Abstract
Bony proliferation (exostoses) and vascular calcification are common in elderly men and women, but it is unclear whether they have a common etiology. Lateral lumbar and hand radiographs were obtained (1967–1970) in 777 men and 1,241 women (mean age 59, range 47–80 years) from the Framingham Heart Study. Each group of hand exostoses, specifically apiostoses (tufting), enthesophytes, and osteophytes, was graded on a scale of 0–3 (absent to severe) and summed across phalanges of digits 2–5. Anterior lumbar osteophytes were assessed in intervertebral spaces T12−L5 and abdominal aortic calcification (AAC) at lumbar segments L1-L4. Information on age, sex, body mass index, smoking, alcohol consumption, physical activity, systolic blood pressure, total cholesterol level, diabetes, and estrogen replacement therapy in women was obtained at the time of radiography and adjusted for in multivariate analyses. We used multivariable logistic regression models to assess the relationship between AAC (dependent variable) and exostoses for each sex. Multivariable adjusted logistic regression revealed a significant association between increased anterior lumbar osteophytes and prevalent AAC in men [odds ratio (OR) = 1.20, 95% confidence interval (CI) 1.1–1.3 per unit increase in osteophytes] and in women (OR = 1.25, 95% CI 1.1–1.4). There also was an inverse association between enthesophytes and AAC in women only (OR = 0.82, 95% CI 0.73–0.92). Apiostoses were weakly associated with AAC in men only. Hand osteophytes were not associated with AAC. In conclusion, in this cross-sectional study, anterior lumbar osteophytes and AAC occurred in the same individuals after adjustment for age and other covariates. In general, hand exostoses were not associated with aortic calcification.
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Stary H, Chandler AB, Dinsmore RE, Fuster V, Glagov S, et al. (1995) A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Circulation 92:1355–1374
Witteman J, Kok FJ, van Saase JL, Valkenburg HA (1986) Aortic calcification as a predictor of cardiovascular mortality. Lancet 2:1120–1122
Iribarren C, Sidney S, Sternfeld B, Browner WS (2000) Calcification of the aortic arch: risk factors and association with coronary heart disease, stroke, and peripheral vascular disease. JAMA 283:2810–2815
Blankenhorn D, Brooks SH, Selzer RH, Crawford DW, Chin HP (1974) Assessment of atherosclerosis from angiographic images. Proc Soc Exp Biol Med 145:1298–1300
Mitchell J, Adams J (1977) Aortic size and aortic calcification: a necropsy study. Atherosclerosis 27:437–446
Eggen D, Solberg L (1986) Variation of atherosclerosis with age. Lab Invest 18:571–579
Kauppila LI, Polak J, Cupples LA, Hannan MT, Kiel DP, Wilson PWF (1997) New indices to classify location, severity, and progression of calcific lesions in the abdominal aorta: a 25-year follow-up study. Atherosclerosis 132:245–250
Wilson PWF, Kauppila LI, O’Donnell C, Kiel DP, Hannan MT, Polak JM, Cupples LA (2001) Abdominal aortic calcification is an important predictor of vascular morbidity and mortality. Circulation 103:1529–1534
Walsh CR, Cupples LA, Levy D, Kiel DP, Hannan M, Wilson PW, O’Donnell CJ (2002) Abdominal aortic calcific deposits are associated with increased risk for congestive heart failure: the Framingham Heart Study. Am Heart J 144:733–739
Aigner T, Dietz U, Stoss H, Vondermark K (1995) Differential expression of collagen type-I, type-II, type-III, and type-X in human osteophytes. Lab Invest 73:236–243
Bord S, Horner A, Hembry R, Reynolds J, JE Compston (1997) Distribution of matrix metalloproteinases and their inhibitor, TIMP-1, in developing human osteophytic bone. J Anat 191:39–48
Miyamoto S, Takaoka K, Yonenobu K, Ono K (1992) Ossification of the ligamentum-flavum induced by bone morphogenetic protein - an experimental study in mice. J Bone Joint Surg (Br) 74:279–283
Yonemori K, Imamura T, Ishidou Y, Okano T, Matsunaga S (1997) Bone morphogenetic protein receptors and activin receptors are highly expressed in ossified ligament tissues of patients with ossification of the posterior longitudinal ligament. Am J Pathol 150:1335–1347
Karasik D, Arensburg B, Tillier A-M, Pavlovsky O (1998) Skeletal age assessment of fossil hominids. J Archaeol Sci 25:689–696
Jones G, Nguyen T, Sambrook PN, Kelly PJ, Eisman JA (1995) A longitudinal study of the effect of spinal degenerative disease on bone density in the elderly. J Rheumatol 22:932–936
Liu G, Peacock M, Eilam O, Dorulla G, Braunstein E, Johnston CC (1997) Effect of osteoarthritis in the lumbar spine and hip on bone mineral density and diagnosis of osteoporosis in elderly men and women. Osteoporos Int 7:564–569
O’Neill T, McCloskey EV, Kanis JA, Bhalla AK, Reeve J, et al. (1999) The distribution, determinants, and clinical correlates of vertebral osteophytosis: a population based survey. J Rheumatol 26:842–848
Weissman B (2000) Orthopedic radiology. Saunders, New York
Zhang Y, Niu J, Kelly-Hayes M, Chaisson CE, Aliabadi P, Felson DT (2002) Prevalence of symptomatic hand osteoarthritis and its impact on functional status among the elderly: the Framingham Study. Am J Epidemiol 156:1021–1027
Schulz E, Arfai K, Liu X, Sayre J, Gilsanz V (2004) Aortic calcification and the risk of osteoporosis and fractures. J Clin Endocrinol Metab 89:4246–4253
Kiel DP, Kauppila LI, Cupples LA, Hannan MT, O’Donnell CJ, Wilson PW (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
Boyden LM, Mao J, Belsky J, Mitzner L, Farhi A, Mitnick MA, Wu D, Insogna K, Lifton RP (2002) High bone density due to a mutation in LDL-receptor-related protein 5. N Engl J Med 346:1513–1521
Dequeker J, Aerssens J, Luyten FP (2003) Osteoarthritis and osteoporosis: clinical and research evidence of inverse relationship. Aging Clin Exp Res 15:426–439
Rogers J, Shepstone L, Dieppe P (1997) Bone formers: osteophyte and enthesophyte formation are positively associated. Ann Rheum Dis 56:85–90
Demer L, Watson K, Bostrom K (1994) Mechanism of calcification in atherosclerosis. Trends Cardiovasc Med 4:45–49
Lane N, Nevitt M, Genant H, Hochberg M (1993) Reliability of new indices of radiographic osteoarthritis of the hand and hip and lumbar disc degeneration. J Rheumatol 20:1911–1918
Kauppila LI, McAlindon T, Evans S, Wilson PW, Kiel D, Felson DT (1997) Disc degeneration/back pain and calcification of the abdominal aorta. A 25-year follow-up study in Framingham. Spine 22:1642–1649
Kricun M, Edeiken J (1973) Atlas of hand bones in systemic disease. Williams & Wilkins, Baltimore
Kellgren J, Lawrence JS (1957) Radiologic assessment of osteoartrosis. Ann Rheum Dis 16:494–501
Altman R, Hochberg M, Murphy WJ, Wolfe F, Lequesne M (1995) Atlas of individual radiographic features in osteoarthritis. Osteoarthritis Cartilage (suppl A):3–70
Kallman D, Wigley F, Scott W, Hochberg M, Tobin J (1989) New radiographic grading scales for osteoarthritis of the hand. Arthritis Rheum 32:1584–1591
Pavlovsky O, Kobyliansky E (1999) Population biology of human aging. Angelo Pontecorboli Press, Florence
Karasik D, Yakovenko K, Barakh I, Kobyliansky E, Livshits G, Batsevich V, Otremski I, Pavlovsky O (1999) Comparative analysis of age prediction by markers of bone change in the hand as assessed by roentgenography. Am J Hum Biol 11:31–44
Felson DT, Kiel DP, Anderson JJ, Kannel WB (1988) Alcohol consumption and hip fractures: the Framingham Study. Am J Epidemiol 128:1102–1110
Kannel WB, Sorlie P (1979) Some health benefits of physical activity. The Framingham Study. Arch Intern Med 139:857–861
Kiely DK, Wolf PA, Cupples LA, Beiser AS, Kannel WB (1994) Physical activity and stroke risk: the Framingham Study. Am J Epidemiol 140:608–620
Samelson EJ, Kiel DP, Broe KE, Zhang Y, Cupples LA, Hannan MT, Wilson PW, Levy D, Williams SA, Vaccarino V (2004) Metacarpal cortical area and risk of coronary heart disease: the Framingham Study. Am J Epidemiol 159:589–595
Agresti A (1990) Categorical data analysis. John Wiley & Sons, New York
Hak A, Pols H, van Hemert A, Hofman A, Witteman J (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
Pye SR, Reid DM, Smith R, Adams JE, Nelson K, Silman AJ, O’Neill TW (2004) Radiographic features of lumbar disc degeneration and self-reported back pain. J Rheumatol 31:753–758
Chaisson CE, Zhang Y, McAlindon TE, Hannan MT, Aliabadi P, Naimark A, Levy D, Felson DT (1997) Radiographic hand osteoarthritis: incidence, patterns, and influence of pre-existing disease in a population based sample. J Rheumatol 24:1337–1343
Kauppila LI, Mikkonen R, Mankinen P, Pelto-Vasenius K, Maenpaa I (2004) MR aortography and serum cholesterol levels in patients with long-term nonspecific lower back pain. Spine 29:2147–2152
Walsh DA (2004) Angiogenesis in osteoarthritis and spondylosis: successful repair with undesirable outcomes. Curr Opin Rheumatol 16:609–615
Koki A, Khan NK, Woerner BM, Dannenberg AJ, Olson L, Seibert K, Edwards D, Hardy M, Isakson P, Masferrer JL (2002) Cyclooxygenase-2 in human pathological disease. Adv Exp Med Biol 507:177–184
Valdes A, Hassett G, Hart D, Spector T (2005) Radiographic progression of lumbar spine disc degeneration is influenced by variation at inflammatory genes: a candidate SNP association study in the Chingford cohort. Spine 30(21):2445–2451
Rogers J, Shepstone L, Dieppe P (2004) Is osteoarthritis a systemic disorder of bone? Arthritis Rheum 50:452–457
Felson DT, Neogi T (2004) Osteoarthritis: is it a disease of cartilage or of bone? Arthritis Rheum 50:341–344
Voudouris KP (2003) Enthesial fibrocartilage-bone interaction. J Musculoskel Neuron Interact 3:89–100
Sarzi-Puttini P, Atzeni F (2004) New developments in our understanding of DISH (diffuse idiopathic skeletal hyperostosis). Curr Opin Rheumatol 16:287–292
Acknowledgments
The Framingham Heart Study is supported by NIH/NHLBI contract N01-HC-25195. We gratefully acknowledge the Framingham Study members who participated in this study, as well as the study coordinators, who contributed to the success of this work. This work was supported by the National Institutes of Health (NIAMS/NIA RO1 AR41398 to D.P.K. and NIAMS AR47785 to D.T.F.). D.K. was supported by a Health Professional Investigator Award from the Research and Education Foundation, American College of Rheumatology (2002).
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Karasik, D., Kiel, D.P., Kiely, D.K. et al. Abdominal Aortic Calcification and Exostoses at the Hand and Lumbar Spine: The Framingham Study. Calcif Tissue Int 78, 1–8 (2006). https://doi.org/10.1007/s00223-005-0054-3
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DOI: https://doi.org/10.1007/s00223-005-0054-3