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. 2013 Apr;24(4):1177-84.
doi: 10.1007/s00198-012-2101-z. Epub 2012 Aug 8.

Severity of aortic calcification is positively associated with vertebral fracture in older men--a densitometry study in the STRAMBO cohort

P Szulc  1 , E J Samelson, E Sornay-Rendu, R Chapurlat, D P Kiel
Affiliations

Severity of aortic calcification is positively associated with vertebral fracture in older men--a densitometry study in the STRAMBO cohort

P Szulc et al. Osteoporos Int. 2013 Apr.

Abstract

In older men, severe abdominal aortic calcification and vertebral fracture (both assessed using dual-energy X-ray absorptiometry) were positively associated after adjustment for confounders including bone mineral density.

Introduction: Abdominal aortic calcification (AAC) is associated with higher fracture risk, independently of low bone mineral density (BMD). Dual-energy X-ray absorptiometry (DXA) can be used to assess both vertebral fracture and AAC and requires less time, cost, and radiation exposure.

Methods: We conducted a cross-sectional study of the association between AAC and prevalent vertebral fractures in 901 men≥50 years old. We used DXA (vertebral fracture assessment) to evaluate BMD, vertebral fracture, and AAC.

Results: Prevalence of vertebral fracture was 11%. Median AAC score was 1 and 12% of men had AAC score>6. After adjustment for age, weight, femoral neck BMD, smoking, ischemic heart disease, diabetes, and hypertension, AAC score>6 (vs ≤6) was associated with 2.5 (95% CI, 1.4-4.5) higher odds of vertebral fracture. Odds of vertebral fracture for AAC score>6 increased with vertebral fracture severity (grade 1, OR=1.8; grade 2, OR=2.4; grade 3, OR=4.4; trend p<0.01) and with the number of vertebral fractures (1 fracture, OR=2.0, >1 fracture, OR=3.5). Prevalence of vertebral fracture was twice as high in men having both a T-score<-2.0 and an AAC score>6 compared with men having only one of these characteristics.

Conclusions: Men with greater severity AAC had greater severity and greater number of vertebral fractures, independently of BMD and co-morbidities. DXA can be used to assess vertebral fracture and AAC. It can provide a rapid, safe, and less expensive alternative to radiography. DXA may be an important clinical tool to identify men at high risk of adverse outcomes from osteoporosis and cardiovascular disease.

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Conflict of interest statement

Conflicts of interest The authors have no conflict of interest to disclose

Figures

Fig. 1
Fig. 1
a Distribution (number) of vertebral fractures according to vertebral level in 901 men aged 50 years and older from the STRAMBO cohort. b Distribution of abdominal aortic calcification (AAC) score by age in 901 men from the STRAMBO cohort. Data are presented as median and interquartile range per 5-year age groups
See this image and copyright information in PMC

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