Cardiovascular disease (CVD) and osteoporosis are common age-related conditions with major public health impact. Mounting evidence suggests a link between the two diseases.
The purpose of this research was to investigate the association of BMD measures (areal and volumetric) with prevalent CVD, incident CVD, and subclinical measures of atherosclerosis.
We utilized data from two prospective epidemiological studies: a) the Health, Aging, and Body Composition (Health ABC) study that enrolled a population of older men and women (age 68-80 years, 51% women, 42% black), and b) the Study of Womens Health Across the Nation (SWAN) that followed a cohort of women through the menopause transition (age 45-58 years, 61% white, 64% peri-menopausal).
In the cross-sectional Health ABC analysis, lower volumetric BMD (vBMD) measures of the spine were associated with higher CVD prevalence in men and women, and areal BMD (aBMD) of the trochanter was related to CVD in women. Additionally, aBMD of the total hip was related to subclinical peripheral arterial disease in men.
In the SWAN analysis, we observed an inverse cross-sectional association between trabecular vBMD of the spine and aortic calcification. Meanwhile, no associations with coronary artery calcification were noted after adjusting for age.
In the longitudinal Health ABC analysis, lower vBMD measures of the spine were associated with higher CVD incidence in white men, but not in blacks. In women, aBMD of the femoral neck was associated with incident CVD in the full cohort. In race-specific analyses, aBMD measures of the total hip, femoral neck, and trochanter exhibited significant relationships with incident CVD in black women, but not in whites.
These relationships were independent of age and shared risk factors between osteoporosis and CVD. The inflammatory cytokines interleukin-6 and tumor necrosis factor-alpha, oxidized LDL, and endogenous estradiol did not explain these associations.
Overall, our findings provide epidemiological evidence for the presence of an inverse association between BMD and CVD. An understanding of the common mechanisms underlying bone loss and atherogenesis has significant public health implications as it may set the stage for dual-purpose preventive and therapeutic interventions that target both osteoporosis and CVD.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-04082006-105628 |
| Date | 06 June 2006 |
| Creators | Farhat, Ghada N |
| Contributors | Dr. Anne Newman, Dr. Karen Matthews, Dr. Carol Baker, Dr. Kim Sutton-Tyrrell, Dr. Jane Cauley |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-04082006-105628/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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