Significant inverse relationships between atherosclerotic calcified plaque and bone mineral density in type 2 diabetes
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Epidemiological evidence exists for a relationship between bone mineral density (BMD) and aortic calcified plaque. In order to determine the relationships between atherosclerotic calcified plaque (CP) and BMD, CP was measured in the coronary arteries, carotid bifurcation, and abdominal aorta using computed tomography (CT) in 1023 patients with type 2 diabetes, 85% being European American (EA) and 15% African American (AA). Trabecular volumetric BMD in thoracic (T-vBMD) and lumbar (L-vBMD) spine was measured with quantitative CT whereas areal BMD (aBMD) in the lumbar spine and hip was measured by dual X-ray absorptiometry. After adjusting for age, significant inverse associations between CP and vBMD were observed in EA men and in AA women, excluding aortic CP. Similarly, after adjusting for age and other covariates, significant inverse relationships were found between CP and vBMD in EA men and in AA women with type 2 diabetes. Estrogen use was consistently associated with an inverse relationship between CP and vBMD in AA but not in EA women. Based on these results, the authors conclude that there is a complex and significant relation between atherosclerotic calcification and bone mineralization in type 2 diabetes that is influenced by age, sex, and ethnicity, with further effect modification by hormone replacement therapy.
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