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Song, Park, Yoo, Koh, Kang, Kim, Kim, Cho, Cho, and Kim: Association of Coronary Artery Disease and Osteoporotic Vertebral Fracture in Korean Men and Women
Original Article
Endocrinology and Metabolism

Endocrinology and Metabolism 2012; 27(1): 39-44.

Published online: 21 March 2012

DOI: https://doi.org/10.3803/EnM.2012.27.1.39

Association of Coronary Artery Disease and Osteoporotic Vertebral Fracture in Korean Men and Women

Sun Ok Song, Kyung-Won Park1, Seung-Hoon Yoo1, Won-Jun Koh1, Byung-Soo Kang1, Tae Ho Kim1, Hyeong Jin Kim1, Yun-Hyeong Cho1, Deok-Kyu Cho1, Se Hwa Kim1

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

1Department of Internal Medicine, Myongji Hospital, Kwandong University College of Medicine, Goyang, Korea.

Corresponding author: Se Hwa Kim. Division of Endocrinology, Department of Internal Medicine, Myongji Hospital, Kwandong University College of Medicine, 55 Hwasu-ro 14 beon-gil, Deokyang-gu, Goyang 412-826, Korea. Tel: +82-31-810-5405, Fax: +82-31-969-0500, bonesh@naver.com

Received 24 October 2011       Accepted 5 January 2012

Copyright © 2012 Korean Endocrine Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

The association of osteoporotic vertebral fracture or osteoporosis with coronary artery disease (CAD) was investigated in Korean men and women.

Methods

Four hundred consecutive postmenopausal women and men aged 50 years and older, undergoing coronary angiography, were enrolled for the evaluation of established or suspected coronary artery disease. CAD was diagnosed if there was narrowing of > 50% diameter in one or more major coronary artery. Morphometric vertebral fracture was assessed using lateral thoracic and lumbar spine radiographs. Bone mineral density was performed using dual-energy x-ray absorptiometry.

Results

Of the 400 subjects in the study (mean age of 61.9 ± 11.6 years), 256 patients had CAD. Vertebral fracture was observed in 94 (23.5%) patients. There was no difference in vertebral fracture according to the presence or absence of CAD. In logistic regression analysis, vertebral fracture was not significantly associated with CAD after adjustment for multiple risk factors. Although women had lower BMD at any given site than men, BMD was not associated with the presence or absence of CAD among 191 patients.

Conclusion

Our study demonstrated that osteoporotic vertebral fracture or osteoporosis was not associated with coronary artery disease in Korean men and women.

Keywords: Atherosclerosis, Bone mineral density, Coronary artery disease, Osteoporosis, Vertebral fracture

Figures and Tables

Table 1
Baseline characteristics of the study subjects (n = 400)
enm-27-39-i001

Values are presented as mean ± SD or number (%).

BMI, body mass index.

Table 2
Baseline characteristics of study subjects according to the CAD severity
enm-27-39-i002

Values are presented as mean ± SD or number (%).

CAD, coronary artery disease; VD, vessel disease.

Table 3
Bone mineral density of the study subjects with or without CAD (n = 191)
enm-27-39-i003

CAD, coronary artery disease.

Table 4
Logistic regression analysis with coronary artery disease as a dependent variable in men
enm-27-39-i004

CI, confidence interval.

Table 5
Logistic regression analysis with coronary artery disease as a dependent variable in women
enm-27-39-i005

CI, confidence interval.

References

1. Epstein FH. Cardiovascular disease epidemiology: a journey from the past into the future. Circulation. 1996. 93:1755–1764.
2. Cooper C, Atkinson EJ, Jacobsen SJ, O'Fallon WM, Melton LJ 3rd. Population-based study of survival after osteoporotic fractures. Am J Epidemiol. 1993. 137:1001–1005.
3. Trivedi DP, Khaw KT. Bone mineral density at the hip predicts mortality in elderly men. Osteoporos Int. 2001. 12:259–265.
4. von der Recke P, Hansen MA, Hassager C. The association between low bone mass at the menopause and cardiovascular mortality. Am J Med. 1999. 106:273–278.
5. Tankò LB, Bagger YZ, Christiansen C. Low bone mineral density in the hip as a marker of advanced atherosclerosis in elderly women. Calcif Tissue Int. 2003. 73:15–20.
6. Tankò LB, Christiansen C, Cox DA, Geiger MJ, McNabb MA, Cummings SR. Relationship between osteoporosis and cardiovascular disease in postmenopausal women. J Bone Miner Res. 2005. 20:1912–1920.
7. Giachelli CM, Bae N, Almeida M, Denhardt DT, Alpers CE, Schwartz SM. Osteopontin is elevated during neointima formation in rat arteries and is a novel component of human atherosclerotic plaques. J Clin Invest. 1993. 92:1686–1696.
8. Dhore CR, Cleutjens JP, Lutgens E, Cleutjens KB, Geusens PP, Kitslaar PJ, Tordoir JH, Spronk HM, Vermeer C, Daemen MJ. Differential expression of bone matrix regulatory proteins in human atherosclerotic plaques. Arterioscler Thromb Vasc Biol. 2001. 21:1998–2003.
9. Hofbauer LC, Brueck CC, Shanahan CM, Schoppet M, Dobnig H. Vascular calcification and osteoporosis: from clinical observation towards molecular understanding. Osteoporos Int. 2007. 18:251–259.
10. Kiel DP, Kauppila LI, Cupples LA, Hannan MT, O'Donnell CJ, Wilson PW. Bone loss and the progression of abdominal aortic calcification over a 25 year period: the Framingham Heart Study. Calcif Tissue Int. 2001. 68:271–276.
11. Choi SH, An JH, Lim S, Koo BK, Park SE, Chang HJ, Choi SI, Park YJ, Park KS, Jang HC, Shin CS. Lower bone mineral density is associated with higher coronary calcification and coronary plaque burdens by multidetector row coronary computed tomography in pre- and postmenopausal women. Clin Endocrinol (Oxf). 2009. 71:644–651.
12. Sinnott B, Syed I, Sevrukov A, Barengolts E. Coronary calcification and osteoporosis in men and postmenopausal women are independent processes associated with aging. Calcif Tissue Int. 2006. 78:195–202.
13. Lin T, Liu JC, Chang LY, Shen CW. Association between coronary artery calcification using low-dose MDCT coronary angiography and bone mineral density in middle-aged men and women. Osteoporos Int. 2011. 22:627–634.
14. Beer S, Saely CH, Hoefle G, Rein P, Vonbank A, Breuss J, Gaensbacher B, Muendlein A, Drexel H. Low bone mineral density is not associated with angiographically determined coronary atherosclerosis in men. Osteoporos Int. 2010. 21:1695–1701.
15. Marcovitz PA, Tran HH, Franklin BA, O'Neill WW, Yerkey M, Boura J, Kleerekoper M, Dickinson CZ. Usefulness of bone mineral density to predict significant coronary artery disease. Am J Cardiol. 2005. 96:1059–1063.
16. Kim KI, Suh JW, Choi SY, Chang HJ, Choi DJ, Kim CH, Oh BH. Is reduced bone mineral density independently associated with coronary artery calcification in subjects older than 50 years? J Bone Miner Metab. 2011. 29:369–376.
17. Demer LL. Vascular calcification and osteoporosis: inflammatory responses to oxidized lipids. Int J Epidemiol. 2002. 31:737–741.
18. Watson KE, Abrolat ML, Malone LL, Hoeg JM, Doherty T, Detrano R, Demer LL. Active serum vitamin D levels are inversely correlated with coronary calcification. Circulation. 1997. 96:1755–1760.
19. Parhami F, Morrow AD, Balucan J, Leitinger N, Watson AD, Tintut Y, Berliner JA, Demer LL. Lipid oxidation products have opposite effects on calcifying vascular cell and bone cell differentiation. A possible explanation for the paradox of arterial calcification in osteoporotic patients. Arterioscler Thromb Vasc Biol. 1997. 17:680–687.
20. Jie KG, Bots ML, Vermeer C, Witteman JC, Grobbee DE. Vitamin K status and bone mass in women with and without aortic atherosclerosis: a population-based study. Calcif Tissue Int. 1996. 59:352–356.
21. Hyder JA, Allison MA, Criqui MH, Wright CM. Association between systemic calcified atherosclerosis and bone density. Calcif Tissue Int. 2007. 80:301–306.
22. Fuster V, Badimon L, Badimon JJ, Chesebro JH. The pathogenesis of coronary artery disease and the acute coronary syndromes. N Engl J Med. 1992. 326:242–250.
23. Hofbauer LC, Brueck CC, Singh SK, Dobnig H. Osteoporosis in patients with diabetes mellitus. J Bone Miner Res. 2007. 22:1317–1328.
24. Jørgensen L, Joakimsen O, Mathiesen EB, Ahmed L, Berntsen GK, Fønnebø V, Joakimsen R, Njølstad I, Schirmer H, Jacobsen BK. Carotid plaque echogenicity and risk of nonvertebral fractures in women: a longitudinal population-based study. Calcif Tissue Int. 2006. 79:207–213.
25. Flipon E, Liabeuf S, Fardellone P, Mentaverri R, Ryckelynck T, Grados F, Kamel S, Massy ZA, Dargent-Molina P, Brazier M. Is vascular calcification associated with bone mineral density and osteoporotic fractures in ambulatory, elderly women? Osteoporos Int. 2011. In press.
26. Shin CS, Kim MJ, Shim SM, Kim JT, Yu SH, Koo BK, Cho HY, Choi HJ, Cho SW, Kim SW, Kim SY, Yang SO, Cho NH. The prevalence and risk factors of vertebral fractures in Korea. J Bone Miner Metab. 2011. In press.
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