title: Decreased bone cortical density at the forearm in subjects with subclinical peripheral arterial disease.
abstract: The association between peripheral arterial disease (PAD) and low bone mass is controversial. In our study, peripheral quantitative computed tomography shows a reduction of cortical but not trabecular, bone mineral density (BMD) at the forearm, in patients with subclinical PAD.
  
  
  BACKGROUND
  Some controversy exists regarding the association between peripheral arterial disease (PAD) and low bone mass. Previous studies have evaluated bone mineral density (BMD) in patients with subclinical PAD, with mixed results. Inconsistency of data may depend on the fact that most studies measured areal bone mineral density (aBMD) by Dual-energy-x ray absorptiometry (DXA). Because DXA cannot distinguish between cortical and trabecular compartments, we reasoned that a study aimed to establish whether these compartments were differentially affected by PAD status could give more information on the nature of this association.
  
  
  METHODS
  In this cross-sectional study, we used peripheral quantitative computed tomography (pQCT) to examine volumetric cortical and trabecular mineral density at the radius (vBMD) in a cohort of subjects with subclinical PAD as defined by ABI ≤0.90 and compared them with healthy subjects with no evidence of PAD.
  
  
  RESULTS
  Patients with subclinical PAD had significantly reduced cortical density (1101.0 ± 45.4 vs 1156.2 ± 51.3 mg/cm(3), p < 0.001) and cortical area (75.0 ± 20.9 vs 99.9 ± 18.2 mm(2), p < 0.001) than healthy subjects. Trabecular density (178.1 ± 47.9 vs 165.8 ± 29.6 mg/cm(3)) was not significantly different in the two groups.
  
  
  CONCLUSIONS
  Subclinical PAD induces a selective bone loss at the radius compartment, not identified by standard DXA, which seems to occur primarily at the cortical level.
authors: Department of Clinical and Experimental Medicine, Section of Metabolic Bone Disease, University of Catania, Clinica Medica OVE, Via Plebiscito 628, 95124, Catania, Italy.
authors: A
authors: A
authors: Gaudio
authors: Department of Clinical and Experimental Medicine, Section of Metabolic Bone Disease, University of Catania, Clinica Medica OVE, Via Plebiscito 628, 95124, Catania, Italy.
authors: F
authors: F
authors: Muratore
authors: Department of Clinical and Experimental Medicine, Section of Vascular Medicine, Medical Angiology Unit, University of Catania, Garibaldi Hospital, Piazza S. Maria di Gesù 5, 95123, Catania, Italy.
authors: V
authors: V
authors: Fiore
authors: Department of Clinical and Experimental Medicine, Section of Metabolic Bone Disease, University of Catania, Clinica Medica OVE, Via Plebiscito 628, 95124, Catania, Italy.
authors: R
authors: R
authors: Rapisarda
authors: Department of Clinical and Experimental Medicine, Section of Vascular Medicine, Medical Angiology Unit, University of Catania, Garibaldi Hospital, Piazza S. Maria di Gesù 5, 95123, Catania, Italy.
authors: S S
authors: SS
authors: Signorelli
authors: Department of Clinical and Experimental Medicine, Section of Metabolic Bone Disease, University of Catania, Clinica Medica OVE, Via Plebiscito 628, 95124, Catania, Italy. carmelo.fiore@tin.it.
authors: C E
authors: CE
authors: Fiore
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000368:Aged; D015519:Bone Density / Q000502:physiology; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D005542:Forearm / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D053245:RANK Ligand / Q000097:blood; D011884:Radius / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D053245:RANK Ligand; C505688:TNFSF11 protein, human
keywords: Cortical density; PAD; RANKL; pQCT