Links between cardiovascular disease and osteoporosis in postmenopausal women: serum lipids or atherosclerosis per se?
Links between cardiovascular disease and osteoporosis in postmenopausal women: serum lipids or atherosclerosis per se?
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DOI：
10.1007/s00198-006-0255-2
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发表时间：
2007-04
影响因子：
4
通讯作者：
Tanko, L. B.
中科院分区：
文献类型：
--
作者：
Bagger, Y. Z.;Rasmussen, H. B.;Alexandersen, P.;Werge, T.;Christiansen, C.;Tanko, L. B.
流行病学观察表明骨质疏松症与急性心血管事件的风险之间存在联系，反之亦然。这两种临床症状是由常见的致病因素还是动脉粥样硬化本身联系在一起，目前还不完全清楚。我们调查了血脂和修饰血脂的载脂蛋白E基因的多态性是否可能是一种生物连锁。这是一项观察性研究，包括1176名60-85岁的老年女性。对女性进行了载脂蛋白E基因epsilon(ɛ)等位基因变异的基因分型，并收集了有关血脂(总胆固醇、甘油三酯、高密度脂蛋白-C、低密度脂蛋白-C、载脂蛋白A1、载脂蛋白B、脂蛋白(A))、髋部和脊柱骨密度、主动脉钙化(AC)、放射学脊柱骨折和自我报告的腕部和髋部骨折、心血管事件以及广泛的人口统计和生活方式特征的数据。载脂蛋白Eɛ4等位基因的存在对血脂水平有显著影响，但与脊柱/髋部骨密度或AC无关。在多元回归模型中，apoA1是AC变异的显著独立贡献者。然而，没有一种脂肪成分是脊柱或臀部骨密度变化的独立贡献者。当比较有或没有脊椎骨折的女性时，血清甘油三酯显示出显著差异。然而，这一发现并不适用于髋部或手腕骨折。在调整年龄后，严重的AC评分(≥6)和/或明显的心血管疾病增加了髋部骨折的风险，但不增加脊柱或手腕骨折的风险。血脂对骨密度调节因子的贡献似乎不是直接的，而是通过促进动脉粥样硬化而间接的，而动脉粥样硬化反过来又可以影响局部的骨代谢，特别是当涉及到终末动脉供应的骨骼部位时。需要进一步的研究来探索低甘油三酯水平与脊椎骨折之间潜在的遗传或环境风险因素。
Epidemiological observations suggest links between osteoporosis and risk of acute cardiovascular events and vice versa. Whether the two clinical conditions are linked by common pathogenic factors or atherosclerosis per se remains incompletely understood. We investigated whether serum lipids and polymorphism in the ApoE gene modifying serum lipids could be a biological linkage. This was an observational study including 1176 elderly women 60–85 years old. Women were genotyped for epsilon (ɛ) allelic variants of the ApoE gene, and data concerning serum lipids (total cholesterol, triglycerides, HDL-C, LDL-C, apoA1, ApoB, Lp(a)), hip and spine BMD, aorta calcification (AC), radiographic vertebral fracture and self-reported wrist and hip fractures, cardiovascular events together with a wide array of demographic and lifestyle characteristics were collected. Presence of the ApoE ɛ4 allele had a significant impact on serum lipid profile, yet no association with spine/hip BMD or AC could be established. In multiple regression models, apoA1 was a significant independent contributor to the variation in AC. However, none of the lipid components were independent contributors to the variation in spine or hip BMD. When comparing the women with or without vertebral fractures, serum triglycerides showed significant differences. This finding was however not applicable to hip or wrist fractures. After adjustment for age, severe AC score (≥6) and/or manifest cardiovascular disease increased the risk of hip but not vertebral or wrist fractures. The contribution of serum lipids to the modulators of BMD does not seem to be direct but rather indirect via promotion of atherosclerosis, which in turn can affect bone metabolism locally, especially when skeletal sites supplied by end-arteries are concerned. Further studies are needed to explore the genetic or environmental risk factors underlying the association of low triglyceride levels to vertebral fractures.
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影响因子：
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作者：
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通讯作者：
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