01.01 LOW BONE MINERAL DENSITY IS ASSOCIATED WITH GREATER AORTIC PULSE-WAVE VELOCITY IN WOMEN: THE NORTHERN IRELAND YOUNG HEARTS PROJECT (NIYHP)

Introduction: Increased vascular stiffness is a risk factor for mortality. We wished to determine whether changes in vascular stiffness are associated with changes in bone mineral density (BMD) in peritoneal dialysis patients. Methods: We measured vascular stiffness by aortic pulse wave velocity (aPWV) and BMD by dual electron absorptiometry (DXA) scanning and compared T scores to compensate for differences in patient ages and gender. Results: Twenty-four patients had repeat aPWV measurements and DXA scans, median 12.4 months apart. aPWV decreased in 15 and increased in 9. As there were more women in the group with an increase in aPWV, we used gender-adjusted DXA T scores Total body T scores fell in both groups, but median T scores remained positive for those with an increase in aPWV, whereas negative T scores on both scans for those with a decrease in or stable aPWV. Lumbar spine T scores fell in those with a reduction in aPWV (–1.6 [–2.4 to 0.6] to –2.1 [–2.4 to 0.3], p < 0.05), whereas there was no significant decrease in those with an increase in aPWV (–0.5 [–1.1 to 0.15] to –0.7 [–1.7 to 0.6]). There were no changes in femoral neck T scores. Conclusions: Our study reinforces the hypothesis of a link between bone disease and vascular disease in dialysis patients. Lumbar spine DXA includes imaging of the aorta and will include aortic calcification, and as such a reduction in lumbar spine T score without a change in femoral neck T score suggests a reduction in aortic calcification. Although our study requires additional confirmation, our data would suggest that changes in aPWV could be used as a surrogate for changes in vascular calcification in the investigation of interventions designed to reduce vascular calcification.

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Bone Mineral Density, Vascular Calcifications, and Arterial Stiffness in Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.1177/089686080802800621 ◽

2008 ◽

Vol 28 (6) ◽

pp. 668-672 ◽

Cited By ~ 9

Author(s):

Teresa Adragao ◽

Patrícia Branco ◽

Rita Birne ◽

José Dias Curto ◽

Edgar de Almeida ◽

...

Keyword(s):

Bone Mineral Density ◽

Peritoneal Dialysis ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Pulse Wave ◽

Dialysis Patients ◽

Mineral Density ◽

Vascular Calcifications ◽

Calcification Score

The objective of this study was to evaluate the correlation of bone mineral density (BMD), evaluated by DXA, with vascular calcifications, arterial stiffness, and vascular disease in patients on peritoneal dialysis. Vascular calcifications were evaluated by vascular calcification score on plain x ray, and arterial stiffness was measured by pulse wave velocity using the Complior device (Artech Medical, Pantin, France). Adjusting for multiple factors, lower BMD at the femoral neck, but not at the lumbar spine, was associated with higher pulse wave velocity ( p = 0.037), higher vascular calcification score ( p = 0.013), and peripheral artery disease ( p = 0.006). These data reinforce the hypothesis of the existence of a link between bone disease and cardiovascular disease in dialysis patients.

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