Table 3 |
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|
Cross-sectional studies investigating relationship CV disease and low BMD |
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|
Study |
Study population |
Number of cases |
% women |
Outcome bone mass |
Outcome CV disease |
Main results # |
|
|
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|
Frye, 1992 [35] |
Population-based |
200 |
100% |
BMD lumbar spine and hip by single photon absorptiometry |
AC by x-ray |
Association AC and BMD lumbar spine: β-2.213 (P < 0.05) Association AC and BMD hip: β-0.661 (NS) |
|
Barengolts, 1998 [32] |
Clinic-based |
45 |
100% |
BMD lumbar spine and hip by DXA |
Coronary calcium score by EBT |
Correlation BDM hip and calcium score: r-0.34 (P = 0.022) Correlation BMD spine and calcium score: r-0.28 (P = 0.056) |
|
Jorgensen, 2001 [27] |
Clinic-based |
63 |
52% |
BMD femoral neck by DXA |
Incident stroke |
Women: OR: 6.6 (95% CI 1.8 to 24.8) Men: OR: 0.6 (95% CI 0.1 to 2.3) |
|
Aoyagi, 2001 [40] |
Population-based |
524 |
100% |
BMD distal and proximal radius, calcaneus single photon absorptiometry by sinlge photon absorptiometry |
AC by x-ray |
BMD distal radius and AC: OR: 1.1 (95% CI 0.9 ro 1.3) BMD calcaneus and AC: OR: 1.1 (0.9 to 1.3) |
|
Van der Klift, 2002 [29] |
Population-based |
5,268 |
57% |
BMD lumbar spine and hip by DXA |
PAD by ABI |
Women: PAD and BMD hip: OR: 1.35 (95% CI 1.02 to 1.79) Men: PAD and BMD hip: OR: 0.89 (95% CI 0.64 to 1.23) |
|
Tanko, 2003 [39] |
Population-based |
963 |
100% |
BMD hip and lumbar spine by DXA |
AC by x-ray |
AC and BMD hip: β-0.10, 9 (P = 0.004) |
|
Hirose, 2003 [56] |
Clinic-based |
7,865 |
9% |
OSI calcaneus |
baPWV |
Women: β-0.11 (P < 0.01) Men: β-0.07 (P < 0.01) |
|
Pennisi, 2004 [50] |
Clinic-based |
36 |
44% |
BMD total body, lumbar spine, and hip by DXA and calcaneus by QUS |
IMT and presence of plaque in carotid artery |
63% patients with BMD spine T <-1 93% patients with BMD hip T <-1 |
|
Jorgensen, 2004 [47] |
Population-based |
5,296 |
52% |
BMD distal radius by single x-ray absorptiometry |
IMT and prevalent plaque |
BMD and IMT: NS BMD and prevalent plaque: OR: 0.90 (95% CI 0.75 to 1.07) BMD and echogenic plaque: OR: 0.51 (95% CI 0.31 to 0.83) |
|
Montalcini, 2004 [49] |
Clinic-based |
157 |
100% |
BMD calcaneus by QUS |
IMT |
BMD and IMT: NS |
|
Magnus, 2005 [23] |
Population-based |
5,050 |
36% |
BMD hip by DXA |
Self reported CV events |
Women: OR: 1.22 (0.80 to 1.86) Men: OR: 1.39 (95% CI 1.03 to 1.87) |
|
Bakhireva, 2005 [31] |
Population-based |
366 |
51% |
BMD lumbar spine and hip by DXA |
CAC by CT scan |
Women: BMD hip and CAC: OR: 0.69 (95% CI 0.51 to 0.93) Men: BMD hip and CAC: OR: 1.03 (0.75 to 1.41) |
|
Wong, 2005 [30] |
Population-based |
3,998 |
50% |
BMD lumbar spine and hip by DXA |
PAD by ABI |
Per SD increase in ABI sign associated with hip BMD: 0.5 (95% CI 0.02 to 0.9) |
|
Yamada, 2005 [53] |
Clinic-based |
260 |
59% |
BMD lumbar spine by DXA and OSI calcanues |
IMT carotid artery and femoral artery |
BMD lumbar spine and FA-IMT: ρ-0.117 (P < 0.005) |
|
Farhat, 2006 [34] |
Population-based |
490 |
100% |
vBMD spine by CT scan |
AC and CAC by CT scan |
AC and BMD: OR: 1.68 (95% CI 1.06 to 2.68) CAC and BMD: OR: 1.19 (95% CI 0.81 to 1.74) |
|
Farhat, 2006 [19] |
Population-based |
1,489 |
51% |
BMD hip by DXA vBMD lumbar spine by QCT |
Prevalent CV disease self reported Prevalent PAD by ABI |
Women: Prevalent CV disease and BMD hip: OR: 1.22 (95% CI 1.03 to 1.43) PAD and BMD hip: NS Men: Prevalent CV disease and BMD hip: NS PAD and BMD hip: OR: 1.39 (95% CI 1.03 to 1.84) |
|
Yamada, 2006 [54] |
Population-based |
149 |
100% |
BMD lumbar spine by DXA and vBMD calcaneus by QCT |
IMT and PWV |
FA-IMT and BMD spine: β-0.067 (P < 0.05) PWV and BMD spine: NS |
|
Sumino, 2006 [60] |
Clinic-based |
315 |
100% |
BMD lumbar spine by DXA |
baPWV |
Association baPWV and BMD: β-0.265 (P = 0.002) |
|
Sinnot, 2006 [43] |
Clinic-based |
480 |
65% |
BMD lumbar spine by QCT |
Calcium score by CT-scan |
No correlation CAD and BMD in women and men |
|
Shaffer, 2007 [51] |
Population-based |
870 |
61% |
BMD lumbar spine, hip and distal radius by DXA |
IMT |
Women >60 years: IMT and BMD spine: β-73.0 (P < 0.001) IMT and BMD hip: β-62.4 (P < 0.001) Men >60 years: IMT and BMD radius: β-27.0 (P < 0.001) |
|
Sumino, 2007 [61] |
Clinic-based |
85 |
100% |
BMD lumbar spine by DXA |
Brachial arterial endothelial function (FMD) |
Correlation FMD and BMD: r .034 (P < 0.01) Association FMD and BMD: β 0.40 (P < 0.01) |
|
Hyder, 2007 [36] |
Clinic-based |
365 |
64% |
BMD lumbar spine by CT-scan |
Atherosclerotic calcium in carotid, coronary and iliac arteries by CT-scan |
Women: Calcium score aorta and BMD: OR: 3.14 (95% CI 1.55 to 6.38) Calcium score iliac arteries and BMD: OR: 2.20 (95% CI 1.13 to 4.29) Men: Calcium score carotid and BMD: OR: 2.85 (95% CI 1.02 to 7.96) Calcium score aorta and BMD: OR: 5.90 (95% CI 1.78 to 19.6) |
|
Shen, 2007 [42] |
Population-based |
682 |
56% |
BMD lumbar spine and hip by DXA |
CAC by CT scan |
CAC and BMD spine: -0.105 ± 0.132 (NS) CAC and BMD hip: 0.022 ± 0.142 (NS) |
|
Sioka, 2007 [24] |
Clinic-based |
21 |
0% |
BMD lumbar spine and hip by DXA |
CAD by angiography |
BMD in severe CAD vs no CAD: 77.8% vs 37.5%, P =? |
|
Sumino, 2008 [52] |
Clinic-based |
175 |
100% |
BMD lumbar spine by DXA |
IMT |
BMD and IMT β-0.313 (P = 0.001) |
|
Kim, 2008 [48] |
Clinic-based |
194 |
100% |
BMD lumbar spine and hip by DXA Prevalent vertebral fracture |
IMT and prevalent plaque |
BMD and IMT: NS BMD and plaque: NS Vertebral fracture and plaque: OR: 2.8 (95% CI 1.17 to 7.12) |
|
Frost, 2008 [45] |
Clinic-based |
54 |
100% |
Lumbar spine and hip by DXA |
IMT and PWV |
BMD spine and IMT: r -.025 (P = 0.26) BMD hip and IMT: r-0.17 (NS) BMD and PWV: NS |
|
Mangiafico, 2008 [57] |
Clinic-based |
182 |
100% |
BMD lumbar spine and hip DXA |
PWA (AIx and PWV) |
BMD hip and AIx: β-5.46 (P < 0.0001) BMD spine and Aix: β-3.29 (P < 0.0001) |
|
Tekin, 2008 [25] |
Clinic-based |
227 |
100% |
BMD lumbar spine by DXA |
Prevalence CAD |
CAD and low BMD: OR: 0.68 (95% CI 0.39 to 1.28) |
|
Broussard, 2008 [18] |
Population-based |
3,881 |
51% |
BMD total femur by DXA |
Framingham CHD risk score by Framingham CHD prediction model |
Women: moderate CHD risk and low BMD: OR: 1.45 (95% CI 1.03 to 2.06) high CHD risk and low BMD: OR: 1.73 (95% CI 1.12 to 2.66) Men: NS |
|
Chow, 2008 [41] |
Population-based |
693 |
54% |
vBMD lumbar spine and hip by QCT and vBMD distal radius by HRpQCT |
AC by CT-scan |
Women: NS Men: NS |
|
Hyder, 2009 [37] |
NA |
1,909 |
50% |
vBMD lumbar spine by CT scan |
CAC and AAC score |
Women: vBMD and CAC (P-trend <0.002) vBMD AND AAC (P-trend <0.004) Men: vBMD and CAC (P-trend <0.034) vBMD and AAC (P-trend <0.001) |
|
Hmamouchi, 2009 [46] |
Clinic-based |
72 |
100% |
BMD lulmbar spine and hip by DXA |
IMT in carotid artery and femoral artery |
CA-IMT and BMD hip: r-0.330 (P < 0.05) FA-IMT and BMD hip: NS IMT and BMD lumbar spine: NS |
|
Mikumo, 2009 [58] |
Clinic-based |
143 |
100% |
BMD lumbar spine by DXA |
PWV |
BMD and PWV: r-99.78 (NS) |
|
Marcowitz, 2005 [20] |
Clinic-based |
209 |
88% |
Lumbar spine, hip and distal radius by DXA |
CAD |
Osteoporosis: OR: 5.58 (95% CI 2.59 to 12.0) for CAD |
|
Ness, 2006 [38] |
Clinic-based |
1,000 |
100% |
Diagnosis osteoporosis or osteopenia by electronic medical records |
AVD |
Prevalence AVD osteoporotis vs osteopenia: 60% vs 35% (P < 0.001) Prevalence AVD osteoporis vs normal bone mass: 60% vs 22% (P < 0.001) |
|
Gupta, 2006 [78] |
Clinic-based |
101 |
100% |
BMD lumbar spine and total hip by DXA |
Prevalent CV disease |
Prevalent CV disease in low BMD vs normal BMD: 61% vs 38% (P < 0.025) |
|
Mangifico, 2006 [28] |
Clinic-based |
345 |
100% |
BMD lumbar spine and femoral neck by DXA |
PAD by ABI |
PAD and BMD lumbar spine: OR: 1.01 (95% CI 0.97 to 1.05) PAD and BMD hip: OR: 0.20 (95% CI 0.05 to 0.70) |
|
Erbilen, 2007 [33] |
Clinic-based |
74 |
0% |
BMD lumbar spine and hip by DXA |
CAD |
Association BMD and CAD: OR: 5.4 (95% CI 1.66 to 17.49) |
|
Sennerby, 2007 [21] |
Clinic-based |
1,327 |
100% |
Incident hip fracture by X-ray and hospital record |
Prevalent CV disease by questionnaire |
OR: 2.38 (95% CI 1.92 to 2.94) |
|
Varma, 2008 [22] |
Clinic-based |
198 |
74% |
Lumbar spine and hip by DXA |
Obstructive CAD |
Prevalence CAD osteoporosis vs osteopenia: 76% vs 68% (P < 0.01) Prevalence CAD osteoporosis vs normal bone mass: 76% vs 47% (P < 0.005) |
|
Seo, 2009 [59] |
Clinic-based |
253 |
100% |
BMD lumbar spine and hip by DXA |
baPWV |
Sign association BMD hip and baPWV: Β-0.123 (P < 0.05) |
|
Pouwels, 2009 [16] |
Clinic-based |
6,763 |
73% |
Incident hip fracture |
Incident stroke by ICD 9 code |
Risk hip fracture after stroke Women: OR: 2.12 (95% CI 1.73 to 2.59) Men: OR: 1.63 (95% CI 1.17 to 2.28) |
|
|
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|
#adjusted for confounders; BMD, bone mineral density; AC, aortic calcification; DXA, dual-energy x-ray absorptiometry; PAD, peripheral arterial disease; ABI, ankle brachial index; OSI, osteosono assessment index; baPWV, brachial-ankle pulse wave velocity; IMT, intimal medial thickness; CAC, coronary artery calcium; QCT, quantitative computerized tomography; PWV, pulse wave velocity; CAD, coronary artery disease; PWA, pulse wave analysis; AIx, augmentation index; CHD, coronary hearth disease; AVD, atherosclerotic vascular disease. |
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den Uyl et al. Arthritis Research & Therapy 2011 13:R5 doi:10.1186/ar3224 |
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