Associations of subclinical manifestations of coronary and carotid artery atherosclerosis with bone strength parameters in asymptomatic women

Summary

We studied the associations between the state of the vascular wall in the coronary and carotid arteries with bone mineral density (BMD) and the bone turnover marker.

Purpose

To examine the associations of arterial stiffness, atherosclerotic plaque (ASP) and coronary artery calcification (CAC) parameters with BMD and bone resorption marker CTX.

Methods

Our cross-sectional study included 357 outpatient—women 45 to 82 years of age. Intima-media thickness (IMT), presence, and number of ASP in the carotid arteries were studied using duplex ultrasound imaging. Pulse wave velocity (PWV) and augmentation index (AI) were assessed via applanation tonometry method. Coronary artery calcification (CAC) on multislice computed tomography was scored using the Agatston calcium index (ACI). BMD was measured using by dual-energy X-ray absorptiometry (DXA). The C-terminal telopeptide of type 1 collagen (CTX) was investigated by enzyme-linked immunosorbent assay.

Results

Women with osteoporosis had higher IMT values (p = 0.045), more ASP (p < 0.001), and higher ACI (p < 0.001) than those with normal BMD values. In a multivariate linear regression analysis adjusted for age, duration of postmenopause, BMI, and levels of CTX and ALP in blood serum, we confirmed that ACI makes an independent contribution to the reduction in BMD of all measured parts of the skeleton, while IMT and the presence of ASP contribute to the reduction in BMD of femoral neck.

Conclusion

The results of our study demonstrated an association between vascular calcification, the presence of ASP in the carotid arteries and low bone mass in women without clinical manifestations of atherosclerosis, which is of clinical significance and important for the prevention of both osteoporotic fractures and cardiovascular incidents.