Association Between Coronary Artery Calcium Score and Bone Mineral Density in Type 2 Diabetes Mellitus with Different Visceral Fat Area

Abstract

Purpose

The relationship between coronary artery calcification and bone mineral density (BMD) in T2DM is still unclear. The aim of this study is to analyze the association between coronary artery calcium score (CACs) and BMD in T2DM with different visceral fat area (VFA), and further to explore the clinical significance of CACs in predicting osteoporosis in T2DM patients.

Patients and Methods

A total of 479 T2DM patients aged ≥50 years were included. Agatston was applied to calculate CACs to evaluate the degree of coronary artery calcification. Dual-energy X-ray absorptiometry (DXA) was used to measure BMD. According to VFA, all subjects were divided into VFA <100cm² and VFA ≥100cm² group. Adjusted regression analysis was performed to analyze the association between CACs and BMD. ROC curve was used to analyze the optimal cut-off value of CACs for screening osteoporosis.

Results

The baseline showed that in VFA ≥100cm² group, CACs increased significantly than that in VFA <100cm² group (212.1±195.9 vs 139.3±141.8, p<0.001) and total hip BMD decreased obviously (0.968±0.19 vs 1.021±0.184, p=0.01). After multivariable adjustment, CACs was not significantly associated with BMD in all patients (p>0.05). However, CACs was negatively associated with BMD of total hip and lumbar spine in patients with VFA ≥100cm² (total hip β=−0.087 p=0.01; lumbar spine β=−0.052 p=0.005), but not VFA <100cm². ROC curve analysis showed that the optimal cut-off value of CACs for screening osteoporosis was 191.505.

Conclusion

The present study implied that associations between CACs and BMD varied by the visceral fat deposition. It is critical to evaluate the condition of visceral fat accumulation for exploring the complex interplay of coronary artery calcification and BMD in T2DM patients. It may be of some clinical value for CACs in predicting osteoporosis in T2DM with visceral obesity.

Keywords:

• bone mineral density
• coronary artery calcium score
• type 2 diabetes mellitus
• visceral fat area

Ethics Approval

This study was approved by the Ethics Committee of The First Hospital of Lanzhou University (LDYYLL2022-331).

Acknowledgments

We thank all patients and their families for consenting use their medical documentations and information that lead to our paper.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This work was supported by Gansu Natural Science Foundation [No. 21JR1RA080] and The First Hospital of Lanzhou University Research Fund [No. ldyyyn2019-39].