title: Femoral neck and spine bone mineral density-Surrogate marker of aortic calcification in postmenopausal women.
abstract: OBJECTIVE
  Osteoporosis and abdominal aortic calcification (AAC) are associated with increased morbidity and mortality in postmenopausal women. The aim of this study was to determine the accuracy of anterior-posterior (AP) dual-energy X-ray absorptiometry (DXA) compared with that of X-ray lateral lumbar radiography (LLR) in detecting and scoring AAC.
  
  
  METHODS
  In this cross-sectional study conducted in 56 postmenopausal asymptomatic females aged 59.0 ± 9.3 years and who never used medications to treat osteoporosis before, we determined femoral neck and lumbar spine bone mineral density (BMD) by AP DXA and AAC by X-ray LLR. We hypothesized that the subtracted femoral neck BMD (BMDFN) from lumbar spine BMD (BMDLS) presented as ΔBMD=BMDLS-BMDFN would have a diagnostic value in detecting abdominal vascular calcification.
  
  
  RESULTS
  The mean BMDFN was 0.744 ± 0.184 g/cm(2), and the mean BMDLS was 0.833 ± 0.157 g/cm(2) (p<0.0001); the mean ΔBMD was 0.089 ± 0.077 g/cm(2), and the mean AAC score was 2.182 ± 1.982. Bivariate Pearson's correlation analysis revealed a significant positive correlation between AAC and ΔBMD (r=0.449, p=0.0006); by linear regression analysis, R(2)=0.2019, and by multiple regression analysis, βst=13.5244 (p<0.0001). We found a sensitivity of 64.3% and specificity of 82.9% by receiver operating characteristic [ROC; area under the ROC curve (AUC=0.759)] in the prediction of AAC by ΔBMD.
  
  
  CONCLUSIONS
  This AP subtracting BMD DXA method provides a useful tool for detecting and scoring subclinical and extensive AAC in postmenopausal women using a simple, semiquantitative, and accurate scoring system with minimal radiation exposure and low cost.
authors.affiliation: Department of Internal medicine, JZU Clinical Hospital "D-r Trifun Panovski"; Bitola-Republic of Macedonia. avramovski@gmail.com.
authors.forename: Petar
authors.initials: P
authors.lastname: Avramovski
authors.forename: Maja
authors.initials: M
authors.lastname: Avramovska
authors.forename: Miroslav
authors.initials: M
authors.lastname: Lazarevski
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Sikole
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D001011:Aorta / Q000473:pathology*; D050197:Atherosclerosis / Q000503:physiopathology*; D015415:Biomarkers; D015519:Bone Density; D003430:Cross-Sectional Studies; D005260:Female; D005269:Femur / Q000473:pathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging*; D017698:Postmenopause; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers