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Clinical Rheumatology

, Volume 13, Issue 4, pp 611–614 | Cite as

Comparison of the bone mineral content of the lower limbs in men with ischaemic atherosclerotic disease

  • M. Laroche
  • J. M. Pouilles
  • C. Ribot
  • P. Bendayan
  • J. Bernard
  • H. Boccalon
  • B. Mazieres
Originals

Summary

In a previous study, the authors demonstrated that in 17 men with ischaemic atherosclerotic disease the bone mineral density (BMD) of the femoral neck was lower than in matched control subjects. The patients with arterial disease were thinner and were heavier smokers than the controls. Osteoporosis and arterial disease of the lower limbs were perhaps due to common risk factors: tobacco consumption and a low body build index. In order to demonstrate the direct effect of atherosclerosis on bone mineral content (BMC), the authors studied by dual-energy X-ray absorptiometry the BMC of both legs in 18 men presenting symptomatic arterial disease of the lower limbs quantified by measurement of distal systolic indexes by doppler ultrasonography.

The mean BMC of the leg more severely affected by arterial disease was significantly lower than the mean BMC of the leg less affected by arterial disease (512±76 g versus 495±80 g: p=0.003). In 13 of the 18 patients, the BMC was lower in the leg more severely affected by arterial disease; in 4 of 18 the difference between the BMC of the left and right legs was less than 1%, and in a single patient the BMC was higher in the leg more affected by arterial disease.

Arterial disease of the lower limbs could lead to bone mineral loss.

Key words

Osteoporosis Atherosclerotic Disease of the Lower Limbs 

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References

  1. 1.
    Laroche, M., Puech, J.L., Poulles, J.M., Arlet, J., Boccalon, H., Puel, P., Mazieres, B., Arlet, Ph., Ribot, C. Arteriopathie des membres inferieurs et ostéoporose masculine. Rev Rhum 1992, 59, 95–101.Google Scholar
  2. 2.
    Carter, S.A. Clinical measurement of systolic pressures in limbs with arterial disease. JAMA, 1969, 207, 1869–1871.Google Scholar
  3. 3.
    Yao, S.T. Ankle systolic pressure in arterial disease of the lower extremities. Br J Surg 1968, 55, 89–91.Google Scholar
  4. 4.
    Fuller, N.J., Laskey, M.A., Elia, M. Assessment of the major body regions by dual-energy X-ray absorptiometry (DEXA) with special reference to limb muscle mass. Clin Physiol 1992, 12, 253–266.Google Scholar
  5. 5.
    Mazess, R.B., Barden, H.S., Bisek, J.P., Hanson, J. Dual-energy X-ray absorptiometry for total body and regional bone-mineral and soft tissue composition. Am J Clin Nutr 1990, 51, 1106–1112.Google Scholar
  6. 6.
    Sartoris, D.J., Resnick, D. Dual-energy radiographic absorptiometry for bone densitometry: current status and perspective. A J R 1989, 152, 241–246.Google Scholar
  7. 7.
    Formica, C., Atkinson, M.G., Nyulasi, I., Mc Kay, J., Heale, W., Seeman, E. Body composition following hemodialysis: studies using dual Energy X-ray absorptiometry and biochemical impedence analysis: Osteoporosis Int 1993, 3, 192–197.Google Scholar
  8. 8.
    Amos, R.S., Wright, V. Mönckeberg's arteriosclerosis and metabolic bone disease. Lancet 1980, ii, 248–294.Google Scholar
  9. 9.
    Burckhardt, R., Barti, R., Frisch, B. et al. The structural relationship of bone forming and endothelial cells of the bone marrow. In: Bone Circulation. Baltimore, Williams and Wilkins, 1984, 2–14.Google Scholar
  10. 10.
    Burckhardt, R., Kettner, G., Böhn W. et al. Changes in trabecular bone, hematopoiesis and marrow vessels in aplastic anaemia, primary osteoporosis and old age: a comparative histomorphometric study. Bone 1987, 8, 157–164.Google Scholar
  11. 11.
    Mathiassen, B., Nielsen, S., Johansen, J., Hartwell, D., Ditzel, J., Rodbro, P., Christiansen, C. Is bone loss accelerated in insulin-dependent diabetics with microvascular complications? Abstracts, Third International Symposium on Osteoporosis, Copenhagen 1990, 611.Google Scholar
  12. 12.
    Reeve, J., Arlot, M., Wootton, R. et al. Skeletal blood flow, iliac histomorphometry and strontium kinetics in osteoporosis: a relationship between blood flow and corrected apposition rate. J Clin Endocrinol Metab 1988, 66, 1124–1131.Google Scholar
  13. 13.
    Kita, K., Kawai, K., Hirohata, K. Changes in bone marrow blood flow with aging. J Orth Research 1987, 5, 569–575.Google Scholar
  14. 14.
    Franklin, H.S., Kelly, P.J. Relationship of bone remodeling, oxygen consumption, and blood flow in bone. J Bone Joint Surg, 52 A, 1377–1389.Google Scholar
  15. 15.
    Sherman, M.S., Sekalovich, W.G. Bone changes in chronic circulatory insufficiency. J Bone Joint Surg 1957, 39 A, 892–901.Google Scholar
  16. 16.
    Ramseier, E. Arteriosclerosis in the arteries of bone. Virchows Archiv für Pathologische Anatomie 1962, 336, 77–86.Google Scholar
  17. 17.
    Mazess, R.B., Barden, H.S., Drinka, P.J., Bauwens, S.F., Orwoll, E.S., Bell, N.H. Influence of age and body weight on spine and femur bone mineral density in US white men. J Bone Min Res 1990, 5, 645–652.Google Scholar
  18. 18.
    Francis, R., Peacock, M., Marshall, D., Horsman, A., Aaron, J. Spinal osteoporosis in men. Bone and Mineral 1989, 5, 347–357.Google Scholar
  19. 19.
    Nordin, B., Need, A., Morris, M., Horowitz, H. New approaches to the problems of osteoporosis. Clin Orthop Rel Res 1985, 200, 181–185.Google Scholar
  20. 20.
    Peck, W.A., Riggs, B.L., Bell, N.H. et al. Research directions in osteoporosis. Am J Med 1988, 84, 275–282.Google Scholar
  21. 21.
    Uriel, S., Barzel, M. Osteoporosis in young men. Arch Int Med 1982, 142, 2079–2086.Google Scholar
  22. 22.
    Spencer, H., Rubio, E., Indreika, M., Seitam, A. Chronic alcoholism: a frequently overlooked cause of osteoporosis in men. Am J Med 1986, 80, 393–397.Google Scholar
  23. 23.
    Seeman, E., Melton, J., O'Fallon, W., Riggs, B.L. Risk factors for spinal osteoporosis in men. Am J Med, 1983, 75, 977–983.Google Scholar
  24. 24.
    Semler, J.C. Risk factors for osteoporosis in men, Abstracts ICCRH, Florence, 1992.Google Scholar
  25. 25.
    Daniell, H. Osteoporosis of the slender smoker. Arch Int Med 1976, 136, 298–304.Google Scholar
  26. 26.
    De Vernejoul, M.C., Bielakoff, J., Hervé, M. et al. Evidence for defective osteoblastic function. A role for alcohol and tobacco consumption in osteoporosis in middle-aged men. Clin Orthop Rel Res 1983, 179, 107–115.Google Scholar
  27. 27.
    Michnovicz, J.J., Hershcopf, R., Haley, N.J., Bradlow, H.L., Fishman, J. Cigarette smoking alters hepatic estrogen metabolism in men: implications for atherosclerosis. Metabolism 1989, 38, 6, 537–541.Google Scholar

Copyright information

© Clinical Rheumatology 1994

Authors and Affiliations

  • M. Laroche
    • 4
  • J. M. Pouilles
    • 1
  • C. Ribot
    • 1
  • P. Bendayan
    • 2
  • J. Bernard
    • 3
  • H. Boccalon
    • 2
  • B. Mazieres
  1. 1.Service d'EndocrinologieCHU PurpanToulouse
  2. 2.Service de Medecine Interne et AngiologieToulouse
  3. 3.Service de Medecine InterneHôpital Militaire LarreyToulouse
  4. 4.Service de RhumatologieCHU RangueilToulouse CedexFrance

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