Остеопороз и кардиоваскулярные заболевания
Аннотация
Цель. Изучить возможную связь между остеопорозом (ОП) и кардиоваскулярными заболеваниями (КВЗ) у женщин в постменопаузальном периоде. Материал и методы. В исследовании приняли участие 98 жен. в возрасте от 45 до 70 лет с менопаузой. Группа ОП- 50 чел. и группа сравнения 48 чел. Диагноз ОП ставился на основании данных денситометрии (показатели денситометрии в области позвоночника и проксимального отдела бедра меньше -2,5 SD и больше -1 SD по Т критерию, соответственно). Проводилось анкетирование по основным факторам риска (ФР) развития ОП и КВЗ, оценивались биохимические показатели липидного и минерального обменов, данные функциональных обследований (ЭКГ, Эхо-КГ, УЗДГ сонных артерий и сосудов нижних конечностей, денситометрия). Результаты. По большинству показателей не было выявлено значимых различий между группами сравнения. В группе жен. без ОП отмечалось более позднее начало менопаузы (50 vs 47 лет, р=0,005), большее число детей в семье (2 vs 1, р=0,01). Различия по другим ФР не выявлены. Не отмечено различий между группами по показателям минерального и липидного обменов, данным ЭКГ обследования, показателям Эхо-КГ (уплотнение аорты и клапанного аппарата сердца). При УЗДГ обследовании (сравнение толщины комплекса интима/медиа) получены различия между группой нормы и ОП только в области луковицы правой общ. сонной арте- рии (0,96мм vs 1,03мм, р=0,02). Результаты. В данном одномоментном когортном исследовании не было выявлено определенной связи между ОП и КВЗ. Необходимы дальнейшие крупные комплексные исследования с использованием клинических, инструментальных и биохимических методов.
Список литературы
1. <div><p>Jalava T, Sarna S, Pylkkänen L et al. Association between vertebral fracture and increased mortality in osteoporotic patients. J. Bone Miner. Res., 2003, 18(7), 1254-60.</p><p>Hasserius R, Karlsson MK, Nilsson BE et al. Prevalent vertebral deformities predict increased mortality and increased fracture rate in both men and women: a 10-year population-based study of 598 individuals from the Swedish cohort in the European Vertebral Osteoporosis Study. Osteoporos. Int., 2003, 14(1), 61-8.</p><p>Trone DW, Kritz-Silverstein D, von Mühlen DG et al. Is radiographic vertebral fracture a risk factor for mortality? Am. J. Epidemiol., 2007, 166(10), 1191-7.</p><p>Naves M, Díaz-López JB, Gómez C et al. The effect of vertebral fracture as a risk factor for osteoporotic fracture and mortality in a Spanish population. Osteoporosis Int., 2003, 14(6), 520-4.</p><p>Kado DM, Browner WS, Palermo L et al. Vertebral fractures and mortality in older women: a prospective study. Study of Osteoporotic Fractures Research Group. Arch. Intern. Med., 1999, 159(11), 1215-20.</p><p>Ensrud KE, Thompson DE, Cauley JA et al. Prevalent vertebral deformities predict mortality and hospitalization in older women with low bone mass. Fracture Intervention Trial Research Group. J. Am. Geriatr. Soc., 2000, 48(3), 241-9.</p><p>Pongchaiyakul C, Nguyen ND, Jones G et al. Asymptomatic vertebral deformity as a major risk factor for subsequent fractures and mortality: a long-term prospective study. J. Bone. Miner. Res., 2005, 20(8), 1349-55.</p><p>Iacovino JR. Mortality outcomes after osteoporotic fractures in men and women. J. Insur. Med., 2001, 33(4), 316-20.</p><p>Johnell O, Kanis JA, Odén A et al. Mortality after osteoporotic fractures. Osteoporos. Int., 2004, 15(1), 38-42.</p><p>Shortt NL, Robinson CM. Mortality after low-energy fractures in patients aged at least 45 years old. J. Orthop. Trauma., 2005, 19(6), 396-400.</p><p>Pinheiro MM, Castro CM, Szejnfeld VL. Low femoral bone mineral density and quantitative ultrasound are risk factors for new osteoporotic fracture and total and cardiovascular mortality: a 5-year population-based study of Brazilian elderly women. J. Gerontol. A. Biol. Sci. Med. Sci., 2006, 61(2), 196-203.</p><p>Bauer DC et al. Quantitative ultrasound and mortality: a prospective study. Osteoporos. Int., 2002, 13(8), 606-12.</p><p>Trivedi DP, Khaw KT. Bone mineral density at the hip predicts mortality in elderly men. Osteoporos. Int., 2001, 12(4), 259-65.</p><p>Kado DM et al. Rate of bone loss is associated with mortality in older women: a prospective study. J. Bone Miner. Res., 2000, 15(10), 1974-80.</p><p>von der Recke P, Hansen MA, Hassager C. The association between low bone mass at the menopause and cardiovascular mortality. Am. J. Med., 1999, 106(3), 273-8.</p><p>Sambrook PN, Chen CJ, March L., et al. High bone turnover is an independent predictor of mortality in the frail elderly. J. Bone Miner. Res., 2006, 21(4), 549-55.</p><p>Mussolino ME, Madans JH, Gillum RF. Bone mineral density and mortality in women and men: the NHANES I epidemiologic follow-up study. Ann. Epidemiol., 2003, 13(10), 692-7.</p><p>Browner WS, Seeley DG, Vogt TM et al. Non-trauma mortality in elderly women with low bone mineral density. Study of Osteoporotic Fractures Research Group. Lancet, 1991, 338(8763), 355-8.</p><p>Broussard DL, Magnus JH. Coronary heart disease risk and bone mineral density among U. S. women and men. J. Womens Health (Larchmt)., 2008, 17(3), 479-90.</p><p>Izmozherova NV, Popov AA, Andreev AN et al. The evaluation of cardiovascular risk in postmenopausal women with osteopenia. Klin. Med. (Mosk). 2007, 85(10), 61-4.</p><p>Warburton DE, Nicol CW, Gatto SN, Bredin SS. Cardiovascular disease and osteoporosis: balancing risk management. Vasc. Health Risk Manag., 2007, 3(5), 673-89.</p><p>Magnus JH, Broussard DL. Relationship between bone mineral density and myocardial infarction in US adults. Osteoporos. Int., 2005, 16(12), 2053-62.</p><p>Yamaguchi T, Sugimoto T, Yano S et al. Plasma lipids and osteoporosis in postmenopausal women. Endocr. J., 2002, 49(2), 211-7.</p><p>Shaffer JR, Kammerer CM, Rainwater DL et al. Decreased bone mineral density is correlated with increased subclinical atherosclerosis in older, but not younger, Mexican American women and men: the San Antonio Family Osteoporosis Study. Calcif. Tissue Int., 2007, 81(6), 430-41.</p><p>Farhat GN, Newman AB, Sutton-Tyrrell K et al. The association of bone mineral density measures with incident cardiovascular disease in older adults. Osteoporos. Int., 2007, 18(7), 999-1008.</p><p>Mussolino ME, Gillum RF. Low bone mineral density and mortality in men and women: the Third National Health and Nutrition Examination Survey linked mor- tality file. Ann. Epidemiol., 2008, 18(11), 847-50.</p><p>Tankò LB, Bagger YZ, Christiansen. Low bone min- eral density in the hip as a marker of advanced atherosclerosis in elderly women. Calcif. Tissue Int., 2003, 73(1), 15-20.</p><p>Tankó LB, Christiansen C, Cox DA et al. Relationship between osteoporosis and cardiovascular disease in postmenopausal women. J. Bone Miner. Res., 2005, 20(11), 1912-20.</p><p>Browner WS, Pressman AR, Nevitt MC et al. Association between low bone density and stroke in elderly women. The study of osteoporotic fractures. Stroke, 1993, 24(7), 940-6.</p><p>Jørgensen L, Engstad T, Jacobsen BK. Bone mineral density in acute stroke patients: low bone mineral density may predict first stroke in women. Stroke, 2001, 32(1), 47-51.</p><p>Mussolino ME, Madans JH, Gillum RF. Bone mineral density and stroke. Stroke, 2003, 34(5), 20-2.</p><p>Samelson EJ, Kiel DP, Broe KE et al. Metacarpal cortical area and risk of coronary heart disease: the Framingham Study. Am. J. Epidemiol., 2004, 159(6), 589-95.</p><p>Banks LM, Lees B, MacSweeney JE, Stevenson JC. Effect of degenerative spinal and aortic calcification on bone density measurements in post-menopausal women: links between osteoporosis and cardiovascular disease? Eur. J. Clin. Invest., 1994, 24(12), 813-7.</p><p>Schulz E, Arfai K, Liu X et al. Aortic calcification and the risk of osteoporosis and fractures. J. Clin. Endocrinol. Metab., 2004, 89(9), 4246-53.</p><p>Kiel DP, Kauppila LI, Cupples LA et al. Bone loss and the progression of abdominal aortic calcification over a 25 year period: the Framingham Heart Study. Calcif. Tissue Int., 2001, 68(5), 271-6.</p><p>Hak AE, Pols HA, van Hemert AM et al. Progression of aortic calcification is associated with metacarpal bone loss during menopause: a population-based longitu- dinal study. Arterioscler. Thromb. Vasc. Biol., 2000, 20(8), 1926-31.</p><p>Barengolts EI, Berman M, Kukreja SC et al. Osteoporosis and coronary atherosclerosis in asymptomatic postmenopausal women. Calcif. Tissue. Int., 1998, 62(3), 209-13.</p><p>Marcovitz PA, Tran HH, Franklin BA et al. Usefulness of bone mineral density to predict significant coronary artery disease. Am. J. Cardiol., 2005, 96(8), 1059-63.</p><p>Jørgensen L, Joakimsen O, Rosvold Berntsen GK et al. Low bone mineral density is related to echogenic carotid artery plaques: a population-based study. Am. J. Epidemiol., 2004, 160(6), 549-56.</p><p>Montalcini T, Emanuele V, Ceravolo R et al. Relation of low bone mineral density and carotid atherosclerosis in postmenopausal women. Am. J. Cardiol., 2004, 94(2), 266-9.</p><p>Uyama O, Yoshimoto Y, Yamamoto Y, Kawai A. Bone changes and carotid atherosclerosis in postmenopausal women. Stroke. 1997, 28(9), 1730-2.</p><p>Saverino A, Del Sette M, Conti M et al. Hyperechoic plaque: an ultrasound marker for osteoporosis in acute stroke patients with carotid disease. Eur. Neurol., 2006, 55(1), 31-6.</p><p>Vattikuti R, Towler DA. Osteogenic regulation of vascular calcification: an early perspective. Am. J. Physiol. Endocrinol. Metab., 2004, 286(5), 686-96.</p><p>van der Klift M, Pols HA, Hak AE et al. Bone mineral density and the risk of peripheral arterial disease: the Rotterdam Study. Calcif. Tissue Int., 2002, 70(6), 443-9.</p><p>Mangiafico RA, Russo E, Riccobene S et al. Increased prevalence of peripheral arterial disease in osteoporotic postmenopausal women. J. Bone Miner. Metab., 2006, 24(2), 125-31.</p><p>Aoyagi K, Ross PD, Orloff J и др. Low bone density is not associated with aortic calcification. Calcif. Tissue Int., 2001, 69(1), 20-4.</p><p>Vogt MT, San Valentin R, Forrest KY et al. Bone mineral density and aortic calcification: the Study of Osteoporotic Fractures. J. Am. Geriatr. Soc., 1997, 45(2), 140-5.</p><p>Drinka PJ, Bauwens SF, DeSmet AA. Lack of correlation between aortic calcification and bone density. Wis. Med. J., 1992, 91(6), 299-301.</p><p>Kiel DP, Kauppila LI, Cupples LA et al. Bone loss and the progression of abdominal aortic calcification over a 25 year period: the Framingham Heart Study. Calcif. Tissue Int., 2001, 68(5), 271-6.</p><p>Sinnott B, Syed I, Sevrukov A, Barengolts E. Coronary calcification and osteoporosis in men and postmenopausal women are independent processes associated with aging. Calcif. Tissue Int., 2006, 78(4), 195-202.</p><p>Карпова Н. Ю., Рашид М. А., Шостак Н. А. и др. Кальциноз аортального клапана у лиц пожилого возраста: клинико-инструментальные сопоставления с показателями костного обмена. Вест. Росс. Гос. Мед. Универс., 2005, 8, 47, 54-59.</p><p>Feldman T, Glagov S, Carroll JD. Restenosis following successful balloon valvuloplasty: bone formation in aortic valve leaflets. Cathet. Cardiovasc. Diagn., 1993, 29(1), 1-7.</p><p>Hunt JL, Fairman R, Mitchell ME et al. Bone formation in carotid plaques: a clinicopathological study. Stroke, 2002, 33(5), 1214-9.</p><p>Mohler ER 3rd, Gannon F, Reynolds C et al. Bone formation and inflammation in cardiac valves. Circulation, 2001, 103(11), 1522-8.</p><p>Boström K, Watson KE, Horn S et al. Bone morphogenetic protein expression in human atherosclerotic lesions. J. Clin. Invest., 1993, 91(4), 1800-9.</p><p>Giachelli CM, Bae N, Almeida M et al. Osteopontin is elevated during neointima formation in rat arteries and is a novel component of human atherosclerotic plaques. J. Clin. Invest., 1993, 92(4), 1686-96.</p><p>Ikeda T, Shirasawa T, Esaki Y et al. Osteopontin mRNA is expressed by smooth muscle-derived foam cells in human atherosclerotic lesions of the aorta. J. Clin. Invest., 1993, 92(6), 2814-20.</p><p>Hirota S, Imakita M, Kohri K et al. Expression of osteopontin messenger RNA by macrophages in atherosclerotic plaques. A possible association with calcification. Am. J. Pathol., 1993, 143(4), 1003-8.</p><p>Collin-Osdoby P. Regulation of vascular calcification by osteoclast regulatory factors RANKL and osteoprotegerin. Circ. Res., 2004, 95(11), 1046-57.</p><p>Sugihara N, Matsuzaki M. The influence of severe bone loss on mitral annular calcification in postmenopausal osteoporosis of elderly Japanese women. Jpn. Circ. J., 1993, 57(1), 14-26.</p><p>Davutoglu V, Yilmaz M, Soydinc S et al. Mitral annular calcification is associated with osteoporosis in women. Am. Heart J., 2004, 147(6), 1113-6.</p><p>Parhami F, Morrow AD, Balucan J et al Lipid oxidation products have opposite effects on calcifying vascular cell and bone cell differentiation. A possible explanation for the paradox of arterial calcification in osteoporotic patients. Arterioscler. Thromb. Vasc. Biol., 1997, 17(4), 680-7.</p><p>63 Tintut Y, Morony S, Demer LL. Hyperlipidemia promotes osteoclastic potential of bone marrow cells ex vivo. Arterioscler. Thromb. Vasc. Biol., 2004, 24(2), 6-10.</p><p>Bagger YZ, Rasmussen HB, Alexandersen P et al. Links between cardiovascular disease and osteoporosis in postmenopausal women: serum lipids or atherosclerosis per se? Osteoporos. Int., 2007, 18(4), 505-12.</p><p>Adami S, Braga V, Zamboni M et al. Relationship between lipids and bone mass in 2 cohorts of healthy women and men. Calcif. Tissue Int., 2004, 74(2), 136-42.</p></div><br />
Для цитирования:
Аникин С.Г., Беневоленмкая Л.И., Demin N.V., Mach E.S., Korsakova Y.O. Остеопороз и кардиоваскулярные заболевания. Научно-практическая ревматология. 2009;47(4):32-40. https://doi.org/10.14412/1995-4484-2009-1148
For citation:
Anikin S.G., Benevolenskaya L.I., Demin N.V., Mach E.S., Korsakova Y.O. Osteoporosis and cardiovascular diseases. Rheumatology Science and Practice. 2009;47(4):32-40. (In Russ.) https://doi.org/10.14412/1995-4484-2009-1148
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