scholarly journals The association between low bone mineral density and coronary artery calcification in osteoporotic and non-osteoporotic patients in a tertiary center in Saudi Arabia

2021 ◽  
Vol 41 (2) ◽  
pp. 101-108
Author(s):  
Ahmed L. Fathala ◽  
Sami Alkulaybi ◽  
Abdulrahman Khawaji ◽  
Abdelghafour Alomari ◽  
Ahmed Almuhaideb
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Saudi Arabia ◽  
Coronary Artery ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Coronary Artery Calcification ◽  
Mineral Density ◽  
Cad Risk

BACKGROUND: Cardiovascular disease (CVD) and osteoporosis are major health-care concerns worldwide. The evidence is contradictory on whether a relationship exists between low bone mineral density (BMD) determined by dual-energy absorptiometry (DXA scan) and coronary artery calcification (CAC) measured by computed tomography. Currently, there are no data on patients from Saudi Arabia. OBJECTIVE: Examine the relationship between CAC and BMD in both genders and study the influence of traditional coronary artery disease (CAD) risk factors and osteoporosis. DESIGN: Retrospective, cross-sectional, analytical. SETTING: Single tertiary care center. PATIENTS AND METHODS: We searched radiology databases for patients who underwent both DXA and CAC score scanning within six months of each other. The inclusion criterion was an absence of any history of CAD. MAIN OUTCOME MEASURE: Association between osteoporosis and CAC. SAMPLE SIZE: 195 (34 osteoporosic, 161 normal BMD or osteopenic) RESULTS: Most of the study population (57.4%) were females. The mean age of all patients was 63.6 (10.1) years. Participants with CAC scores of 0 were significantly younger than those who had CAC scores >0. The presence of diabetes mellitus, hypertension, and hypercholesterolemia was higher in patients with CAC scores >0. CAC score and other CAD risk factors were not significantly different between the osteoporotic and nonosteoporotic groups, except for body mass index. A high CAC score (>100) was present in 28%, 20%, 11%, and 30% of participants with no osteoporosis, osteoporosis of the lumbar spine, osteoporosis of the femoral neck, and participants with osteoporosis of both the lumbar spine and femoral neck, respectively ( P =.762), suggesting there is no association between CAC and the presence of osteoporosis. CONCLUSIONS: Osteoporosis is not associated with higher CAC scores in Saudi Arabia and CAD risk factors are not significantly prevalent in osteoporosis. It appears that CAC and osteoporosis are independent age-related diseases that share common risk factors. LIMITATIONS: Single-center, retrospective. CONFLICT OF INTEREST: None.

scholarly journals Coronary Artery Calcification is Inversely Related to Bone Mineral Density in Young Women:

Circulation ◽  
2001 ◽  
Vol 103 (suppl_1) ◽  
pp. 1344-1344
Author(s):  
Pamela J Schreiner ◽  
Cora E Lewis ◽  
Robert C Detrano ◽  
Stephen B Hulley
Keyword(s):  
Bone Mineral Density ◽  
Coronary Artery ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Postmenopausal Women ◽  
Young Women ◽  
Coronary Artery Calcification ◽  
Subclinical Atherosclerosis ◽  
Calcium Score ◽  
Mineral Density

0003 Coronary artery calcification (CAC), a marker of subclinical atherosclerosis, is related to low bone mineral density (BMD) in postmenopausal women, potentially due to age or declining estrogen levels. Little is known about this association in premenopausal women. During the Year 10 CARDIA Study, BMD was measured by dual energy X-ray absorptiometry at the hip (pelvis, femoral neck, intertrochanteric (IT) region, Ward’s triangle) and the lumbar spine in a subgroup; CAC was measured in a different subgroup by electron beam tomography within the same year. A calcium score was calculated as the product of an area of potential calcification covered by 6 adjacent pixels and the peak CT number within that region; a calcium score >0 indicates the presence of any CAC. Data for both measures were available for 75 women, ages 29-41 years (mean age 35 years). CAC was present in 14.7% of these young women. Mean weight was 75.2±19.1 kg, range 48.6 to 124.4 kg. Mean areal BMD was consistent with the age and reproductive status of these women: 1.18, 0.89, 1.15, and 0.83 g/cm 2 for the pelvis, femoral neck, IT region and Ward’s triangle, respectively; and 1.09 g/cm 2 for the lumbar spine. Cross-sectional logistic regression was performed to determine the crude association between BMD and CAC. BMD was not related to CAC at any site. Weight, however, was strongly associated with CAC, with a prevalence odds ratio (pOR) of 2.53 (95% CI 1.43, 4.49) for a 1-sd increment in weight. When weight was considered as a confounder to the association between BMD and CAC, BMD in the IT region was inversely related to CAC, with a 1-sd (0.17 g/cm 2 ) decrement in the IT region BMD associated with a 233% increase in the odds of CAC (pOR=3.33, 95% CI 1.08, 10.4). This association was not materially affected by adjustment for age, ethnicity, or height. Nearly identical results were seen for CARDIA men, with an inverse association between IT region BMD and CAC after adjustment for weight. These data suggest that in a population-based group of young women with low prevalence of either osteopenia or osteoporosis, lower BMD may be a marker of subclinical atherosclerosis, comparable to findings in postmenopausal women.

scholarly journals Association of Bone Mineral Density and Coronary Artery Calcification in Patients with Osteopenia and Osteoporosis

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 699
Author(s):  
Tzyy-Ling Chuang ◽  
Malcolm Koo ◽  
Yuh-Feng Wang
Keyword(s):  
Bone Mineral Density ◽  
Coronary Artery ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Coronary Artery Calcification ◽  
Multinomial Logistic Regression ◽  
Mineral Density ◽  
Increased Risk ◽  
Southern Taiwan ◽  
Significant Factors

The aim of this study was to investigate the association between bone mineral density (BMD) and coronary artery calcification (CAC) in adults with osteopenia or osteoporosis. A retrospective medical review study was conducted in a regional hospital in southern Taiwan. Medical records of patients who underwent both a coronary computed tomography scan and a BMD measurement were identified. Multinomial logistic regression analyses were used to assess the association between BMD and CAC levels in patients with osteopenia or osteoporosis. Of the 246 patients, 119 were female and 42.3% had CAC. For patients with osteopenia, after adjusting for the significant factors of CAC, no significant association was observed between BMD with either moderate CAC (0 < CAC score ≤ 100) or high CAC (CAC score > 100). However, in patients with osteoporosis, after adjusting for the significant factors of CAC, BMD in the lumbar spine was inversely associated with moderate CAC (odds ratio = 0.38, p = 0.035). In conclusion, a lower BMD in the lumbar spine was associated with an increased risk of moderate CAC in patients with osteoporosis. It is crucial to take action to maintain bone health, particularly in those who already have osteoporosis, to reduce the risk of developing CAC and its associated morbidity and mortality.

scholarly journals P129 Predictors of low bone mineral density in rheumatoid arthritis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Malika A Swar ◽  
Marwan Bukhari
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Bone Mineral Density ◽  
Family History ◽  
Bone Loss ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Fragility Fracture ◽  
Mineral Density ◽  
History Of

Abstract Background/Aims  Osteoporosis (OP) is an extra-articular manifestation of rheumatoid arthritis (RA) that leads to increased fracture susceptibility due to a variety of reasons including immobility and cytokine driven bone loss. Bone loss in other populations has well documented risk factors. It is unknown whether bone loss in RA predominantly affects the femoral neck or the spine. This study aimed to identify independent predictors of low bone mineral density (BMD) in patients RA at the lumbar spine and the femoral neck. Methods  This was a retrospective observational cohort study using patients with Rheumatoid arthritis attending for a regional dual X-ray absorptiometry (DEXA) scan at the Royal Lancaster Infirmary between 2004 and 2014. BMD in L1-L4 in the spine and in the femoral neck were recorded. The risk factors investigated were steroid use, family history of osteoporosis, smoking, alcohol abuse, BMI, gender, previous fragility fracture, number of FRAX(tm) risk factors and age. Univariate and Multivariate regression analysis models were fitted to explore bone loss at these sites using BMD in g/cm2 as a dependant variable. . Results  1,527 patients were included in the analysis, 1,207 (79%) were female. Mean age was 64.34 years (SD11.6). mean BMI was 27.32kg/cm2 (SD 5.570) 858 (56.2%) had some steroid exposure . 169(11.1%) had family history of osteoporosis. fragility fracture history found in 406 (26.6%). 621 (40.7%) were current or ex smokers . There was a median of 3 OP risk factors (IQR 1,3) The performance of the models is shown in table one below. Different risk factors appeared to influence the BMD at different sites and the cumulative risk factors influenced BMD in the spine. None of the traditional risk factors predicted poor bone loss well in this cohort. P129 Table 1:result of the regression modelsCharacteristicB femoral neck95% CIpB spine95%CIpAge at scan-0.004-0.005,-0.003&lt;0.01-0.0005-0.002,0.00050.292Sex-0.094-0.113,-0.075&lt;0.01-0.101-0.129,-0.072&lt;0.01BMI (mg/m2)0.0080.008,0.0101&lt;0.010.01130.019,0.013&lt;0.01Fragility fracture-0.024-0.055,0.0060.12-0.0138-0.060,0.0320.559Smoking0.007-0.022,0.0350.650.0286-0.015,0.0720.20Alcohol0.011-0.033,0.0 5560.620.0544-0.013,0.1120.11Family history of OP0.012-0.021,0.0450.470.0158-0.034,0.0650.53Number of risk factors-0.015-0.039,0.0080.21-0.039-0.075,-0.0030.03steroids0.004-0.023,0.0320.030.027-0.015,0.0690.21 Conclusion  This study has shown that predictors of low BMD in the spine and hip are different and less influential than expected in this cohort with RA . As the FRAX(tm) tool only uses the femoral neck, this might underestimate the fracture risk in this population. Further work looking at individual areas is ongoing. Disclosure  M.A. Swar: None. M. Bukhari: None.

scholarly journals AB0910 SARCOPENIA AND BONE MINERAL DENSITY IN MEN WITH CORONARY HEART DISEASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1757.2-1757
Author(s):  
T. Raskina ◽  
I. Grigoreva ◽  
J. Averkieva ◽  
A. Kokov ◽  
V. Masenko
Keyword(s):  
Bone Mineral Density ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Muscle Mass ◽  
Bone Mineral ◽  
Mineral Density ◽  
Group 3 ◽  
Group 2

Objectives:To examine bone mineral density (BMD) in men with coronary heart disease (CHD), depending on the state of the muscle mass, strength and function.Methods:79 men aged over 50 years with verified CHD were examined (mean age 63 (57; 66) years).The BMD and T-criterion (standart deviation, SD) of the femoral neck and lumbar spine (L1-L4) were evaluated using dual-energy x-ray absorptiometry (DXA) on the Lunar Prodigy Primo bone densitometer (USA). The following reference intervals were used: normal BMD values (T-criterion ≥-1), osteopenia (OPe) (T-criterion from -1 to -2.5), and osteoporosis (OP) (T-criterion <-2.5).To assess muscle mass, the total area (cm2) of the lumbar muscles of the axial section at the level of the 3rd lumbar vertebra (L3) was determined using multispiral computed tomography on a 64-slice computer tomograph “Somatom Sensation 64” (Siemens AG Medical Solution, Germany). The ratio of the obtained index of the area of skeletal muscle to the square of the patient’s growth index determined the “ skeletalmuscular index L3” (SMI). The media considered the threshold value to be 52.4 cm2/m2.Results:The femoral neck BMD in the examined patients was 0.96 (0.89; 1.03) g/cm2, which corresponds to -0.50 (-1.00; 0) SD according to the T-criterion, in the lumbar spine -1.23 (1.11; 1.32) g/cm2and 0.4 (-0.50; 1.20) SD according to the T-criterion.In accordance with the recommendations of the European working group on sarcopenia in Older people (EWGSOP, 2010, 2018), the patients were divided into 3 groups: 31 patients without sarcopenia (group 1), 21 patients with isolated muscle loss (presarcopenia) (group 2) and 27 patients with sarcopenia (group 3).BMD in the femoral neck in the group of patients without sarcopenia was 0.96 (0.72; 1.26) g/cm2, which corresponds to -0.50 (-0.8; 0.2) SD according to the T-criterion, in the lumbar spine – 1.19 (1.10; 1.275) g/cm2and 0.1 (-0.6; 0.8) SD according to the T-criterion. BMD in the femoral neck in the group of patients with presarcopenia (group 2) – 0.995 (0.94; 1.04) g/cm2and -0.3 (-0.70; 0) SD according to the T-criterion, in the lumbar spine – 1.32 (1.24; 1.40) g/cm2and 1.20 (0.50; 1.90) SD according to the T-criterion. In patients with established sarcopenia (group 3), the following indicators of BMD and T-criterion were recorded: 0.95 (0.845; 0.98) g/cm2and -0.60 (-1.40; -0.40) SD and 1.23 (0.085; 1.31) g/cm2and 0.4 (-0.8; 1.1) SD in the femoral neck and lumbar spine, respectively.A comparative analysis of the results of the DXA found that patients with sarcopenia had a significant decrease in the BMD and T-criterion in the femoral neck compared to patients with presarcopenia (p=0.039 and p=0.040, respectively). There were no differences between the groups of patients without sarcopenia and with sarcopenia and presarcopenia (p>0.05).It was found that patients with sarcopenia had significantly lower BMD and T-criterion in the lumbar spine compared to patients with presarcopenia (p=0.017 and p=0.0165, respectively). The values of the BMD and T-criterion in the groups of patients without sarcopenia and with presarcopenia and sarcopenia in the lumbar spine were comparable (p>0.05).Conclusion:The presence of sarcopenia is associated with loss of BMD in the femoral neck and in the lumbar spine. The results obtained confirm the high probability of common pathogenetic links between OP and sarcopenia.Disclosure of Interests:None declared

scholarly journals Bone mineral density predictors in long-standing type 1 and type 2 diabetes mellitus

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stefana Catalina Bilha ◽  
Letitia Leustean ◽  
Cristina Preda ◽  
Dumitru D. Branisteanu ◽  
Laura Mihalache ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Mineral Density ◽  
Cross Sectional ◽  
The Impact

Abstract Background Despite the increased fracture risk, bone mineral density (BMD) is variable in type 1 (T1D) and type 2 (T2D) diabetes mellitus. We aimed at comparing independent BMD predictors in T1D, T2D and control subjects, respectively. Methods Cross-sectional case-control study enrolling 30 T1D, 39 T2D and 69 age, sex and body mass index (BMI) – matched controls that underwent clinical examination, dual-energy X-ray absorptiometry (BMD at the lumbar spine and femoral neck) and serum determination of HbA1c and parameters of calcium and phosphate metabolism. Results T2D patients had similar BMD compared to T1D individuals (after adjusting for age, BMI and disease duration) and to matched controls, respectively. In multiple regression analysis, diabetes duration – but not HbA1c- negatively predicted femoral neck BMD in T1D (β= -0.39, p = 0.014), while BMI was a positive predictor for lumbar spine (β = 0.46, p = 0.006) and femoral neck BMD (β = 0.44, p = 0.007) in T2D, besides gender influence. Age negatively predicted BMD in controls, but not in patients with diabetes. Conclusions Long-standing diabetes and female gender particularly increase the risk for low bone mass in T1D. An increased body weight partially hinders BMD loss in T2D. The impact of age appears to be surpassed by that of other bone regulating factors in both T1D and T2D patients.

scholarly journals Lack of Association between Pulse Steroid Therapy and Bone Mineral Density in Patients with Multiple Sclerosis

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Serap Zengin Karahan ◽  
Cavit Boz ◽  
Sevgi Kilic ◽  
Nuray Can Usta ◽  
Mehmet Ozmenoglu ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Steroid Therapy ◽  
Negative Relationship ◽  
High Dose ◽  
Mineral Density ◽  
Factors Affecting

Multiple sclerosis (MS) has been associated with reduced bone mineral density (BMD). The purpose of this study was to determine the possible factors affecting BMD in patients with MS. We included consecutive 155 patients with MS and 90 age- and sex-matched control subjects. Patients with MS exhibited significantly lowerT-scores andZ-scores in the femoral neck and trochanter compared to the controls. Ninety-four (61%) patients had reduced bone mass in either the lumbar spine or the femoral neck; of these, 64 (41.3%) had osteopenia and 30 (19.4%) had osteoporosis. The main factors affecting BMD were disability, duration of MS, and smoking. There was a negative relationship between femoral BMD and EDSS and disease duration. No association with lumbar BMD was determined. There were no correlations between BMD at any anatomic region and cumulative corticosteroid dose. BMD is significantly lower in patients with MS than in healthy controls. Reduced BMD in MS is mainly associated with disability and duration of the disease. Short courses of high dose steroid therapy did not result in an obvious negative impact on BMD in the lumbar spine and femoral neck in patients with MS.

Estimation of Central Osteopenia in Children With Chronic Polyarthritis Treated With Glucocorticoids

PEDIATRICS ◽  
1993 ◽  
Vol 91 (6) ◽  
pp. 1127-1130
Author(s):  
Antero Kotaniemi ◽  
Anneli Savolainen ◽  
Hannu Kautiainen ◽  
Heikki Kröger
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Bone Size ◽  
Mineral Density ◽  
Volumetric Density ◽  
Chronic Polyarthritis ◽  
The Mean ◽  
Bone Volumetric Density

Study objective. To investigate the degree and determinants of osteopenia in juvenile chronic polyarthritis. Design. Retrospective case-control study of central bone mineral density. Setting. Rheumatism Foundation Hospital and Kuopio University Hospital, Finland. Subjects. A sample of 43 girls aged 7 to 19 with juvenile chronic polyarthritis treated with systemic glucocorticoids and a control sample of 44 healthy girls matched for age. Main outcome measures. Bone mineral density and bone size (width) measured by dual-energy x-ray absorptiometry and bone volumetric density calculated as an approximation of true bone density at both the lumbar spine and femoral neck. Results. The girls with juvenile chronic arthritis had reduced bone mineral density, bone size, and bone volumetric density at both the lumbar spine and femoral neck (statistically significant findings, P = .022 for the bone size of the femoral neck and P &lt; .001 for the other parameters). At the spine, the mean bone mineral density was 80%, the mean bone size 89%, and the mean bone volumetric density 89% of the values in the control group. At the femoral neck, the values were 78%, 93%, and 83%, respectively. The groups were matched for age, but the girls with arthritis were smaller and lighter. In the juvenile arthritis group, the femoral bone mineral density and bone volumetric density and the spinal bone width correlated negatively with the mean glucocorticoid dose. Conclusion. Axial bone mineral density is clearly reduced in severe juvenile polyarthritis and is mediated by both decreased bone volumetric density and diminished growth.

scholarly journals Divergent Significance of Bone Mineral Density Changes in Aging Depending on Sites and Sex Revealed through Separate Analyses of Bone Mineral Content and Area

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Yasumoto Matsui ◽  
Marie Takemura ◽  
Atsushi Harada ◽  
Fujiko Ando ◽  
Hiroshi Shimokata
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral Content ◽  
Bone Mineral ◽  
Mineral Content ◽  
Neck Region ◽  
Community Dwelling ◽  
Mineral Density ◽  
Area Change

Bone mineral density (aBMD) is equivalent to bone mineral content (BMC) divided by area. We rechecked the significance of aBMD changes in aging by examining BMC and area separately. Subjects were 1167 community-dwelling Japanese men and women, aged 40–79 years. ABMDs of femoral neck and lumbar spine were assessed by DXA twice, at 6-year intervals. The change rates of BMC and area, as well as aBMD, were calculated and described separately by the age stratum and by sex. In the femoral neck region, aBMDs were significantly decreased in all age strata by an increase in area as well as BMC loss in the same pattern in both sexes. In the lumbar spine region, aBMDs decreased until the age of 60 in women, caused by the significant BMC decrease accompanying the small area change. Very differently in men, aBMDs increased after their 50s due to BMC increase, accompanied by an area increase. Separate analyses of BMC and area change revealed that the significance of aBMD changes in aging was very divergent among sites and between sexes. This may explain in part the dissociation of aBMD change and bone strength, suggesting that we should be more cautious when interpreting the meaning of aBMD change.

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