Abstract

Background: Although coronary artery calcification (CAC) is osteoporosis associated there is need for data considering the influence of overweight, sex and other factors in the interplay when analyzing bone microarchitecture intermediate phenotypes in older adults.
Objectives: we aim to establish whether weight and sex are interrelated in a peripheral bone microarchitecture-CAC scenario in those particular patients, considering factors that could alter calcium homeostasis.
Study design: This is retrospective cross-sectional research involving 256 older adults, 168 women and 88 men, from the São Paulo Ageing & Health (SPAH) Study.
Method: The Agatston score assessed CAC and high-resolution peripheral quantitative computed tomography (HR-pQCT) tibia and radius bone microarchitecture. A Poisson log-link regression model was used to gauge rate ratio probability between coronary score >100, HR-pQCT variables, factors osteoporosis-related (calcium supplementation, bisphosphonates, vitamin D, coffee, aspirin), sex and body mass index (BMI).
Result: The population’s mean age was 79.5+4 years. One hundred and ninety-six showed BMI>25 (76.6%), with higher female prevalence (83.9% vs. 62.5%, p <0 .001). Coffee intake and medication for bone health lacked association. In the general group, radio porosity was CAC associated (Exp(β):1.058, CI95%:1.018-1.100, p=0.005) and aspirin (Exp(β): 1.432, CI95%:1.097-1.869). Tibia trabecular number had a negative interrelation (Exp(β): 0.789, CI95%: 0.654-0.953, p=0.014. When divided by BMI groups, those with BMI>25 maintained the relations (all p <0.05) however it was lost in the remaining group. Selecting BMI>25 cases, in women only aspirin and radio porosity were related to CAC, in men were trabecular parameters (p<0.05).
Conclusion: Coffee or medication intake used in bone metabolism lacks associations in the models studied. The CAC-bone microarchitecture relationship is modified by weight in older adults. Furthermore, being overweight entailed different performances for cortical and trabecular bone microarchitecture and aspirin intake between sexes. At last, our findings shows that in older adults, sex and overweight express differences in bone microarchitecture related to coronary calcification

Keywords:Coronary calcification; Osteoporosis; Overweight; Bone microarchitecture; Sex differences

Abbreviations: CAC: Coronary Artery Calcification; SPAH: São Paulo Ageing & Health study; HR-pQCT: High-Resolution Peripheral Quantitative Computed Tomography; BMI: Body Mass Index; DEXA: Dual-Energy X-Ray Absorptiometry; CVD: Cardiovascular Disease; AIDR 3D: Adaptive Iterative Dose Reduction 3-Dimensional Algorithm; BMD: Bone Mineral Density; WHO: World Health Organization; CT: Coronary Tomography; Tb.vBMD: Trabecular Volumetric Density; Tb.N: Number of Trabeculae; Tb.Th: Trabecular Thickness; Tb.Sp: Trabecular Separation; Ct.vBMD: Cortical Volumetric Density; Ct.Po: Cortical Porosity; CAPPesq: Ethics Committee of the University of São Paulo School of Medicine; EVOS: European Vertebral Osteoporosis Study; FAPESP: Sao Paulo State Research and Support Foundation; CNPQ: National Council of Science and Technology