Higher prevalence of morphometric vertebral fractures in patients with recent coronary events independently of BMD measurements

• Published in: Bone (New York, N.Y.) Vol. 52; no. 2; pp. 562 - 567
• Main Authors: Silva, Henrique C, Pinheiro, Marcelo M, Genaro, Patrícia S, Castro, Charlles H.M, Monteiro, Carlos M.C, Fonseca, Francisco A.H, Szejnfeld, Vera L
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Inc 01-02-2013; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Biomarkers - blood; Blood Glucose - metabolism; Body Composition; Bone Density; Bone mineral density; Brazil - epidemiology; Cardiovascular disease; Cardiovascular Diseases - blood; Cardiovascular Diseases - complications; Cardiovascular Diseases - pathology; Cardiovascular Diseases - physiopathology; Coronary events; Diseases of the osteoarticular system; Female; Fracture; Fundamental and applied biological sciences. Psychology; Humans; Injuries of the limb. Injuries of the spine; Lipids - blood; Logistic Models; Lumbar Vertebrae - pathology; Lumbar Vertebrae - physiopathology; Male; Medical sciences; Metabolic Syndrome - blood; Metabolic Syndrome - complications; Metabolic Syndrome - epidemiology; Middle Aged; Orthopedics; Osteoporosis; Osteoporosis - complications; Osteoporosis - epidemiology; Osteoporosis - physiopathology; Osteoporosis. Osteomalacia. Paget disease; Osteoprotegerin - blood; Prevalence; Spinal Fractures - blood; Spinal Fractures - complications; Spinal Fractures - epidemiology; Spinal Fractures - physiopathology; Traumas. Diseases due to physical agents; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Coronary events; Osteoporosis; Cardiovascular disease; Fracture; Bone mineral density; Human; Prevalence; Diseases of the osteoarticular system; Coronary artery; Vertebra; Epidemiology; Trauma; Morphology
• ISSN: 8756-3282; 1873-2763
• DOI: 10.1016/j.bone.2012.11.004

Abstract Cardiovascular disease and osteoporosis are important causes of morbi-mortality in the elderly and may be mutually related. Low bone mineral density (BMD) may be associated with increased risk of cardiovascular events. We investigated the prevalence of low bone mass and fractures in metabolic syndrome patients with acute coronary events. A case–control study was conducted with 150 individuals (30–80 years-old) with metabolic syndrome. Seventy-one patients had had an acute coronary syndrome episode in the last 6 months (cases) and the remaining 79 had no coronary event (controls). Cases and controls were matched for gender, BMI and age. DXA measurements and body composition were performed while spine radiographs surveyed for vertebral fractures and vascular calcification. Biochemical bone and metabolic parameters were measured in all patients. No statistically significant difference in BMD and the prevalence of osteopenia, osteoporosis and non-vertebral fractures was observed between cases and controls. The prevalence of vertebral fractures and all fractures was higher in the cases (14.1 versus 1.3%, p = 0.003 and 22.5 versus 7.6%, p = 0.010, respectively). Male gender (OR = 0.22 95% CI 0.58 to 0.83, p = 0.026) and daily intake of more than 3 portions of dairy products (OR = 0.19 95% CI 0.49 to 0.75, p = 0.017) were associated with lower prevalence of fractures. Cases had higher risk for fractures (OR = 4.97, 95% CI 1.17 to 30.30, p = 0.031). Bone mass and body composition parameters were not associated with cardiovascular risk factors or bone mineral metabolism. Patients with fragility fractures had higher OPG serum levels than those without fractures ( p < 0.001). Our findings demonstrated that patients with recent coronary events have a higher prevalence of vertebral fractures independently of BMD.