title: Calcified atherosclerotic plaque and bone mineral density in type 2 diabetes: the diabetes heart study.
abstract: The purpose of the present study was to determine the relationships between atherosclerotic calcified plaque (CP) and bone mineral density (BMD) in subjects with type 2 diabetes mellitus (DM2). CP in the coronary arteries, carotid bifurcation, and abdominal aorta was measured using computed tomography (CT) in 1023 diabetic subjects from 453 families. Trabecular volumetric BMD in thoracic (T-vBMD) and lumbar (L-vBMD) spine was measured with quantitative CT (QCT), while areal BMD (aBMD) in the lumbar spine and hip was measured by dual X-ray absorptiometry (DXA). Correlation coefficients were computed to assess the magnitude of associations and generalized estimating equations (GEE1) were used to make statistical inferences while accounting for familial correlation. Subjects were 53.8% female, 85% European American (EA) and 15% African American (AA). After adjustment for age, significant inverse associations between CP and vBMD persisted in EA men (correlations between -0.11 and -0.16, all p<0.05 with the exception of carotid CP vs. T-vBMD, p=0.076) and in AA women, excluding aortic CP (correlations between -0.16 and -0.25, all p<0.05). Estrogen use in AA but not EA women was consistently associated with an inverse relation between CP and vBMD. Significant inverse relationships between CP and vBMD were observed in EA men and AA women with DM2 after adjusting for age and other covariates. QCT determined vBMD was more strongly related to CP than aBMD by DXA. The relation between CP and BMD in diabetes is influenced by age, sex, and ethnicity, with further effect modification by hormone replacement therapy.
authors.affiliation: Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA. jcarr@wfubmc.edu
authors.forename: J Jeffrey
authors.initials: JJ
authors.lastname: Carr
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Register
authors.forename: Fang-Chi
authors.initials: FC
authors.lastname: Hsu
authors.forename: Kurt
authors.initials: K
authors.lastname: Lohman
authors.forename: Leon
authors.initials: L
authors.lastname: Lenchik
authors.forename: Donald W
authors.initials: DW
authors.lastname: Bowden
authors.forename: Carl D
authors.initials: CD
authors.lastname: Langefeld
authors.forename: Jianzhou
authors.initials: J
authors.lastname: Xu
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Rich
authors.forename: Lynne E
authors.initials: LE
authors.lastname: Wagenknecht
authors.forename: Barry I
authors.initials: BI
authors.lastname: Freedman
mesh_terms: D001741:Black or African American; D050197:Atherosclerosis / Q000145:classification* / Q000150:complications / Q000208:ethnology; D015519:Bone Density / Q000187:drug effects / Q000502:physiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000208:ethnology / Q000473:pathology* / Q000503:physiopathology*; D004967:Estrogens / Q000627:therapeutic use; D005060:Europe / Q000208:ethnology; D005260:Female; D006321:Heart; D020249:Hormone Replacement Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D017698:Postmenopause / Q000187:drug effects; D012727:Sex Characteristics; D044465:White People
chemical_list: D004967:Estrogens