CAD; however, it is unclear whether this result is confounded by common risk factors given the heterogeneity between study populations and methodologies. Further large-scale epidemiological studies are required.
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