title: Osteoporosis and ischemic cardiovascular disease.
abstract: Osteoporosis and cardiovascular disease were long viewed as independent of each other. However, numerous epidemiological studies, which are discussed in the first part of this review, have provided incontrovertible evidence of a link. Thus, the risk of coronary artery disease and stroke is higher in patients with a history of osteoporotic fracture or low bone mineral density than in non-osteoporotic patients. In the other direction, patients with cardiovascular disease are at higher risk for bone loss and osteoporotic fracture. The link between osteoporosis and cardiovascular disease is due in part to shared conventional risk factors such as estrogen deprivation in women, smoking, low physical activity, and diabetes. In addition, atheroma plaque calcification involves cytokines and growth factors that also play a role in bone turnover, including proinflammatory cytokines (IL-6 and TNFα), osteoprotegerin, sclerostin, matrix GLA protein, and FGF-23. Several recent studies have provided support for these pathophysiological hypotheses. Thus, elevation of osteoprotegerin, sclerostin, or FGF-23 levels may explain and predict the occurrence of both osteoporotic fractures and cardiovascular events. The association between osteoporosis and cardiovascular disease found in most epidemiological and pathophysiological studies suggests a need for evaluating potential benefits from routine bone absorptiometry and osteoporotic fracture detection in patients with cardiovascular disease and from exercise testing and arterial Doppler imaging in patients with osteoporosis.
authors.affiliation: Centre de rhumatologie, hôpital Pierre-Paul-Riquet, CHU de Purpan, 1, place du Dr-Baylac, 31059 Toulouse cedex, France. Electronic address: laroche.m@chu-toulouse.fr.
authors.forename: Michel
authors.initials: M
authors.lastname: Laroche
authors.affiliation: Centre de rhumatologie, hôpital Pierre-Paul-Riquet, CHU de Purpan, 1, place du Dr-Baylac, 31059 Toulouse cedex, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Pécourneau
authors.affiliation: Service de rhumatologie, CHU de Nice, 06003 Nice, France.
authors.forename: Hubert
authors.initials: H
authors.lastname: Blain
authors.affiliation: Service de rhumatologie, CHU de Nice, 06003 Nice, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Breuil
authors.affiliation: Service de rhumatologie, CHU E.-Herriot, 69003 Lyon, France.
authors.forename: Roland
authors.initials: R
authors.lastname: Chapurlat
authors.affiliation: Service de rhumatologie, CHU de Lille, 59000 Lille, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Cortet
authors.affiliation: Institut de médecine nucléaire, institut Calot, 62600 Berk-sur-Mer, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Sutter
authors.affiliation: Centre de rhumatologie, hôpital Pierre-Paul-Riquet, CHU de Purpan, 1, place du Dr-Baylac, 31059 Toulouse cedex, France.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Degboe
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000503:physiopathology*; D015897:Comorbidity; D000089703:Fibroblast Growth Factor-23; D006801:Humans; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000503:physiopathology; D010024:Osteoporosis / Q000453:epidemiology* / Q000503:physiopathology*; D012307:Risk Factors
keywords: Atherosclerosis; Cardiovascular disease; Epidemiology; Osteoporosis; Pathophysiology