title: Ischemic heart disease is associated with lower cortical volumetric bone mineral density of distal radius.
abstract: In this study, high-resolution peripheral quantitative computed tomography (HR-pQCT) was used to investigate geometric, volumetric and microstructural parameters at the distal radius and at the distal tibia in participants with ischaemic heart disease. We found that, compared with participants without ischaemic heart disease, they had substantially lower cortical volumetric bone mineral density (BMD) at the distal radius.
  
  
  BACKGROUND
  HR-pQCT captures novel aspects of bone geometry and volumetric bone mineral density (vBMD) and offers the ability to measure bone microarchitecture, but data relating measures obtained from this technique in patients with ischemic heart disease (IHD) are lacking.
  
  
  METHODS
  Here, we report an analysis from the Hertfordshire Cohort Study, where we were able to study associations between measures obtained from HR-pQCT of distal radius and distal tibia in 350 participants (184 men and 166 women) aged 71.5-80.5 years with or without IHD (e.g. heart attack, angina or heart failure; n = 75 and n = 275, respectively).
  
  
  RESULTS
  Analyses for all participants (men and women together) revealed that cortical vBMD (Ct.vBMD) was lower (p < 0.001) and cortical thickness (Ct.th) was not different (p = 0.519), whereas cortical porosity (Ct.Po) was higher (p = 0.016) in participants with IHD at the distal radius. Moreover, trabecular microarchitectural parameters were not significantly different in patients with IHD (p > 0.05 for all). Adjustment for a priori confounders (age, gender, body mass index, smoking status, alcohol consumption, high blood pressure and diabetes mellitus) did not materially affect the relationship described for Ct.vBMD (p = 0.002), but differences in Ct.Po were attenuated. Analyses in men alone revealed that only Ct.vBMD was lower at the distal radius in participants with IHD with and without adjustment for a priori confounders (p = 0.0002 and p = 0.004, respectively), whereas no statistical differences were found in women, although patterns of differences were similar in both sexes. Moreover, no association was found between IHD and bone parameters at the distal tibia either in men or women.
  
  
  CONCLUSIONS
  We have demonstrated that IHD is associated with lower Ct.vBMD of the distal radius.
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.
authors.forename: J
authors.initials: J
authors.lastname: Paccou
authors.forename: M H
authors.initials: MH
authors.lastname: Edwards
authors.forename: K A
authors.initials: KA
authors.lastname: Ward
authors.forename: K A
authors.initials: KA
authors.lastname: Jameson
authors.forename: C L
authors.initials: CL
authors.lastname: Moss
authors.forename: N C
authors.initials: NC
authors.lastname: Harvey
authors.forename: E M
authors.initials: EM
authors.lastname: Dennison
authors.forename: C
authors.initials: C
authors.lastname: Cooper
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000502:physiology*; D015331:Cohort Studies; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology*; D010024:Osteoporosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D011884:Radius / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D013977:Tibia / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed / Q000379:methods