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Ischemic heart disease is associated with lower cortical volumetric bone mineral density of distal radius

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Abstract

Summary

In this study, high-resolution peripheral quantitative computed tomography (HR-pQCT) was used to investigate geometric, volumetric and microstructural parameters at the distal radius and at the distal tibia in participants with ischaemic heart disease. We found that, compared with participants without ischaemic heart disease, they had substantially lower cortical volumetric bone mineral density (BMD) at the distal radius.

Introduction

HR-pQCT captures novel aspects of bone geometry and volumetric bone mineral density (vBMD) and offers the ability to measure bone microarchitecture, but data relating measures obtained from this technique in patients with ischemic heart disease (IHD) are lacking.

Methods

Here, we report an analysis from the Hertfordshire Cohort Study, where we were able to study associations between measures obtained from HR-pQCT of distal radius and distal tibia in 350 participants (184 men and 166 women) aged 71.5–80.5 years with or without IHD (e.g. heart attack, angina or heart failure; n = 75 and n = 275, respectively).

Results

Analyses for all participants (men and women together) revealed that cortical vBMD (Ct.vBMD) was lower (p < 0.001) and cortical thickness (Ct.th) was not different (p = 0.519), whereas cortical porosity (Ct.Po) was higher (p = 0.016) in participants with IHD at the distal radius. Moreover, trabecular microarchitectural parameters were not significantly different in patients with IHD (p > 0.05 for all). Adjustment for a priori confounders (age, gender, body mass index, smoking status, alcohol consumption, high blood pressure and diabetes mellitus) did not materially affect the relationship described for Ct.vBMD (p = 0.002), but differences in Ct.Po were attenuated. Analyses in men alone revealed that only Ct.vBMD was lower at the distal radius in participants with IHD with and without adjustment for a priori confounders (p = 0.0002 and p = 0.004, respectively), whereas no statistical differences were found in women, although patterns of differences were similar in both sexes. Moreover, no association was found between IHD and bone parameters at the distal tibia either in men or women.

Conclusions

We have demonstrated that IHD is associated with lower Ct.vBMD of the distal radius.

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Acknowledgments

This research has been made possible thanks to a fellowship grant from Arthritis Research UK (grant number 19583). The present work was funded by an unrestricted grant from SERVIER and the International Osteoporosis Foundation. Funding was also received from la Société Française de Rhumatologie. 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.

Conflicts of interest

Professor Cooper has received consultancy fees/honoraria from Servier, Eli Lilly, Merck, Amgen, Alliance, Novartis, Medtronic, GSK and Roche. Julien Paccou, Mark Edwards, Kate Ward, Karen Jameson, Charlotte Moss, Nicholas Harvey and Elaine Dennison declare that they have no conflict of interest.

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Authors and Affiliations

  1. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK

    J. Paccou, M. H. Edwards, K. A. Jameson, C. L. Moss, N. C. Harvey, E. M. Dennison & C. Cooper

  2. Department of Rheumatology, Lille University Hospital, Lille 2, 59037, Lille cedex, France

    J. Paccou

  3. MRC Human Nutrition Research, Elsie Widdowson Laboratory, 120 Fulbourn Road, Cambridge, CB1 9NL, UK

    K. A. Ward

  4. Victoria University, Wellington, New Zealand

    E. M. Dennison

  5. NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, OX3 5UG, UK

    C. Cooper

  6. NIHR Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Trust, Southampton General Hospital, Southampton, SO16 6YD, UK

    C. Cooper

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  1. J. Paccou
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  7. E. M. Dennison
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  8. C. Cooper
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Correspondence to C. Cooper.

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Paccou, J., Edwards, M.H., Ward, K.A. et al. Ischemic heart disease is associated with lower cortical volumetric bone mineral density of distal radius. Osteoporos Int 26, 1893–1901 (2015). https://doi.org/10.1007/s00198-015-3132-z

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  • DOI: https://doi.org/10.1007/s00198-015-3132-z

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