Association of cardiovascular disease prevalence with BMD and fracture in men with T2DM
Xiao-Ke Kong1,2, Rui Xie1,2, Deng Zhang1,2
1Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
Lower bone mineral density (BMD) is linked to higher cardiovascular disease (CVD) risk in men with type 2 diabetes. Monitoring femoral neck BMD may help reduce CVD risk in this population.
Area of Science:
- Endocrinology
- Cardiology
- Gerontology
Background:
- Type 2 diabetes mellitus (T2DM) significantly increases cardiovascular disease (CVD) risk.
- Bone mineral density (BMD) has a known association with CVD, yet research has predominantly focused on women.
- This study investigates the relationship between BMD and CVD prevalence specifically in men with T2DM.
Purpose of the Study:
- To explore the association between bone mineral density (BMD) and the prevalence of cardiovascular disease (CVD) in men with type 2 diabetes mellitus (T2DM).
- To determine if BMD measurements can serve as an indicator for CVD risk in this specific demographic.
Main Methods:
- A retrospective cross-sectional study involving 856 men with T2DM.
- Bone mineral density (BMD) measured at the lumbar spine, femoral neck (FN), and total hip (TH) using dual-energy X-ray absorptiometry (DXA).
- Cardiovascular disease (CVD) defined by a composite of major cardiac and cerebrovascular events; associations analyzed using restricted cubic spline curves and logistic regression.
Main Results:
- A total of 163 (19.0%) patients experienced CVD.
- A linear, negative association was observed between femoral neck BMD (FN-BMD), total hip BMD (TH-BMD), and CVD prevalence.
- Each 1-SD decrease in BMD at the lumbar spine, FN, and TH was associated with increased odds of CVD (ORs ranging from 1.26 to 1.34).
- Low BMD T-scores (<-1) at the lumbar spine and FN were independently linked to higher CVD prevalence.
Conclusions:
- Cardiovascular disease (CVD) prevalence is inversely correlated with bone mineral density (BMD) in men with type 2 diabetes mellitus (T2DM).
- The femoral neck (FN) appears to be a particularly sensitive site for this association.
- Monitoring FN-BMD and implementing early interventions, especially for hypertensive patients with T2DM, may mitigate CVD risk.
Background:
Patients with type 2 diabetes mellitus (T2DM) are predisposed to cardiovascular disease (CVD). Bone mineral density (BMD) is linked to CVD, but most studies focused on women. Our analysis aims to explore the association of BMD and fracture with the prevalence of CVD in men with T2DM.
Methods:
In this retrospective cross-sectional study, 856 men with T2DM were enrolled. BMDs at the lumbar spine (L2-4), femoral neck (FN), and total hip (TH) were measured by dual-energy X-ray absorptiometry (DXA). The CVD outcome was determined as the sum of the following conditions: congestive heart failure, coronary heart disease, angina pectoris, myocardial infarction, the requirement for coronary artery revascularization, and stroke. The relationship between BMDs and CVD was investigated by restricted cubic spline curves and logistic regression models.
Results:
A total of 163 (19.0%) patients developed CVD. The restricted cubic spline curve revealed a linear and negative association between FN-BMD, TH-BMD, and CVD. After full adjustments for confounding covariates, the odds ratios were 1.34 (95% confidence interval [CI] [1.11-1.61], p < .05), 1.3 (95% CI [1.05-1.60], p < .05), and 1.26 (95% CI [1.02-1.55], p < .05) for each 1-SD decrease in BMDs of L2-4, FN and TH, respectively. T-scores of < -1 for BMD of L2-4 and FN were independently associated with CVD (p < .05). Subgroup analyses further supported our findings.
Conclusions:
The prevalence of CVD was inversely correlated with BMD levels in men with T2DM, particularly at the FN. We hypothesized that monitoring FN-BMD and early intervention would help reduce CVD risk in men with T2DM, especially those with hypertension.
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