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. 2022 Dec 16:15:3949-3960.
doi: 10.2147/DMSO.S392152. eCollection 2022.

Association Between Coronary Artery Calcium Score and Bone Mineral Density in Type 2 Diabetes Mellitus with Different Visceral Fat Area

Ying Yang  1   2 , Lingling Li  1   2 , Yangyang Zhang  1   2 , Hong Yang  1   2 , Jia Bai  1   2 , Haihong Lv  1   2 , Songbo Fu  1   2
Affiliations

Association Between Coronary Artery Calcium Score and Bone Mineral Density in Type 2 Diabetes Mellitus with Different Visceral Fat Area

Ying Yang et al. Diabetes Metab Syndr Obes. .

Abstract

Purpose: The relationship between coronary artery calcification and bone mineral density (BMD) in T2DM is still unclear. The aim of this study is to analyze the association between coronary artery calcium score (CACs) and BMD in T2DM with different visceral fat area (VFA), and further to explore the clinical significance of CACs in predicting osteoporosis in T2DM patients.

Patients and methods: A total of 479 T2DM patients aged ≥50 years were included. Agatston was applied to calculate CACs to evaluate the degree of coronary artery calcification. Dual-energy X-ray absorptiometry (DXA) was used to measure BMD. According to VFA, all subjects were divided into VFA <100cm2 and VFA ≥100cm2 group. Adjusted regression analysis was performed to analyze the association between CACs and BMD. ROC curve was used to analyze the optimal cut-off value of CACs for screening osteoporosis.

Results: The baseline showed that in VFA ≥100cm2 group, CACs increased significantly than that in VFA <100cm2 group (212.1±195.9 vs 139.3±141.8, p<0.001) and total hip BMD decreased obviously (0.968±0.19 vs 1.021±0.184, p=0.01). After multivariable adjustment, CACs was not significantly associated with BMD in all patients (p>0.05). However, CACs was negatively associated with BMD of total hip and lumbar spine in patients with VFA ≥100cm2 (total hip β=-0.087 p=0.01; lumbar spine β=-0.052 p=0.005), but not VFA <100cm2. ROC curve analysis showed that the optimal cut-off value of CACs for screening osteoporosis was 191.505.

Conclusion: The present study implied that associations between CACs and BMD varied by the visceral fat deposition. It is critical to evaluate the condition of visceral fat accumulation for exploring the complex interplay of coronary artery calcification and BMD in T2DM patients. It may be of some clinical value for CACs in predicting osteoporosis in T2DM with visceral obesity.

Keywords: bone mineral density; coronary artery calcium score; type 2 diabetes mellitus; visceral fat area.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flow diagram of the enrollment of study subjects.
Figure 2
Figure 2
Identification of coronary artery calcifications (red arrows) in patients with type 2 diabetes. The coronary calcium score of left was 64 (with non-visceral obesity) while the right was 302 (with visceral obesity).
Figure 3
Figure 3
Coronary artery calcium score distribution difference between VFA<100cm2 and VFA≥100cm2.
Figure 4
Figure 4
Bone mineral density distribution difference between VFA<100cm2 and VFA≥100cm2 in 3 locations.
Figure 5
Figure 5
Coronary artery calcium score distribution difference among normal, osteopenia and osteoporosis in visceral fat area <100cm2 and visceral fat area ≥100cm2 group.
Figure 6
Figure 6
Standardized regression coefficients are shown for correlation between CACs and BMD by adjusted regression analyses in all patients, visceral fat area <100cm2 and visceral fat area ≥100cm2.
Figure 7
Figure 7
ROC curve analysis of CACs screening osteoporosis.
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