Calcified atherosclerotic plaque and bone mineral density in type 2 diabetes: The diabetes heart study

被引:53
|
作者
Carr, J. Jeffrey [1 ,2 ]
Register, Thomas C. [3 ]
Hsu, Fang-Chi [2 ]
Lohman, Kurt [2 ]
Lenchik, Leon [1 ]
Bowden, Donald W. [4 ,5 ,6 ]
Langefeld, Carl D. [2 ]
Xu, Jianzhou [2 ]
Rich, Stephen S. [7 ]
Wagenknecht, Lynne E. [2 ]
Freedman, Barry I. [4 ]
机构
[1] Wake Forest Univ, Bowman Gray Sch Med, Dept Radiol, Winston Salem, NC 27157 USA
[2] Wake Forest Univ, Bowman Gray Sch Med, Div Publ Hlth Sci, Winston Salem, NC 27157 USA
[3] Wake Forest Univ, Bowman Gray Sch Med, Dept Pathol, Winston Salem, NC 27157 USA
[4] Wake Forest Univ, Bowman Gray Sch Med, Dept Internal Med, Winston Salem, NC 27157 USA
[5] Wake Forest Univ, Bowman Gray Sch Med, Dept Biochem, Winston Salem, NC 27157 USA
[6] Wake Forest Univ, Bowman Gray Sch Med, Ctr Human Genom, Winston Salem, NC 27157 USA
[7] Univ Virginia, Ctr Publ Hlth Genom, Charlottesville, VA 22908 USA
关键词
atherosclerosis; type 2 diabetes mellitus; osteoporosis; trabecular bone mineral density; calcium; computed tomography;
D O I
10.1016/j.bone.2007.08.023
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The purpose of the present study was to determine the relationships between atherosclerotic calcified plaque (CP) and bone mineral density (BMD) in subjects with type 2 diabetes mellitus (DM2). CP in the coronary arteries, carotid bifurcation, and abdominal aorta was measured using computed tomography (CT) in 1023 diabetic subjects from 453 families. Trabecular volumetric BMD in thoracic (T-vBMD) and lumbar (L-vBMD) spine was measured with quantitative CT (QCT), while areal BNID (aBMD) in the lumbar spine and hip was measured by dual X-ray absorptiometry (DXA). Correlation coefficients were computed to assess the magnitude of associations and generalized estimating equations (GEE1) were used to make statistical inferences while accounting for familial correlation. Subjects were 53.8% female, 85% European American (EA) and 15% African American (AA). After adjustment for age, significant inverse associations between CP and vBMD persisted in EA men (correlations between -0.11 and -0.16, all p<0.05 with the exception of carotid CP vs. T-vBMD, p=0.076) and in AA women, excluding aortic CP (correlations between -0.16 and -0.25, all p<0.05). Estrogen use in AA but not EA women was consistently associated with an inverse relation between CP and vBMD. Significant inverse relationships between CP and vBMD were observed in EA men and AA women with DM2 after adjusting for age and other covariates. QCT determined vBMD was more strongly related to CP than aBMD by DXA. The relation between CP and BMD in diabetes is influenced by age, sex, and ethnicity, with further effect modification by hormone replacement therapy. (C) 2007 Elsevier Inc. All rights reserved.
引用
收藏
页码:43 / 52
页数:10
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