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KMID : 1007020030010010031
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Korean Soceity of Osteroporosis
2003 Volume.1 No. 1 p.31 ~ p.39
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Association Between Aortic Calcificatin and Bone Mineral Density Measured by 3d-QCT
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Choi Woong-Hwan
Lee Chang-Beom
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Abstract
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Objectives: When spinal bone mineral density is measured by DEXA (Dual Energy X-ray Absorptiometry) system through AP scan, spinal bone mineral density is overestimated because of aortic calcification and osteophyte. Bone resorption is determined by active osteoclast pool size. Active osteoclast pool size is regulated by a complex network of interaction of various hormone and cytokines that is eventually converged into the common effector system(OPG/OPGL). As is the case in OPG knock out mice, unopposed OPGL activity against OPG increases active osteoclast pool size and bone resorption and results in severe early-onset osteoporosis and calcification of aorta and renal arteries. Therefore we performed this study to know the age-related incidence of aortic calcification and osteophyte and the relationship between osteoporosis and aortic calcification.
Methods: We tried to determine the age-related incidence of aortic calcification and identify osteophytes in 127 osteoporosis patients [mean age 61 yr (30-60), female to male ratio 2.7:1], using 3D-QCT. In another study, 108 postmenopausal women were grouped by age 45-55, 56-69, and over 70 and BMD of lumbar spines and aortic calcifications were measured. We divided the same age patients (56-69 yrs) into aortic calcification group and non-calcification group and tried to find out the differences of BMD of lumbar spines between two groups.
Results: Aortic calcification was present in over 48% of patients with the age of more than 60 yrs and osteophyte in over 68 % of patients in the same age group. In the study of 108 postmenopausal patients, BMD decreases significantly with aging, and frequency of aortic calcification increases with aging. In the study of patients with the same age patients(56-69 yrs), mean BMD in patients with aortic calcification is significantly lower than those without aortic calcification(61.3 vs 74.0mg/cc, p<0.05).
Conclusion: Aortic calcification is significantly associated with decreased BMD. This means that increasing osteoporosis and aortic calcification with age may be due to the same physiologic process. A significant percentage of aged patients have aortic calcification and osteophytes. So we recommend that the DEXA system would be replaced with the new methods like 3D-QCT for the accurate measurement of spinal BMD and early detection and treatment of osteoporosis patients.
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KEYWORD
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Aortic calcification, osteoporosis, 3D-QCT
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