Associations of Trabecular and Cortical Volumetric Bone Mineral Density With Coronary Artery Calcification Score

The link between osteoporosis and cardiovascular diseases has been extensively reported, and previous studies show an inverse association between trabecular bone volumetric bone mineral density (Tb.vBMD) in the spine and coronary artery calcification score (CACS). 1,2However, the association between cortical vBMD (Ct.vBMD) in the long bones and CACS may differ from the association for Tb.vBMD because the 2 bone compartments are largely differentially regulated. 3 Methods | To compare the associations of Tb.vBMD and Ct.vBMD with CACS, we used the cross-sectional population-based Swedish Cardiopulmonary Bioimage Study (SCAPIS) pilot cohort, consisting of randomly selected participants aged 50 to 64 years. 4 Coronary artery calcification score expressed as Agatston score, 4 Tb.vBMD in the vertebral body of the 12th thoracic vertebra, 5 and Ct.vBMD at the right midshaft femur 5 were all assessed in 1060 participants (519 men and 541 women) using computed tomography (Table ).Institutional ethical review board approval was obtained, and written consent was obtained for all patients.A 2-sided P value less than .05was considered significant.Results | The association between Tb.vBMD and Ct.vBMD was modest (variance explained r 2 = 11%), demonstrating that these parameters may provide substantial nonoverlapping information for prediction of CACS.In combined models also adjusted for cardiovascular risk factors (full model in the Figure), Tb.