Progression of Aortic Calcification Is Associated With Metacarpal Bone Loss During Menopause

TLDR

Atherosclerosis and osteoporosis are major causes of morbidity and mortality in postmenopausal women, yet no study has examined whether progression of aortic calcification is linked to bone loss. This study aimed to determine whether progression of aortic calcification is associated with metacarpal bone loss during menopause. We followed 236 premenopausal women for nine years and additionally assessed cross‑sectional associations in 720 postmenopausal women using radiographic aortic calcification and metacarpal radiogrammetry. Progression of aortic calcification occurred in 25 % of women and was associated with greater loss of metacarpal bone mass (3.2 mm² vs 2.0 mm²) and density (7.2 % vs 5.6 %)—a graded inverse relationship that remained significant after adjusting for confounders.

Abstract

Abstract —Atherosclerosis and osteoporosis are major causes of morbidity and mortality in postmenopausal women and have been suggested to be associated. No study has examined whether progression of atherosclerotic calcification is associated with bone loss. In the present study, we examined progression of aortic calcification, diagnosed by radiographic detection of calcified deposits in the abdominal aorta, in relation to metacarpal bone loss, as assessed by metacarpal radiogrammetry, during menopause. Initially premenopausal women (n=236), aged 45 to 57 years at baseline, were followed for 9 years. We additionally assessed the cross-sectional association between the extent of aortic calcification and metacarpal bone mass and density in 720 postmenopausal women. Twenty-five percent of women going through menopause showed progression of aortic calcification. The average loss of metacarpal bone mass among women with progression of aortic calcification was 3.2 mm 2 , and their loss of metacarpal bone density was 7.2 mm 2 %, whereas in women without progression of aortic calcification, these losses were 2.0 mm 2 and 5.6 mm 2 %, respectively, adjusted for age and years of follow-up ( P <0.05). Additional adjustment for age at menopause, body mass index, blood pressure, smoking, diabetes mellitus, and use of hormone replacement therapy, thiazide, and loop diuretics did not influence these results. In postmenopausal women, a graded inverse cross-sectional association between the extent of aortic calcification and metacarpal bone mass and density was found. In conclusion, our results indicate that progression of atherosclerotic calcification is associated with increased bone loss in women during menopause.