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. 2022 Mar 29:13:20406223221086998.
doi: 10.1177/20406223221086998. eCollection 2022.

Associations between bone mineral density and coronary artery calcification: a systematic review and meta-analysis

Peiyu Zhang  1 , Liu Yang  2 , Qingwen Xu  1 , Yidi Zeng  2 , Yipin Yu  2 , Qinghua Peng  3 , Hao Liang  4
Affiliations

Associations between bone mineral density and coronary artery calcification: a systematic review and meta-analysis

Peiyu Zhang et al. Ther Adv Chronic Dis. .

Abstract

Background: The studies about the correlation between bone mineral density (BMD) and coronary arterial calcification (CAC) were still controversial. The aim of this study was to conduct a meta-analysis to evaluate the association between BMD and CAC.

Methods: We systematically searched PubMed, Embase, Google scholar and Cochrane library for observational studies. We pooled odds ratio (OR) or correlation coefficient, and 95% confidence interval (CI) of the studies. Continuous data were pooled by mean difference (MD). Sub-group analysis was applied to investigate sources of heterogeneity. Funnel plots for publication bias was also performed.

Results: Seventeen studies met the inclusion criteria. Pooled ORs for the prevalence of CAC in patients with low BMD versus patients with normal BMD was 2.11 (95% CI: 1.11 - 4.02, P = 0.02). The data pooled for comparing CAC score of low BMD and normal BMD patients is 33.77 (95% CI: 23.77 - 43.77, p = 0.000). The pooled ORs of multivariate logistic regression to predict the association were 1.00 (95% CI: 0.92 - 1.10, p = 0.95, age-adjusted), and 0.95 (95% CI: 0.86 - 1.05, p = 0.33, multivariable-adjusted). Cohort category and BMD assessment method were the main sources of heterogeneity.

Conclusions: Low BMD is associated with higher prevalence and severity of CAC, especially in postmenopausal women. But the relation is not significant after adjusting age and other confounding variables. Low BMD and CAC may be two independent processes with aging. More large-scale studies with high-quality design are still needed to increase the understanding of them.

Keywords: bone mineral density; coronary artery calcification; meta-analysis.

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Conflict of interest statement

Conflict of interest statement: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA flow chart for literature screening.
Figure 2.
Figure 2.
Forest plot of association between bone mineral density and coronary artery calcification.
Figure 3.
Figure 3.
Forest plot of coronary artery calcification score comparison between low bone mineral density and normal bone mineral density.
Figure 4.
Figure 4.
Forest plot of bone mineral density difference in non- coronary artery calcification and coronary artery calcification.
Figure 5.
Figure 5.
Forest plot of relationship between bone mineral density (BMD) and coronary artery calcification score (Correlation coefficient). (a) The pooled correlation coefficient of lumbar spine BMD and CAC score and (b) The pooled correlation coefficient of femur BMD and CAC score.
Figure 6.
Figure 6.
Forest plot of Logistic regression analysis of the relationship between low bone mineral density in different locations and coronary artery calcification (age-adjusted).
Figure 7.
Figure 7.
Forest plot of Logistic regression analysis of the relationship between low bone mineral density in different locations and coronary artery calcification (multivariable-adjusted).
See this image and copyright information in PMC

References

    1. Wang L, Jerosch-Herold M, Jacobs DR, et al. Coronary artery calcification and myocardial perfusion in asymptomatic adults: the MESA (Multi-Ethnic Study of Atherosclerosis). J Am Coll Cardiol 2006; 48: 1018–1026. - PMC - PubMed
    1. Agatston AS, Janowitz WR, Hildner FJ, et al. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 1990; 15: 827–832. - PubMed
    1. Coughlan T, Dockery F. Osteoporosis and fracture risk in older people. Clin Med 2014; 14: 187–191. - PMC - PubMed
    1. Kanis JA. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. Osteoporos Int 1994; 4: 368–381. - PubMed
    1. Leopold JA. MicroRNAs regulate vascular medial calcification. Cells 2014; 3: 963–980. - PMC - PubMed

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