Skip to main content


Log in

Association between coronary artery calcification using low-dose MDCT coronary angiography and bone mineral density in middle-aged men and women

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript



Six hundred sixty-one participants who had at least one cardiac risk factor but were without known coronary heart disease underwent low-dose multidetector computed tomography coronary angiography (MDCT-CA) and dual-energy X-ray absorptiometry. The association between presence of subclinical coronary calcified plaque and low bone mineral density for the middle-aged individual was not significant after multivariate adjustment.


Results of previous clinical studies assessing the relationship between osteoporosis and coronary calcification are inconsistent. This study aimed to evaluate the association between subclinical coronary calcification and osteoporosis in middle-aged men, premenopausal women, and postmenopausal women by using low-dose MDCT-CA and bone mineral density (BMD).


This study enrolled 661 participants with at least one cardiac risk factor but without known coronary artery disease (CAD). All subjects underwent low-dose MDCT-CA and dual-energy X-ray absorptiometry on the same day.


The mean age was 52.2 years for men, 44.8 years for premenopausal women, and 59.1 years for postmenopausal women. The prevalence of calcified plaques between men with normal BMD and low BMD at lumbar spine were significantly different (P = 0.042). The prevalence of mixed plaque and calcified plaque between pre- and postmenopausal women with normal BMD and low BMD at lumbar spine and femoral neck were not significantly different (P > 0.05). Possible association between lumbar spine, femoral neck, and total proximal femur BMD and the presence of CAP was evaluated for men, premenopausal women, and postmenopausal women using multivariate logistic regression analysis: results were not significant (P > 0.05).


Our study demonstrates that the association between the presence of subclinical coronary calcification and low BMD among middle-aged men and women was not significant after controlling for age and other risk factors for CAD and osteoporosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. Department of Health, Executive Yuan, R.O.C. (2008) Statistics of causes of death. Taipei: Department of Health, Executive Yuan, R.O.C.. Available at: Accessed 30 December 2009

  2. Kado DM, Browner WS, Blackwell T et al (2000) Rate of bone loss is associated with mortality in older women: a prospective study. J Bone Miner Res 15:1974–1980

    Article  CAS  PubMed  Google Scholar 

  3. Bliuc D, Nguyen ND, Milch VE et al (2009) Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 301:513–521

    Article  CAS  PubMed  Google Scholar 

  4. Szulc P, Samelson EJ, Kiel DP et al (2009) Increased bone resorption is associated with increased risk of cardiovascular events in men—the MINOS Study. J Bone Miner Res 24:2023–2031

    Article  CAS  PubMed  Google Scholar 

  5. 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

    Article  PubMed  Google Scholar 

  6. Hamerman D (2005) Osteoporosis and atherosclerosis: biological linkages and the emergence of dual-purpose therapies. Qjm 98:467–484

    Article  CAS  PubMed  Google Scholar 

  7. Hak AE, Pols HA, van Hemert AM (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

    CAS  PubMed  Google Scholar 

  8. Jacobs PC, Prokop M, van der Graaf Y et al (2010) Comparing coronary artery calcium and thoracic aorta calcium for prediction of all-cause mortality and cardiovascular events on low-dose non-gated computed tomography in a high-risk population of heavy smokers. Atherosclerosis 209(2):455–462

    Article  CAS  PubMed  Google Scholar 

  9. Farhat GN, Cauley JA, Matthews KA et al (2006) Volumetric BMD and vascular calcification in middle-aged women: the study of women's health across the nation. J Bone Miner Res 21:1839–1846

    Article  PubMed  Google Scholar 

  10. Sinnott B, Syed I, Sevrukov A et al (2006) Coronary calcification and osteoporosis in men and postmenopausal women are independent processes associated with aging. Calcif Tissue Int 78:195–202

    Article  CAS  PubMed  Google Scholar 

  11. Budoff MJ, Achenbach S, Blumenthal RS et al (2006) American Heart Association Committee on Cardiac Imaging, Council on Clinical Cardiology. Assessment of coronary artery disease by cardiac computed tomography: a scientific statement from the American Heart Association. Circulation 114:1761–1791

    Article  PubMed  Google Scholar 

  12. Ropers D, Rixe J, Anders K et al (2006) Usefulness of multidetector row computed tomography with 64- × 0.6-mm collimation and 330-ms rotation for the noninvasive detection of significant coronary artery stenoses. Am J Cardiol 97:343–348

    Article  PubMed  Google Scholar 

  13. Husmann L, Herzog BA, Burkhard N et al (2009) Body physique and heart rate variability determine the occurrence of stair-step artifacts in 64-slice CT coronary angiography with prospective ECG-triggering. Eur Radiol 19:1698–1703

    Article  PubMed  Google Scholar 

  14. Pontone G, Andreini D, Bartorelli AL et al (2009) Accuracy of coronary computed tomography angiography: a comparison between prospective and retrospective electrocardiogram triggering. J Am Coll Cardiol 54:346–355

    Article  PubMed  Google Scholar 

  15. Leber AW, Becker A, Knez A et al (2006) Accuracy of 64-slice computed tomography to classify and quantify plaque volumes in the proximal coronary system: a comparative study using intravascular ultrasound. J Am Coll Cardiol 47:672–677

    Article  PubMed  Google Scholar 

  16. World Health Organization (2003) Prevention and management of osteoporosis, Report of a WHO Scientific Group. WHO Geneva pp. 53–60

  17. Aoyagi K, Ross PD, Orloff J et al (2001) Low bone density is not associated with aortic calcification. Calcif Tissue Int 69:20–24

    Article  CAS  PubMed  Google Scholar 

  18. Vogt MT, San Valentin R, Forrest KY et al (1997) Bone mineral density and aortic calcification: the study of osteoporotic fractures. J Am Geriatr Soc 45:140–145

    CAS  PubMed  Google Scholar 

  19. 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

    Article  CAS  PubMed  Google Scholar 

  20. van der Klift M, Pols HA, Hak AE et al (2002) Bone mineral density and the risk of peripheral arterial disease: the Rotterdam Study. Calcif Tissue Int 70:443–449

    Article  PubMed  CAS  Google Scholar 

  21. Erbilen E, Yazici S, Ozhan H et al (2007) Relationship between angiographically documented coronary artery disease and low bone mass in men. Circ J 717:1095–1098

    Article  Google Scholar 

  22. Hyder JA, Allison MA, Wong N et al (2009) Association of coronary artery and aortic calcium with lumbar bone density: the MESA Abdominal Aortic Calcium Study. Am J Epidemiol 169:186–194

    Article  PubMed  Google Scholar 

  23. Rumberger JA, Simons DB, Fitzpatrick LA et al (1995) Coronary artery calcium area by electron-beam computed tomography and coronary atherosclerotic plaque area. A histopathologic correlative study. Circulation 92:2157–2162

    CAS  PubMed  Google Scholar 

  24. Budoff MJ, Dowe D, Jollis JG et al (2008) Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial. J Am Coll Cardiol 52:1724–1732

    Article  PubMed  Google Scholar 

  25. Fine JJ, Hopkins CB, Ruff N et al (2006) Comparison of accuracy of 64-slice cardiovascular computed tomography with coronary angiography in patients with suspected coronary artery disease. Am J Cardiol 97:173–174

    Article  PubMed  Google Scholar 

  26. Choi SH, An JH, Lim S et al (2009) Lower bone mineral density is associated with higher coronary calcification and coronary plaque burdens by multidetector row coronary computed tomography in pre- and postmenopausal women. Clin Endocrinol (Oxf) 71:644–651

    Article  Google Scholar 

  27. Mendelsohn ME, Karas RH (1999) The protective effects of estrogen on the cardiovascular system. N Engl J Med 340:1801–1811

    Article  CAS  PubMed  Google Scholar 

  28. Tanko 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

    Article  CAS  PubMed  Google Scholar 

  29. Seifert-Klauss V, Link T, Heumann C et al (2006) Influence of pattern of menopausal transition on the amount of trabecular bone loss. Results from a 6-year prospective longitudinal study. Maturitas 55:317–324

    Article  CAS  PubMed  Google Scholar 

  30. Drinka PJ, DeSmet AA, Bauwens SF et al (1992) The effect of overlying calcification on lumbar bone densitometry. Calcif Tissue Int 50:507–510

    Article  CAS  PubMed  Google Scholar 

  31. Orwoll ES, Oviatt SK, Mann T (1990) The impact of osteophytic and vascular calcifications on vertebral mineral density measurements in men. J Clin Endocrinol Metab 70:1202–1207

    Article  CAS  PubMed  Google Scholar 

  32. Carr JJ, Register TC, Hsu FC et al (2008) Calcified atherosclerotic plaque and bone mineral density in type 2 diabetes: the Diabetes Heart Study. Bone 42:43–52

    Article  CAS  PubMed  Google Scholar 

  33. Dunajska K, Milewicz A, Jóźków P et al (2006) Sex steroids concentrations in relation to bone mineral density in men with coronary atherosclerosis. Maturitas 55:142–149

    Article  CAS  PubMed  Google Scholar 

  34. Kuo DJ, Lee YC, Huang WF (2007) Hormone therapy use and prescription durations of menopausal women in Taiwan: a 5 years' National Cohort Study. Maturitas 58:259–268

    Article  CAS  PubMed  Google Scholar 

Download references


This study is supported in part by Taiwan Department of Health Clinical Trial and Research Center of Excellence (DOH99-TD-B-111-004).

Conflicts of interest


Author information

Authors and Affiliations


Corresponding author

Correspondence to T. Lin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lin, T., Liu, J.C., Chang, L.Y. et al. Association between coronary artery calcification using low-dose MDCT coronary angiography and bone mineral density in middle-aged men and women. Osteoporos Int 22, 627–634 (2011).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: