The Correlation Between Bone Mineral Density And Coronary Artery Calcification

ObjectivesTo explore the correlation between bone mineral density（BMD）and coronary artery calcification（CAC）.MethodsA total of 7,926 patients who had completed BMD examination in Fujian Provincial Hospital from December 2017 to October 2020 were included in this study.286 patients who had completed BMD examination and CAC assessment were screened out,and 153 patients were included according to the exclusion criteria.General information such as age,gender,past medical history,medication history,blood lipid,BMD,and CAC was collected retrospectively.Independent sample T-test was used to compare the differences between normal data groups,Mann-Whitney U test was used to compare the differences between non-normal data groups,and chi-square test was used to compare the differences between classified data groups.The relationship between coronary artery calcification score（CACs）,BMD,and risk factors of atherosclerotic cardiovascular disease（ASCVD）was analyzed by Spearman rank correlation.The multivariate Logistic regression analysis screened the independent predictors of CAC,and a regression equation model was constructed to predict CAC.The receiver operating characteristic curve（ROC）was drawn according to the prediction probability of the model,and the area under the curve（AUC）was calculated.Results1.In the analysis of the gender subgroup,the proportion of coronary atherosclerotic heart disease（CHD）and smoking history in the male group was significantly higher than that in the female group.The proportion of dyslipidemia in the female group was higher than that in the male group.In the aspect of blood lipid,the total cholesterol（TC）,low-density lipoprotein cholesterol（LDL-C）,high-density lipoprotein cholesterol（HDL-C）,and apolipoprotein A（Apo A）in the female group were higher than those in the male group（P<0.05）.The proportion of osteoporosis（OP）in the female group was higher than that in the male group;except for the total hip T-value,the BMD and T values of all parts in the female group were lower than those in the male group,and OP had higher CACs than non-OP in the female group（P<0.05）.There were significant differences in BMD of different CAC grades in the female group（P<0.05）.Overall,BMD of all parts showed a downward trend with the increase of CAC grades,while there was no significant relationship between CAC grades and BMD in the male group.2.In the correlation analysis,it was found that BMD in various parts in the female group was negatively correlated with CACs,while BMD in various parts in the male group was not correlated with CACs.There was a positive correlation between CACs,Apo B/Apo A ratio,and 10-year ASCVD risk（P<0.05）,and a negative correlation between Apo A,BMD of the male femoral neck,and 10-year ASCVD risk（P<0.05）.3.Multivariate Logistic regression analysis showed that Lumbar 1-4 BMD and age were independent predictors of CAC in women,in which Lumbar 1-4 BMD was a protective factor,age was an independent risk factor.The regression model for predicting CAC was constructed as follows:P=e^z/（1+e^z）,Z=-2.178+（-5.530*X₁）+（0.079*X₂）,where X₁represented Lumbar 1-4 BMD,X₂represented age,and e was the natural logarithm.The AUC=0.753（95CI%:0.648-0.858,P<0.001）.When the Cutoff value was 0.490 and Yoden Index was 0.475,the sensitivity and specificity were the best,which were 91.9%and 55.6%,respectively.Conclusions1.There was a close relationship between BMD and CAC,and there was an obvious gender difference between them.2.BMD and Apo A were negatively correlated with 10-year ASCVD risk,while CACs and Apo B/Apo A ratio were positively correlated with 10-year ASCVD risk.3.In the female group,BMD of various sites was negatively correlated with CACs,and Lumbar 1-4 BMD and age were independent predictors of CAC in women.