Abstract
Summary
We analyzed 609 women belonging to the JPOS study in a 10-year follow-up survey, to examine the association of osteoporosis with atherosclerosis. Osteoporosis or prevalent vertebral fracture at baseline was associated with increased intima-media thickness of the carotid bifurcation in postmenopausal women, adjusted for age, BMI, and other variables at baseline.
Introduction
Whether low bone mass predicts increased carotid atherosclerosis has not been fully investigated.
Methods
In 2006, we conducted a 10-year follow-up survey of 1,040 women (follow-up rate: 68.6%). We analyzed 609 women ≥50 years old in 2006 without a history of cardiovascular or connective tissue diseases at baseline. BMD and evaluation of vertebral fracture at baseline were used. The intima-media thickness of carotid bifurcation (BIF-IMT) was measured by B-mode ultrasonography in 2006.
Results
Adjusted BIF-IMT values of subjects with spine T-score ≥-1, between-2.5 and -1, and <-2.5 or prevalent vertebral fracture were 1.19 mm, 1.34 mm, 1.57 mm, respectively, in women with less than 10 years since menopause (YSM) (n = 159), 1.30 mm, 1.32 mm, 1.53 mm, in women with YSM ≥10 without a history of hypertension at baseline (n = 144) (both with p < 0.05 for linear trend). Those values among no versus prevalent vertebral fracture in women with YSM ≥10 were 1.40 mm, 1.66 mm with p < 0.05 (n = 202). Those associations were independent of age, BMI, total cholesterol, smoking and drinking habits, history of diabetes mellitus, and hypertension (for women with YSM < 10) at baseline.
Conclusion
Osteoporosis including prevalent vertebral fracture may be associated with carotid atherosclerosis in the first 10 years of postmenopausal women.
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References
McFarlane SI, Muniyappa R, Shin JJ et al (2004) Osteoporosis and cardiovascular disease: brittle bones and boned arteries, is there a link? Endocrine 23:1–10
Baldini V, Mastropasqua M, Francucci CM et al (2005) Cardiovascular disease and osteoporosis. J Endocrinol Invest 28(10 Suppl):69–72
Hamerman D (2005) Osteoporosis and atherosclerosis: biological linkages and the emergence of dual-purpose therapies. QJM 98:467–484
Samelson EJ, Kiel DP, Broe KE et al (2004) Metacarpal cortical area and risk of coronary heart disease: the Framingham Study. Am J Epidemiol 159:589–595
Tanko LB, Christiansen C, Cox DA et al (2005) Relationship between osteoporosis and cardiovascular disease in postmenopausal women. JBMR 20:1912–1920
Browner WS, Seeley DG, Vogt TM et al (1991) Non-trauma mortality in elderly women with low bone mineral density. Study of osteoporotic fractures research group. Lancet 338:355–358
Von der Recke P, Hansen MA, Hassager C (1999) The association between low bone mass at the menopause and cardiovascular mortality. Am J Med 106:273–278
Lorenz MW, Markus HS, Bots ML et al (2007) Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis. Circulation 115:459–467
Kitamura A, Iso H, Imano H et al (2004) Carotid intima-media thickness and plaque characteristics as a risk factor for stroke in Japanese elderly men. Stroke 35:2788–2794
Uyama O, Yoshimoto Y, Yamamoto Y et al (1997) Bone changes and carotid atherosclerosis in postmenopausal women. Stroke 28:1730–1732
Kammerer CM, Dualan AA, Samollow PB et al (2004) Bone mineral density, carotid artery intimal medial thickness, and the vitamin D receptor BsmI polymorphism in Mexican American women. Calcif Tissue Int 75:292–298
Yamada S, Inaba M, Goto H et al (2006) Associations between physical activity, peripheral atherosclerosis and bone status in healthy Japanese women. Atherosclerosis 188:196–202
Wenger NK (2003) Coronary heart disease: the female heart is vulnerable. Prog Cardiovasc Dis 46:199–229
Lerner DJ, Kannel WB (1986) Patterns of coronary heart disease morbidity and mortality in the sexes: a 26-year follow-up of the Framingham population. Am Heart J 111:383–390
Iki M, Morita A, Ikeda Y et al (2006) Biochemical markers of bone turnover predict bone loss in perimenopausal women but not in postmenopausal women-the Japanese Population-based Osteoporosis (JPOS) Cohort Study. Osteoporos Int 17:1086–1095
Iki M, Kagamimori S, Kagawa Y et al (2001) Bone mineral density of the spine, hip and distal forearm in representative samples of the Japanese female population: Japanese Population-Based Osteoporosis (JPOS) Study. Osteoporos Int 12:529–537
WHO Techical report (1994) Assessment of Fracture Risk and its Application to Screening for Postmenopausal Osteoporosis WHO Technical Report Series 843
McCloskey EV, Spector TD, Eyres KS et al (1993) The assessment of vertebral deformity: a method for use in population studies and clinical trials. Osteoporos Int 3:138–147
Schaefer EJ, Lamon-Fava S, Cohn SD et al (1994) Effects of age, gender, and menopausal status on plasma low density lipoprotein cholesterol and apolipoprotein B levels in the Framingham Offspring Study. J Lipid Res 35:779–792
Ford ES, Giles WH, Dietz WH (2002) Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 287:356–359
Flora A, Baker AB, Loewenson RB et al (1968) Comparative study of cerebral atherosclerosis in males and females. Circulation 38:859–869
Sacco RL, Benjamin EJ, Broderick JP et al (1997) American Heart Association Prevention Conference. IV. Prevention and rehabilitation of stroke. Risk factors. Stroke 28:1507–1517
Jorgensen L, Joakimsen O, Rosvold Berntsen GK et al (2004) Low bone mineral density is related to echogenic carotid artery plaques: a population-based study. Am J Epidemiol 160:549–556
Dobs AS, Nieto FJ, Szklo M et al (1999) Risk factors for popliteal and carotid wall thicknesses in the Atherosclerosis Risk in Communities (ARIC) Study. Am J Epidemiol 150:1055–1067
Joakimsen O, Bønaa KH, Stensland-Bugge E et al (2000) Population-based study of age at menopause and ultrasound assessed carotid atherosclerosis: The Tromsø Study. J Clin Epidemiol 53:525–530
Barengolts EI, Berman M, Kukreja SC et al (1998) Osteoporosis and coronary atherosclerosis in asymptomatic postmenopausal women. Calcif Tissue Int 62:209–213
Hak AE, Pols HA, van Hemert AM et al (2000) Progression of aortic calcification is associated with metacarpal bone loss during menopause: a population-based longitudinal study. Arterioscler Thromb Vasc Biol 20:1926–1931
Kiel DP, Kauppila LI, Cupples LA et al (2001) Bone loss and the progression of abdominal aortic calcification over a 25 year period: the Framingham Heart Study. Calcif Tissue Int 68:271–276
Pennisi P, Signorelli SS, Riccobene S et al (2004) Low bone density and abnormal bone turnover in patients with atherosclerosis of peripheral vessels. Osteoporos Int 15:389–395
Tankó LB, Bagger YZ, Christiansen C (2003) Low bone mineral density in the hip as a marker of advanced atherosclerosis in elderly women. Calcif Tissue Int 73:15–20
Hollander M, Hak AE, Koudstaal PJ et al (2003) Comparison between measures of atherosclerosis and risk of stroke. The Rotterdam Study. Stroke 34:2367–2373
Fanning NF, Walters TD, Fox AJ et al (2006) Association between calcification of the cervical carotid artery bifurcation and white matter ischemia. Am J Neuroradiol 27:378–383
Wilcosky T, Wing S (1987) The healthy worker effect. Selection of workers and work forces. Scand J Work Environ Health 13:70–72
Acknowledgements
This study was conducted by the JPOS group, comprising Fumiaki Marumo (chairman of the study group, professor emeritus, Tokyo Medical and Dental University), Toshihisa Matsuzaki (co-chairman of the study group, Institute of Comprehensive Community Care), Etsuko Kajita (Nagoya University School of Health Sciences), Tomoharu Matsukura (Kanazawa University), and Takashi Yamagami (Hokuriku Health Service Association), along with the authors. Financial support for the baseline survey was provided by the Japan Milk Promotion Board and the Japan Dairy Council. The follow-up surveys were financially supported by a Grant-in-aid for Scientific Research (B #10470114, 1998–2000, B #1437017, 2002–2003, and B #18390201, 2006, C #18590619, 2006) from the Japanese Society for the Promotion of Science and a grant in 2000–2002 from the Research Society for Metabolic Bone Diseases, Japan. The authors wish to express special thanks to the personnel of the health departments of Miyko-jima City, Sanuki City, and Nishi-Aizu Town for their excellent support of the study, and to those from SRL, Tokyo, Japan; Toyo Medic, Osaka, Japan; and Toyukai Medical Corporation, Tokyo, Japan, for their technical assistance with the surveys.
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Tamaki, J., Iki, M., Hirano, Y. et al. Low bone mass is associated with carotid atherosclerosis in postmenopausal women: The Japanese Population-based Osteoporosis (JPOS) Cohort Study. Osteoporos Int 20, 53–60 (2009). https://doi.org/10.1007/s00198-008-0633-z
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DOI: https://doi.org/10.1007/s00198-008-0633-z