Carotid Intima-Media Thickness is Inversely Related to Bone Density in Female but not in Male Patients with Acute Stroke

Abstract

Background and purpose: Atherosclerosis and osteoporosis are two major public health problems. It is still uncertain whether an abnormal carotid ultrasonography, either increased intima-media thickness (IMT) or plaque thickness, is associated with osteoporosis in acute ischemic stroke patients. To investigate the possible relationships between osteoporosis and carotid atherosclerosis, we evaluated the correlation between carotid IMT/plaque thickness and bone mineral density (BMD) in acute ischemic stroke patients.

Methods: Patients having their first ischemic stroke within seven days were screened for the study. The IMT was scanned approximately 10 mm proximal to the beginning of the dilatation of the carotid bulb. The plaques were measured in both common and internal carotid arteries. The BMD was measured at total hip and lumbar spine in the anterior-posterior projection, using dual-energy x-ray absorptiometry.

Results: A total of 155 patients were enrolled in the study and the mean age was 68.3 ± 10.34 years. Multiple linear regression analysis reveals that age (P < .001), smoking (P = .016), and osteoporosis (P = .001) were significantly associated with increased carotid IMT/plaque thickness. Old age, current smoking, and osteoporosis were significantly related to increased IMT/plaque thickness in acute ischemic stroke patients. In women, IMT/plaque thickness was significantly related to age (P = .01) and osteoporosis (P = .025). In men, though there was no significant relationship, a trend toward old age and having osteoporosis was observed in increased IMT/plaque thickness (P = .051, P = .086).

Conclusions: This study showed that carotid IMT/plaque thickness was inversely related to the BMD in female but not in male patients with acute ischemic stroke.

Keywords: Atherosclerosis; bone mineral density (BMD); intima-media thickness (IMT); stroke.