Vitamin D status and abdominal aortic calcification in postmenopausal women
- 294 Downloads
Vitamin D has an important role in bone metabolism and may be involved in the process of vascular calcification. The objective of this study was to evaluate the effect of vitamin D status on the presence of abdominal aortic calcification (AAC). We enrolled, in a cross-sectional study, 429 postmenopausal women [mean age, weight, and BMI of 59.5 ± 8.3 (50–83) years, 75.8 ± 13.3 (35–165) kg, and 29.9 ± 5.2 (14.6–50.8) kg/m2, respectively]. Lateral vertebral fracture assessment (VFA) images and scans of the lumbar spine and proximal femur were obtained using a Lunar Prodigy densitometer. Vertebral fractures (VFs) were defined using the Genant semiquantitative (SQ) approach. We used the Kauppila score to assess AAC extension. Clinical risk factors of osteoporosis were collected, and 25-hydroxy vitamin D was measured using electrochemiluminescence (Roche). Prevalence of osteoporosis and hypovitaminosis D (<20 ng/ml) was 21.0% and 78.1%, respectively. VFs grade 2/3 were identified in 76 patients (17.7%). Two thirds of the evaluable participants did not have any detectable AAC. The prevalence of significant atherosclerotic burden, defined as a radiographic 24-point AAC score of 5 or higher, was 7.9%. The group of women with extended AAC were older and had a statistically significant higher menopause duration and more prevalent grade 2/3 VFs. Compared to women with normal values of vitamin D, women with vitamin D insufficiency (<20 ng/ml) and deficiency (<10 ng/ml) had a lower BMD and more prevalent VFs. No difference was noted with regard to AAC among the three groups. Multiple stepwise conditional logistic regression analysis showed that the presence of AAC was associated significantly with age and the presence of VFs. Extended aortic calcifications are independently associated with prevalent VFA-identified VFs but not with serum vitamin D levels in postmenopausal women. VFA imaging using DXA may detect at the same time prevalent VFs and AAC, an important cardiovascular disease risk factor.
KeywordsAbdominal aortic calcification Vertebral fracture assessment (VFA) Dual-energy X-ray absorptiometry (DXA) Osteoporosis Women
The study was funded by grants from the University Mohammed V of Rabat and AMIRHAL (Association Marocaine d’Information et de Recherche sur l’Handicap et l’Appareil Locomoteur).
Compliance with ethical standards
Conflict of interest
- 7.Zagura M, Serg M, Kampus P, Zilmer M, Eha J, Unt E, Lieberg J, Cockcroft JR, Kals J (2011) Aortic stiffness and vitamin D are independent markers of aortic calcification in patients with peripheral arterial disease and in healthy subjects. Eur J Vasc Endovasc Surg 42:689–695CrossRefPubMedCentralGoogle Scholar
- 11.Kim KJ, Kim KM, Park KH, Choi HS, Rhee Y, Lee YH, Cha BS, Kim MJ, Oh SM, Brown JK, Lim SK (2012) Aortic calcification and bone metabolism: the relationship between aortic calcification, BMD, vertebral fracture, 25-hydroxyvitamin D, and osteocalcin. Calcif Tissue Int 91:370–378CrossRefPubMedCentralGoogle Scholar
- 19.Schousboe JT, Ensrud KE, Nyman JA, Kane RL, Melton LJ 3rd (2006) Cost-effectiveness of vertebral fracture assessment to detect prevalent vertebral deformity and select postmenopausal women with a femoral neck T-score >−2.5 for alendronate therapy: a modeling study. J Clin Densitom 9:133–143CrossRefPubMedCentralGoogle Scholar
- 23.Schousboe JT, Lewis JR, Kiel DP (2017) Abdominal aortic calcification on dual-energy X-ray absorptiometry: Methods of assessment and clinical significance. Bone (NY)Google Scholar
- 47.Wang L, Song Y, Manson JE, Pilz S, März W, Michaëlsson K, Lundqvist A, Jassal SK, Barrett-Connor E, Zhang C, Eaton CB (2012) Circulating 25-hydroxy-vitamin D and risk of cardiovascular disease: a meta-analysis of prospective studies. Circ Cardiovasc Qual Outcomes 5:819–829CrossRefPubMedCentralGoogle Scholar