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Low volumetric BMD tied to calcified atherosclerotic plaque progression in black adults
In black adults, the progression of calcified atherosclerotic plaque in the abdominal aorta is significantly associated with lower baseline volumetric bone mineral density in both the lumbar and thoracic vertebrae.
Barry I. Freedman, MD, professor of nephrology and section chief of nephrology for the Center on Diabetes, Obesity and Metabolism at Wake Forest School of Medicine in Winston-Salem, North Carolina, and colleagues evaluated data from the African American-Diabetes Heart Study on 300 black adults (mean age, 55 years) with type 2 diabetes (baseline HbA1c, 8.1%). Researchers sought to determine the predictors of progression of calcified atherosclerotic plaque in the aorta and carotid and coronary arteries. Participants were followed for a mean of 5.3 years.
Over time, calcified atherosclerotic plaque increased in the aorta and carotid and coronary arteries (P < .0001 for all). Change in aorta plaque was inversely associated with baseline lumbar volumetric BMD and thoracic volumetric BMD, but baseline volumetric BMD was not tied to a change in coronary or carotid artery plaque. An increase in aorta plaque was associated with lower baseline lumbar volumetric BMD (P = .006), and lower baseline thoracic volumetric BMD was associated with an increase in aorta plaque (P = .005).
Increased progression of carotid artery plaque was associated with lower baseline estimated glomerular filtration rate (P = .0004). Pericardial fat that was higher at baseline was associated with increased progression of carotid artery plaque (P = .001) and aorta plaque (P = .0006).
"Given the increased risk of cardiovascular disease among persons with [type 2 diabetes] and the known risk of vascular morbidity and mortality that is associated with calcification of the abdominal aorta, it seems prudent to carefully evaluate [African Americans] who manifest bone loss for CVD risk factors and initiate early treatment of risk factors,” the researchers wrote. “Despite marked differences in propensities to develop [calcified atherosclerotic plaque] and osteoporosis between [African Americans] and [European Americans], along with different vitamin D axes, longitudinal analyses in both ethnic groups demonstrate significant inverse associations between bone mineralization and [calcified atherosclerotic plaque], supporting a causal relationship beyond conventional CVD risk factors.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.