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Sex Differences in the Association Between Bone Mineral Density and Coronary Artery Disease in Patients Referred for Cardiac Computed Tomography

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Sex Differences in the Association Between Bone Mineral Density and Coronary Artery Disease in Patients Referred for Cardiac Computed Tomography. / Therkildsen, Josephine; Winther, Simon; Nissen, Louise; Jørgensen, Hanne S; Thygesen, Jesper; Ivarsen, Per; Frost, Lars; Isaksen, Christin; Langdahl, Bente L; Hauge, Ellen-Margrethe; Böttcher, Morten.

In: Journal of Clinical Densitometry, Vol. 24, No. 1, 01.2021, p. 55-66.

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@article{143ba84879834ca2b52b3cb0e6451136,
title = "Sex Differences in the Association Between Bone Mineral Density and Coronary Artery Disease in Patients Referred for Cardiac Computed Tomography",
abstract = "Atherosclerosis and osteoporosis are both common and preventable diseases. Evidence supports a link between coronary artery disease (CAD) and low bone mineral density (BMD). This study aimed to assess the association between thoracic spine BMD and CAD in men and women with symptoms suggestive of CAD. This cross-sectional study included 1487 (mean age 57 years (range 40-80), 47% men) patients referred for cardiac computed tomography (CT). Agatston coronary artery calcium score (CACS), CAD severity (no, mild, moderate, and severe), vessel involvement (no, 1-, 2-, and 3/left main disease), and invasive measurements were evaluated. BMD of three thoracic vertebrae was measured using quantitative CT. We used the American college of radiology cut-off values for lumbar spine BMD to categorize patients into very low (<80 mg/cm3), low (80-120 mg/cm3), or normal BMD (>120 mg/cm3). BMD as a continuous variable was included in the linear regression analyses to assess associations between CACS (CACS=0, CACS 1- 399, and CACS ≥ 400) and BMD, and CAD severity and BMD. Significant lower BMD was present with increasing CACS and stenosis degree unadjusted. Multivariate linear regression analyses in women revealed a significant correlation between BMD and CACS groups (β = -4.06, p<0.05), but no correlation between BMD and CAD severity (β = -1.59, p = 0.14). No association was found between BMD and CACS (β = -1.50, p = 0.36) and CAD severity (β = 0.07, p = 0.94) in men. BMD is significantly correlated to CACS after adjusting for confounders in women, but not in men, suggesting a possible sex difference in pathophysiology.",
keywords = "Cardiac computed tomography, bone mineral density, coronary artery calcification, coronary artery disease, quantitative computed tomography",
author = "Josephine Therkildsen and Simon Winther and Louise Nissen and J{\o}rgensen, {Hanne S} and Jesper Thygesen and Per Ivarsen and Lars Frost and Christin Isaksen and Langdahl, {Bente L} and Ellen-Margrethe Hauge and Morten B{\"o}ttcher",
note = "Copyright {\textcopyright} 2019 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.",
year = "2021",
month = jan,
doi = "10.1016/j.jocd.2019.09.003",
language = "English",
volume = "24",
pages = "55--66",
journal = "Journal of Clinical Densitometry",
issn = "1094-6950",
publisher = "Elsevier BV",
number = "1",

}

RIS

TY - JOUR

T1 - Sex Differences in the Association Between Bone Mineral Density and Coronary Artery Disease in Patients Referred for Cardiac Computed Tomography

AU - Therkildsen, Josephine

AU - Winther, Simon

AU - Nissen, Louise

AU - Jørgensen, Hanne S

AU - Thygesen, Jesper

AU - Ivarsen, Per

AU - Frost, Lars

AU - Isaksen, Christin

AU - Langdahl, Bente L

AU - Hauge, Ellen-Margrethe

AU - Böttcher, Morten

N1 - Copyright © 2019 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

PY - 2021/1

Y1 - 2021/1

N2 - Atherosclerosis and osteoporosis are both common and preventable diseases. Evidence supports a link between coronary artery disease (CAD) and low bone mineral density (BMD). This study aimed to assess the association between thoracic spine BMD and CAD in men and women with symptoms suggestive of CAD. This cross-sectional study included 1487 (mean age 57 years (range 40-80), 47% men) patients referred for cardiac computed tomography (CT). Agatston coronary artery calcium score (CACS), CAD severity (no, mild, moderate, and severe), vessel involvement (no, 1-, 2-, and 3/left main disease), and invasive measurements were evaluated. BMD of three thoracic vertebrae was measured using quantitative CT. We used the American college of radiology cut-off values for lumbar spine BMD to categorize patients into very low (<80 mg/cm3), low (80-120 mg/cm3), or normal BMD (>120 mg/cm3). BMD as a continuous variable was included in the linear regression analyses to assess associations between CACS (CACS=0, CACS 1- 399, and CACS ≥ 400) and BMD, and CAD severity and BMD. Significant lower BMD was present with increasing CACS and stenosis degree unadjusted. Multivariate linear regression analyses in women revealed a significant correlation between BMD and CACS groups (β = -4.06, p<0.05), but no correlation between BMD and CAD severity (β = -1.59, p = 0.14). No association was found between BMD and CACS (β = -1.50, p = 0.36) and CAD severity (β = 0.07, p = 0.94) in men. BMD is significantly correlated to CACS after adjusting for confounders in women, but not in men, suggesting a possible sex difference in pathophysiology.

AB - Atherosclerosis and osteoporosis are both common and preventable diseases. Evidence supports a link between coronary artery disease (CAD) and low bone mineral density (BMD). This study aimed to assess the association between thoracic spine BMD and CAD in men and women with symptoms suggestive of CAD. This cross-sectional study included 1487 (mean age 57 years (range 40-80), 47% men) patients referred for cardiac computed tomography (CT). Agatston coronary artery calcium score (CACS), CAD severity (no, mild, moderate, and severe), vessel involvement (no, 1-, 2-, and 3/left main disease), and invasive measurements were evaluated. BMD of three thoracic vertebrae was measured using quantitative CT. We used the American college of radiology cut-off values for lumbar spine BMD to categorize patients into very low (<80 mg/cm3), low (80-120 mg/cm3), or normal BMD (>120 mg/cm3). BMD as a continuous variable was included in the linear regression analyses to assess associations between CACS (CACS=0, CACS 1- 399, and CACS ≥ 400) and BMD, and CAD severity and BMD. Significant lower BMD was present with increasing CACS and stenosis degree unadjusted. Multivariate linear regression analyses in women revealed a significant correlation between BMD and CACS groups (β = -4.06, p<0.05), but no correlation between BMD and CAD severity (β = -1.59, p = 0.14). No association was found between BMD and CACS (β = -1.50, p = 0.36) and CAD severity (β = 0.07, p = 0.94) in men. BMD is significantly correlated to CACS after adjusting for confounders in women, but not in men, suggesting a possible sex difference in pathophysiology.

KW - Cardiac computed tomography

KW - bone mineral density

KW - coronary artery calcification

KW - coronary artery disease

KW - quantitative computed tomography

U2 - 10.1016/j.jocd.2019.09.003

DO - 10.1016/j.jocd.2019.09.003

M3 - Journal article

C2 - 31668962

VL - 24

SP - 55

EP - 66

JO - Journal of Clinical Densitometry

JF - Journal of Clinical Densitometry

SN - 1094-6950

IS - 1

ER -