Bone mineral density and atherosclerosis: the Multi-Ethnic Study of Atherosclerosis, Abdominal Aortic Calcium Study.
BACKGROUND
Molecular and cell biology studies have demonstrated an association between bone and arterial wall disease, but the significance of a population-level association is less clear and potentially confounded by inability to account for shared risk factors.


OBJECTIVE
To test population-level associations between atherosclerosis types and bone integrity.


METHODS
Volumetric trabecular lumbar bone mineral density (vBMD), ankle-brachial index (ABI), intima-media thickness (IMT) of the common carotid (CCA-IMT) and internal carotid (ICA-IMT) arteries, and carotid plaque echogenicity.


METHODS
A random subset of participants from the Multi-Ethnic Study of Atherosclerosis (MESA) assessed between 2002 and 2005.


RESULTS
904 post-menopausal female (62.4 years; 62% non-white; 12% ABI <1; 17% CCA-IMT >1mm; 33% ICA-IMT >1mm) and 929 male (61.4 years; 58% non-white; 6% ABI <1; 25% CCA-IMT >1mm; 40% ICA-IMT >1mm) were included. In serial, sex-specific regression models adjusting for age, ethnicity, body mass index, dyslipidemia, hypertension, smoking, alcohol consumption, diabetes, homocysteine, interleukin-6, sex hormones, and renal function, lower vBMD was associated with lower ABI in men (p for trend <0.01) and greater ICA-IMT in men (p for trend <0.02). CCA-IMT was not associated with vBMD in men or women. Carotid plaque echogenicity was independently associated with lower vBMD in both men (trend p=0.01) and women (trend p<0.04). In all models, adjustment did not materially affect results.


CONCLUSIONS
Lower vBMD is independently associated with structural and functional measures of atherosclerosis in men and with more advanced and calcified carotid atherosclerotic plaques in both sexes.
Hyder
Joseph A
JA
Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA. joseph.a.hyder@gmail.com
Allison
Matthew A
MA
Barrett-Connor
Elizabeth
E
Detrano
Robert
R
Wong
Nathan D
ND
Sirlin
Claude
C
Gapstur
Susan M
SM
Ouyang
Pamela
P
Carr
J Jeffrey
JJ
Criqui
Michael H
MH
D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000503:physiopathology*; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000208:ethnology / Q000503:physiopathology*; D015519:Bone Density; D002118:Calcium / Q000378:metabolism*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012737:Sex Factors
D002118:Calcium