Correlation Analysis Of Bone Mineral Density,Bone Metabolism Indexes And Coronary Artery Calcification In Middle-aged And Elderly Population

Objective:To investigate the correlation among bone mineral density,bone metabolism and the degree of coronary artery calcification in middle-aged and elderly population.Methods:This study involved 186 subjects(39～81 years old)who underwent coronary artery CT angiography(CTA)in the Health Management Center and the Department of Cardiology of Qilu Hospital of Shandong University from June 2018 to October 2020.According to the measured bone mineral density(BMD)results,the study population was divided into three groups:health group,osteopenia group and osteoporosis group.Detailed records of bone metabolic markers related to study population,including:N-terminal midfragment of osteocalcin(N-MID),fetal globulin A(Fetuin-A),total I type collagen amino peptide(tP1NP),extended β-I type collagen peptide(β-CTx),alkaline phosphatase(ALP),parathyroid hormone(PTH),calcium(Ca)and phosphorus(P),other biochemical indicators and the basic situation.The coronary artery calcium scoring was calculated with Agatston score(AS),and the total coronary artery calcium scoring was obtained by summing up the scores of the branches.According to the total score,the subjects were divided into non-coronary artery calcium group and coronary artery calcium group(non-coronary artery calcium group:≤10;coronary artery calcium group:>10).SPSS22.0 was used for statistical analysis.Results:1.Comparison of basic data of the research object between the non-coronary artery calcium group and the coronary artery calcium groupThe total score of coronary artery calcification calculated by Agatston score method(AS)was divided into two groups(non-coronary artery calcium group and coronary artery calcium group).Comparison of basic data of the research object,including age,differential pressure,fasting blood glucose(FBG),high-density lipoprotein cholesterol(HDL-C)and history of menopause was statistically significant difference between the groups.There were no significant differences in gender,height,body mass,BMI,systolic blood pressure,diastolic blood pressure,heart rate(HR),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),and smoking and drinking history between the groups.2.Comparison between the bone mass obtained by T and coronary calcification Comparison of bone mass in lumbar spine and hip with coronary artery calcification:The change of bone mass was different between coronary artery calcium group and non-coronary artery calcium group.Further,intra-group comparison showed that there was a statistically significant difference between health group and osteopenia group,as well as between health group and osteoporosis group,while there was no statistically significant difference between osteopenia and osteoporosis group.3.Comparison of BMD values and coronary artery calcification in different partsBMD values measured by dual-energy X-ray absorptiometry were compared with coronary calcification,and the results showed that the BMD values in the hip(neck,trochanter,internal,total)and lumbar spine(L1-L4,total)were statistically significant different between coronary artery calcium group and non-coronary artery calcium group.4.Comparison of biochemical indexes of bone metabolism and coronary artery calcificationComparison of bone metabolism-related indexes between coronary artery calcium group and non-coronary artery calcium group showed statistically significant differences in Fetuin-A and ALP,while there were no statistically significant differences in tP1NP、β-CTx、N-MID、PTH、Ca and P.5.Correlation analysis of coronary calcification with biochemical indexes of bone metabolism and BMDThe results of this study showed that coronary artery calcium scoring was positively correlated with age、pressure difference、FBG、ALP、hip bone mass、lumbar bone mass、female menopause history.Coronary artery calcium scoring was negatively correlated with gender、HDL-C、Fetuin-A、neck BMD、rotor BMD、internal BMD、total hip BMD、L1BMD、L2BMD、L3BMD、L4BMD and total lumbar BMD.6.Binary Logistic regression analysis of coronary calcification with biochemical indexes of bone metabolism and BMDThe model include gender、age、differential pressure、FBG、HDL-C、ALP、Fetuin-A、hip bone mass、lumbar spine bone mass、neck BMD value、rotor BMD value、internal value of BMD、hip BMD value、L1-L4BMD value、total lumbar BMD values of these variables.Among them,gender、age、HDL-C、Fetuin-A、L4BMD value these five variables in the model there is statistical significance.Conclusion:1.The age,FBG and HDL-C of coronary artery calcification group were significantly higher than those of non-calcification group.In this study,pressure difference was added to common risk factors for comparison,and the results showed that pressure difference was significantly different between the groups,and pressure difference was positively correlated with coronary artery calcification score.The results of this study also showed that there was a significant difference in the history of menopause between the two groups,and there was a significant positive correlation.2.Bone mass in the hip and lumbar spine was compared with coronary calcification.Bone loss and osteoporosis were more common in patients with coronary artery calcification than in those without coronary artery calcification.Low BMD was positively correlated with coronary artery calcification.In addition,according to the comparison of BMD values measured by dual-energy X-ray absorptiometry and coronary calcification,the BMD values of the hip(neck,rotor,interior,total)and the lumbar spine(L1-L4,total)showed statistically significant difference between the group with coronary calcification and the group without calcification.Coronary artery calcium score was negatively correlated with BMD value of each part.The value of L4BMD had a certain influence on the incidence of coronary artery calcification.3.Among the biochemical indexes of bone metabolism,Fetuin-A and ALP showed statistically significant differences with coronary artery calcification,and were correlated with coronary artery calcification.Furthermore,Fetuin-A is an independent risk factor for coronary calcification.However,no correlation was found between other bone metabolism biochemical indexes and coronary artery calcification.