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Updated: Sep 28, 2025
A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
Published on: June 2, 2022
Associations between bone mineral density and coronary artery calcification: a systematic review and meta-analysis
Peiyu Zhang1, Liu Yang2, Qingwen Xu1
1School of Integrative Medicine, Hunan University of Chinese Medicine, Changsha, China.
Insights
Low bone mineral density (BMD) is linked to a higher prevalence of coronary arterial calcification (CAC). However, this association becomes insignificant when adjusting for age and other factors, suggesting independent aging processes.
Area of Science:
- Cardiovascular Health
- Bone Metabolism
- Gerontology
Background:
- The relationship between bone mineral density (BMD) and coronary arterial calcification (CAC) remains a subject of ongoing scientific debate.
- Existing studies present conflicting findings regarding the correlation between BMD and CAC.
Purpose of the Study:
- To conduct a comprehensive meta-analysis to clarify the association between BMD and CAC.
- To evaluate the prevalence and severity of CAC in individuals with varying BMD levels.
Main Methods:
- Systematic literature search across major databases (PubMed, Embase, Google Scholar, Cochrane Library).
- Inclusion of observational studies, pooling odds ratios (OR) and correlation coefficients with 95% confidence intervals (CI).
- Sub-group analysis and funnel plots were employed to assess heterogeneity and publication bias.
Main Results:
- Seventeen studies met the inclusion criteria.
- Low BMD was associated with a significantly higher prevalence of CAC (OR = 2.11, P=0.02) and increased CAC scores (MD = 33.77, P=0.000).
- However, multivariate logistic regression showed no significant association after adjusting for confounders (age-adjusted OR = 1.00, P=0.95; multivariable-adjusted OR = 0.95, P=0.33).
Conclusions:
- Low BMD is linked to increased prevalence and severity of CAC, particularly in postmenopausal women.
- The association loses statistical significance when accounting for age and other confounding variables.
- Low BMD and CAC may represent independent aging processes, necessitating further high-quality research.
Background:
The studies about the correlation between bone mineral density (BMD) and coronary arterial calcification (CAC) were still controversial. The aim of this study was to conduct a meta-analysis to evaluate the association between BMD and CAC.
Methods:
We systematically searched PubMed, Embase, Google scholar and Cochrane library for observational studies. We pooled odds ratio (OR) or correlation coefficient, and 95% confidence interval (CI) of the studies. Continuous data were pooled by mean difference (MD). Sub-group analysis was applied to investigate sources of heterogeneity. Funnel plots for publication bias was also performed.
Results:
Seventeen studies met the inclusion criteria. Pooled ORs for the prevalence of CAC in patients with low BMD versus patients with normal BMD was 2.11 (95% CI: 1.11 - 4.02, P = 0.02). The data pooled for comparing CAC score of low BMD and normal BMD patients is 33.77 (95% CI: 23.77 - 43.77, p = 0.000). The pooled ORs of multivariate logistic regression to predict the association were 1.00 (95% CI: 0.92 - 1.10, p = 0.95, age-adjusted), and 0.95 (95% CI: 0.86 - 1.05, p = 0.33, multivariable-adjusted). Cohort category and BMD assessment method were the main sources of heterogeneity.
Conclusions:
Low BMD is associated with higher prevalence and severity of CAC, especially in postmenopausal women. But the relation is not significant after adjusting age and other confounding variables. Low BMD and CAC may be two independent processes with aging. More large-scale studies with high-quality design are still needed to increase the understanding of them.
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