Coronary arterial calcification and thoracic spine mineral density in early menopause

Abstract

Objectives Cardiovascular disease and osteoporosis increase in women after menopause. While aortic calcification is associated with bone loss in women, a similar relationship for coronary arterial calcification (CAC), a risk factor for coronary artery disease in women, is less clear. This study was designed to examine the relationship between CAC and volumetric bone mineral density (vBMD) in women (n = 137) who were within a median of 18 months past their last menses at screening for the Kronos Early Estrogen Prevention Study (KEEPS).

Methods CAC was measured using 64-slice computed tomography; vBMD was measured from these images using the Spine Cancer Assessment program. Concentrations of osteocalcin, bone alkaline phosphatase, tartrate-resident acid phosphatase-5b and osteopontin as bone matrix protein in serum and plasma were evaluated by ELISA.

Results CAC scores ranged from 0 to 327.6 Agatston Units (AU); 113 women had a score of 0 AU, 20 had a CAC score between 0 and 50 AU, and four had a CAC score > 50 AU. Although not statistically significant, there was a trend toward decreasing central density of thoracic T9 with increasing CAC. On average, levels of markers of bone turnover were within the normal range but did not correlate with age or with months past menopause.

Conclusions Clinically significant CAC and spine vBMD are quantifiable from the same scans within the first 3 years of menopause. Additional work is needed to determine how these measurements change with increasing age or with estrogenic treatments.

Key words:

• BONE-SPECIFIC ALKALINE PHOSPHATASE
• CORONARY HEART DISEASE
• MENOPAUSE
• OSTEOCALCIN
• OSTEOPONTIN

Acknowledgements

The authors gratefully acknowledge all participants in this study and KEEPS study-coordinator, Teresa G. Zais (Mayo Clinic center). Dr. Miyabara is a visiting scientist from the Tokyo Women's Medical University.

Conflict of interest  The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Source of funding  This work was supported by the Kronos Longevity Research Institute and The Mayo Foundation for Medical Education and Research.