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Published on: August 28, 2018
Association between coronary artery calcium and thoracic spine bone mineral density: Multiethnic Study of
Venkat S Manubolu1, Song Mao1, April Kinninger1
1Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA, USA.
Insights
Osteoporosis, characterized by low bone mineral density (BMD), is linked to increased coronary artery calcification (CAC) severity. This association between reduced thoracic spine BMD and higher CAC scores was observed in both men and women, independent of other risk factors.
Area of Science:
- Cardiology
- Osteoporosis Research
- Public Health
Background:
- Osteoporosis and coronary artery disease were historically viewed as independent conditions.
- Emerging evidence suggests shared underlying etiologies beyond aging.
- The relationship between bone mineral density and coronary artery calcification requires further elucidation.
Purpose of the Study:
- To investigate the association between thoracic spine bone mineral density (BMD) and the severity of coronary artery calcium (CAC) score.
- To determine if this relationship persists after accounting for traditional cardiovascular risk factors.
Main Methods:
- Analysis of data from the MESA study, a prospective cohort of 6814 participants aged 45-84.
- Utilized non-contrast chest CT scans to assess coronary artery calcium (CAC) and thoracic spine bone mineral density (BMD).
- Categorized thoracic spine BMD into normal, osteopenia, and osteoporosis based on T-scores.
Main Results:
- A significant association was found between lower thoracic spine BMD and increased CAC.
- Prevalence of CAC >0 was 36% in normal BMD, 49% in osteopenia, and 68% in osteoporosis groups.
- After adjusting for risk factors, osteoporosis showed a significant association with CAC (OR: 1.40, 95% CI 1.16-1.69, p < 0.0004).
Conclusions:
- A significant inverse relationship exists between thoracic spine BMD and CAC in both genders, independent of cardiovascular risk factors.
- This finding suggests a potential common pathway linking bone health and cardiovascular calcification.
- Further research is warranted to explore the pathophysiological mechanisms connecting BMD and CAC.
Background And Aims:
Previously, osteoporosis and coronary artery disease were considered unrelated. However, beyond age, these two conditions appear to share common etiologies that are not yet fully understood. We examined the relationship between thoracic spine bone mineral density (BMD) and severity of coronary artery calcium (CAC) score.
Methods And Results:
MESA is a prospective cohort study of 6814 men and women between the ages of 45 and 84 years, without clinical cardiovascular disease. This study included participants who underwent non-contrast chest CT scans to determine CAC score and thoracic spine BMD. The thoracic spine BMD was categorized into osteoporosis (defined as T score: ≤ -2.5), osteopenia (T-score between: -2.5 and -1) and normal BMD (T-score ≥ -1). There were 3392 subjects who had CAC >0 at baseline. The prevalence of CAC >0 was 36% in normal BMD group, 49% in the osteopenia and 68% in osteoporosis group. After adjusting for risk factors of atherosclerosis, in multivariate regression models we found a significant association between CAC and osteoporosis (OR: 1.40, 95% CI 1.16-1.69, p value < 0.0004). Furthermore, we stratified our results by gender and found a statistically significant association in both men and women.
Conclusion:
Results from this cross-sectional analysis of a large population based ethnically diverse cohort indicate a significant inverse relationship between thoracic BMD and CAC in both genders independent of other cardiovascular risk factors. Future studies need to explore the underlying pathophysiological mechanisms relating BMD and coronary artery calcification.
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