title: Severity of aortic calcification is positively associated with vertebral fracture in older men--a densitometry study in the STRAMBO cohort.
abstract: In older men, severe abdominal aortic calcification and vertebral fracture (both assessed using dual-energy X-ray absorptiometry) were positively associated after adjustment for confounders including bone mineral density.
  
  
  BACKGROUND
  Abdominal aortic calcification (AAC) is associated with higher fracture risk, independently of low bone mineral density (BMD). Dual-energy X-ray absorptiometry (DXA) can be used to assess both vertebral fracture and AAC and requires less time, cost, and radiation exposure.
  
  
  METHODS
  We conducted a cross-sectional study of the association between AAC and prevalent vertebral fractures in 901 men≥50 years old. We used DXA (vertebral fracture assessment) to evaluate BMD, vertebral fracture, and AAC.
  
  
  RESULTS
  Prevalence of vertebral fracture was 11%. Median AAC score was 1 and 12% of men had AAC score>6. After adjustment for age, weight, femoral neck BMD, smoking, ischemic heart disease, diabetes, and hypertension, AAC score>6 (vs ≤6) was associated with 2.5 (95% CI, 1.4-4.5) higher odds of vertebral fracture. Odds of vertebral fracture for AAC score>6 increased with vertebral fracture severity (grade 1, OR=1.8; grade 2, OR=2.4; grade 3, OR=4.4; trend p<0.01) and with the number of vertebral fractures (1 fracture, OR=2.0, >1 fracture, OR=3.5). Prevalence of vertebral fracture was twice as high in men having both a T-score<-2.0 and an AAC score>6 compared with men having only one of these characteristics.
  
  
  CONCLUSIONS
  Men with greater severity AAC had greater severity and greater number of vertebral fractures, independently of BMD and co-morbidities. DXA can be used to assess vertebral fracture and AAC. It can provide a rapid, safe, and less expensive alternative to radiography. DXA may be an important clinical tool to identify men at high risk of adverse outcomes from osteoporosis and cardiovascular disease.
authors.affiliation: INSERM UMR 1033, University of Lyon, Hospices Civils de Lyon, Lyon, France. pawel.szulc@inserm.fr
authors.forename: P
authors.initials: P
authors.lastname: Szulc
authors.forename: E J
authors.initials: EJ
authors.lastname: Samelson
authors.forename: E
authors.initials: E
authors.lastname: Sornay-Rendu
authors.forename: R
authors.initials: R
authors.lastname: Chapurlat
authors.forename: D P
authors.initials: DP
authors.lastname: Kiel
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D015519:Bone Density / Q000502:physiology; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D015995:Prevalence; D012720:Severity of Illness Index; D016103:Spinal Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D013904:Thoracic Vertebrae / Q000293:injuries; D061205:Vascular Calcification / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D055815:Young Adult