Coronary calcification and bone microarchitecture by high-resolution peripheral quantitative computed tomography from the São Paulo Ageing and Health (SPAH) Study

Abstract

Epidemiological studies reveal a link between osteoporosis and the risk of ischemic cardiovascular disease. We illustrate an association between coronary calcification and bone microarchitecture in older adults based on the SPAH study. This cross-sectional research comprised 256 individuals subjected to cardiac coronary computed tomography angiography (CCTA) for coronary artery calcification (CAC), high-resolution peripheral quantitative computed tomography (HR-pQCT) at the tibia and radius with standardized z score parameters, and dual-energy X-ray absorptiometry (DXA) to evaluate bone status. We used Student's t test and the Mann-Whitney and Chi-squared tests for comparison of basal measurements. Association analysis was performed using the Poisson regression model with adjustment for CAC and sex. Multivariate analysis revealed different bone variables for predicting CAC in DXA and HR-pQCT scenarios. Although most of the bone parameters are related to vascular calcification, only cortical porosity (Ct.Po) remained uniform by HR-pQCT. Results for were as follows: the tibia-women (exp β = 1.12 (95% CI 1.10-1.13, p < 0.001) and men (exp β = 1.44, 95% CI 1.42-1.46, p < 0.001); the radius-women (exp β = 1.07 (95% CI 1.07-1.08, p < 0.001) and men (exp β = 1.33 (95% CI 1.30-1.37, p < 0.001). These findings suggest an inverse relationship between CAC and cortical bone content, as assessed by HR-pQCT, with higher coronary calcification in individuals older than 65 years.

Figure 1

Flow diagram of the study population.

Figure 2

Coronary calcium content between the sexes. CACs values are expressed in a logarithmic display and sex comparisons made by Mann–Whitney test.