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Bone mineral density, arterial stiffness, and coronary atherosclerosis in healthy postmenopausal women

Seo, Seok Kyo MD1; Cho, SiHyun MD1; Kim, Hye Yeon MD2; Choi, Young Sik MD2; Park, Ki Hyun MD2; Cho, Dong Jae MD2; Lee, Byung Seok MD1

doi: 10.1097/gme.0b013e3181a15552
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Objective: The aim of this study was to assess the correlation between bone mineral density (BMD), arterial stiffness, and coronary atherosclerosis in healthy postmenopausal women.

Methods: We performed a retrospective review of 152 postmenopausal women who visited the health promotion center for a routine checkup, after excluding participants who had factors affecting BMD and coronary artery disease. BMD was evaluated by dual-energy x-ray absorptiometry in the lumbar spine and femur. Arterial stiffness was measured by brachial-ankle pulse wave velocity (baPWV), and coronary atherosclerosis was assessed by 64-row multidetector computed tomography.

Results: Women with osteoporosis had a significantly higher baPWV than those in the osteopenia and normal BMD groups. Higher baPWV was also associated with the presence of atherosclerosis. The baPWV was significantly positively correlated with age, systolic blood pressure, diastolic blood pressure, and neutrophil to lymphocyte ratio and negatively correlated with femur BMD. The optimum predictive value of baPWV in coronary atherosclerosis was estimated using the receiver operating characteristic curve. A cutoff of 1,506 cm/second would give a sensitivity of 83.3% and specificity of 82.9%. A higher overall risk for coronary atherosclerosis emerges with higher baPWV levels (>1,500 cm/s) after controlling for age and cardiovascular risk factors.

Conclusions: Arterial stiffness by measuring baPWV can be a useful independent predictor for coronary atherosclerosis. In addition, our results suggest that postmenopausal women with osteoporosis should be considered for further evaluation of coronary atherosclerosis.

This study was conducted to assess the correlation of bone mineral density, arterial stiffness, and coronary atherosclerosis in healthy postmenopausal women. Arterial stiffness by measuring brachial ankle pulse wave velocity can be a useful independent predictor for coronary atherosclerosis, which is negatively associated with bone mineral density.

From the 1Department of Obstetrics and Gynecology, Gangnam Severance Hospital; and 2Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea.

Received January 13, 2009; revised and accepted February 17, 2009.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Byung Seok Lee, MD, Department of Obstetrics and Gynecology, Yongdong Severance Hospital, Yonsei University College of Medicine, 146-92 Dogok-dong, Gangnam-gu, Seoul 135-720, Korea. E-mail: dr222@yuhs.ac

©2009The North American Menopause Society