Lower leg arterial calcification assessed by high-resolution peripheral quantitative computed tomography is associated with bone microstructure abnormalities in women
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In older women, the presence of lower leg arterial calcification assessed by high-resolution peripheral quantitative computed tomography is associated with relevant bone microstructure abnormalities at the distal tibia and distal radius.
Here, we report the relationships of bone geometry, volumetric bone mineral density (BMD) and bone microarchitecture with lower leg arterial calcification (LLAC) as assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT).
We utilized the Hertfordshire Cohort Study (HCS), where we were able to study associations between measures obtained from HR-pQCT of the distal radius and distal tibia in 341 participants with or without LLAC. Statistical analyses were performed separately for women and men. We used linear regression models to investigate the cross-sectional relationships between LLAC and bone parameters.
The mean (SD) age of participants was 76.4 (2.6) and 76.1 (2.5) years in women and men, respectively. One hundred and eleven of 341 participants (32.6 %) had LLAC that were visible and quantifiable by HR-pQCT. The prevalence of LLAC was higher in men than in women (46.4 % (n = 83) vs. 17.3 % (n = 28), p < 0.001). After adjustment for confounding factors, we found that women with LLAC had substantially lower Ct.area (β = −0.33, p = 0.016), lower Tb.N (β = −0.54, p = 0.013) and higher Tb.Sp (β = 0.54, p = 0.012) at the distal tibia and lower Tb.Th (β = −0.49, p = 0.027) at the distal radius compared with participants without LLAC. Distal radial or tibial bone parameter analyses in men according to their LLAC status revealed no significant differences with the exception of Tb.N (β = 0.27, p = 0.035) at the distal tibia.
In the HCS, the presence of LLAC assessed by HR-pQCT was associated with relevant bone microstructure abnormalities in women. These findings need to be replicated and further research should study possible pathophysiological links between vascular calcification and osteoporosis.
KeywordsBone microstructure High-resolution peripheral quantitative computed tomography Lower leg arterial calcification Volumetric bone mineral density
This research has been made possible thanks to a fellowship grant from Arthritis Research UK (grant number 19583). The present work was funded by grants from servier and la Société Française de Rhumatologie. This research is funded by MRC (Programme number U105960371). The Hertfordshire Cohort Study was supported by the Medical Research Council (MRC) of Great Britain, Arthritis Research UK and the International Osteoporosis Foundation. The work herein was also supported by the NIHR Nutrition BRC, University of Southampton, and the NIHR Musculoskeletal BRU, University of Oxford. KAW’s research is funded by MRC Programme number U105960371. Imaging was performed at MRC Human Nutrition Research, Cambridge. We thank all of the men and women who took part in the Hertfordshire Cohort Study, the HCS Research Staff and Vanessa Cox who managed the data.
Compliance with ethical standards
The East and North Hertfordshire Ethical Committees granted ethical approval for the study, and all participants gave written informed consent in accordance with the Declaration of Helsinki.
Conflicts of interest
Professor Cooper has received consultancy fees/honoraria from Servier, Eli Lilly, Merck, Amgen, Alliance, Novartis, Medtronic, GSK, Roche.
Julien Paccou, Mark Edwards, Janina Patsch, Kate Ward, Karen Jameson, Charlotte Moss and Elaine Dennison declare that they have no conflict of interest.
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