QCT Volumetric Bone Mineral Density and Vascular and Valvular Calcification: The Framingham Study.
QCT Volumetric Bone Mineral Density and Vascular and Valvular Calcification: The Framingham Study.
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DOI：
10.1002/jbmr.2530
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发表时间：
2015-10
期刊：
影响因子：
--
通讯作者：
Samelson EJ
中科院分区：
文献类型：
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作者：
Chan JJ;Cupples LA;Kiel DP;O'Donnell CJ;Hoffmann U;Samelson EJ
越来越多的证据表明，骨和血管钙化具有共同的发病机制。关于骨和瓣膜钙化之间的潜在联系知之甚少。本研究的目的是确定脊柱骨矿物质密度（BMD）与血管和瓣膜钙化之间的关系。参与者包括1317名参与者（689名女性，628名男性），他们参加了Fractionary Offspring研究（平均年龄60岁）。通过计算机断层扫描（CT）测量整体、骨小梁和皮质体积骨密度（vBMD）以及动脉和瓣膜钙化，并按性别特异性四分位数进行分类（Q4 =高vBMD）。使用Agatston评分（AS）量化冠状动脉（CAC）、腹主动脉（AAC）、主动脉瓣（AVC）和二尖瓣（MVC）的钙化。任何钙（AS >0）的患病率分别为CAC 69%、AAC 81%、AVC 39%和MVC 20%。在女性中，CAC随着小梁vBMD四分位数的降低而增加：校正平均CAC = 2.1（Q4）、2.2（Q3）、2.5（Q2）、2.6（Q1）;趋势p = 0.04。然而，男性中CAC和小梁vBMD之间没有相反的趋势：CAC = 4.3（Q4），4.3（Q3），4.2（Q2），4.3（Q1）;趋势p = 0.92。在女性（AAC = 4.5 [Q4]，4.8 [Q3]，5.4 [Q2]，5.1 [Q1];趋势p = 0.01）和男性（AAC = 5.5 [Q4]，5.8 [Q3]，5.9 [Q2]，6.2 [Q1];趋势p = 0.01）中，AAC随着小梁vBMD四分位数的降低而增加。我们没有观察到女性或男性的小梁vBMD与AVC或MVC之间的相关性。最后，女性和男性的皮质vBMD与血管钙化和瓣膜钙化无关。脊柱vBMD低的女性和男性有更严重的血管钙化，特别是在腹主动脉。男女AAC和脊柱vBMD之间的负相关可能归因于共同的病因，并且可能是一个重要的联系，可以将治疗工作集中在骨折和心血管事件高风险个体上。
There is increasing evidence that bone and vascular calcification share common pathogenesis. Little is known about potential links between bone and valvular calcification. The purpose of this study was to determine the association between spine bone mineral density (BMD) and vascular and valvular calcification. Participants included 1317 participants (689 women, 628 men) in the Framingham Offspring Study (mean age 60 years). Integral, trabecular, and cortical volumetric bone density (vBMD) and arterial and valvular calcification were measured from computed tomography (CT) scans and categorized by sex-specific quartiles (Q4 = high vBMD). Calcification of the coronary arteries (CAC), abdominal aorta (AAC), aortic valve (AVC), and mitral valve (MVC) were quantified using the Agatston Score (AS). Prevalence of any calcium (AS >0) was 69% for CAC, 81% for AAC, 39% for AVC, and 20% for MVC. In women, CAC increased with decreasing quartile of trabecular vBMD: adjusted mean CAC = 2.1 (Q4), 2.2 (Q3), 2.5 (Q2), 2.6 (Q1); trend p = 0.04. However, there was no inverse trend between CAC and trabecular vBMD in men: CAC = 4.3 (Q4), 4.3 (Q3), 4.2 (Q2), 4.3 (Q1); trend p = 0.92. AAC increased with decreasing quartile of trabecular vBMD in both women (AAC = 4.5 [Q4], 4.8 [Q3], 5.4 [Q2], 5.1 [Q1]; trend p = 0.01) and men (AAC = 5.5 [Q4], 5.8 [Q3], 5.9 [Q2], 6.2 [Q1]; trend p = 0.01). We observed no association between trabecular vBMD and AVC or MVC in women or men. Finally, cortical vBMD was unrelated to vascular calcification and valvular calcification in women and men. Women and men with low spine vBMD have greater severity of vascular calcification, particularly at the abdominal aorta. The inverse relation between AAC and spine vBMD in women and men may be attributable to shared etiology and may be an important link on which to focus treatment efforts that can target individuals at high risk of both fracture and cardiovascular events.