Low bone density and abnormal bone turnover in patients with atherosclerosis of peripheral vessels

• Published in: Osteoporosis international 2004-05, Vol.15 (5), p.389-395
• Main Authors: PENNISI, P, SIGNORELLI, S. S, RICCOBENE, S, CELOTTA, G, DI PINO, L, LA MALFA, T, FIORE, C. E
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon; Age; Aged; Arteriosclerosis - blood; Arteriosclerosis - complications; Arteriosclerosis - diagnostic imaging; Atherosclerosis; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Biomarkers - blood; Blood and lymphatic vessels; Bone Density; Bone Remodeling; Calcinosis - complications; Cardiology. Vascular system; Cardiovascular disease; Carotid Artery Diseases - blood; Carotid Artery Diseases - complications; Carotid Artery Diseases - diagnostic imaging; Collagen; Collagen - blood; Diseases of the osteoarticular system; Female; Femoral Artery - diagnostic imaging; Gender; Glycoproteins - blood; Humans; Internal medicine; Ligands; Male; Medical sciences; Middle Aged; Osteocalcin - blood; Osteoporosis; Osteoporosis - etiology; Osteoporosis. Osteomalacia. Paget disease; Osteoprotegerin; Peptide Fragments - blood; Peripheral Vascular Diseases - blood; Peripheral Vascular Diseases - complications; Peripheral Vascular Diseases - diagnostic imaging; Phosphatase; Receptors, Cytoplasmic and Nuclear - blood; Receptors, Tumor Necrosis Factor; Ultrasonography; Womens health
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-003-1550-9

Patients with vascular calcifications often have low bone mineral density (BMD), but it is still uncertain if osteoporosis and peripheral vascular disease (VD) are interrelated and linked by a common pathomechanism. Moreover, data on bone turnover in patients with advanced atherosclerosis are lacking. We measured BMD by dual-energy X-ray absorptiometry (DXA) and quantitative bone ultrasound (QUS), as well as the serum levels of osteocalcin (OC), bone-specific alkaline phosphatase (BAP), osteoprotegerin (OPG) and its ligand RANKL, and the urinary concentration of the C-terminal telopeptides of type I collagen (CrossLaps), in 36 patient (20 male and 16 female) with serious atherosclerotic involvement of the carotid and/or femoral artery to investigate the underlying mechanism of vascular and osseous disorders. Thirty age-matched and gender matched healthy individuals served as controls. After adjustment for age, BMD was significantly reduced at the lumbar spine in 23/36 (63%) patients (mean T score -1.71+/-1.42) and at the proximal femur in 34/36 (93%) patients (neck mean T score -2.5+/-0.88). Ten patients (27%) had abnormal QUS parameters. Gender and diabetes had no effect on the relationship between vascular calcification and bone density at any site measured. VD subjects had OC and BAP serum levels lower than controls (13.3+/-3.1 vs 27.7+/-3.3 ng/ml, P