Coronary Artery Calcium Score and Bone Metabolism: A Pilot Study in Postmenopausal Women.
BACKGROUND
Since 1991 many studies evaluated the link between cardiovascular diseases and osteoporosis, two age-related conditions, but the main common pathologic pathway has not been determined yet. The histological similarity between arterial calcified plaque and bone matrix and involvement of similar cells and mediators provide a special field of research. Therefore in the present study, we aimed to evaluate the relationship between coronary artery calcium score (CACS) as a surrogate marker of atherosclerosis and bone mediators and parameters in postmenopausal women.


METHODS
Eleven postmenopausal women who had CACS higher than 80 were enrolled into the study and underwent bone densitometry. In addition, their serum and urine samples were taken for measuring osteoprotegerin, osteocalcin, and β cross laps. Patients' 10-year probability of fracture was calculated by the World Health Organization fracture-risk assessment tool (FRAX).


RESULTS
The regression analysis of our results showed the association between CACS and OC (std β=0.66, 95% confidence interval [CI] 5.47-72.27,P=0.027), femoral bone density (std β=-0.6, 95% CI -6864.34-14.27,P=0.05) and T-score (std β=-0.6, 95% CI -773.08-1.28,P=0.05) which remained significant after adjustment for age, weight, years since menopause and body mass index. No association was found between CACS and osteoprotegerin, spinal bone density and FRAX score.


CONCLUSIONS
In conclusion, this pilot study with small sample size showed the potential association between CACS and osteocalcin, femoral bone density and T-score. However, the relationship between CACS and osteoprotegerin, receptor activator of nuclear factor-kappa B ligand, FRAX score and other bone parameters remain to be clarified in larger sample size studies.
Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Pooneh
P
Salari
Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Abbasali
A
Keshtkar
Head of Imaging Center, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Shapour
S
Shirani
Department of Epidemiology, Center for Academic and Health Policy, and Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Leila
L
Mounesan
Bone density; Calcium; Coronary artery disease; Osteocalcin; Osteoprotegerin