Orthopaedics Cardiology and CTVS Medicine

Both Trabecular And Cortical BMD Affect Coronary-Artery Calcium Score: JAMA

• byDoctor News Daily Team
• 18 February, 2025
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Sweden: Trabecular and cortical volumetric bone mineral density (BMD) have opposite association with coronary-artery calcium score (CACS), suggests a recent study in the journal JAMA Cardiology. The findings of the study suggest a different role of trabecular and cortical volumetric BMD on coronary artery calcification risk, mainly in women.
Both trabecular and cortical volumetric bone-mineral density (BMD) are associated with coronary-artery calcium score (CACS), but in different directions, according to a new pilot study.
The association between cardiovascular diseases and osteoporosis has been reported extensively. Previous studies have shown an inverse relationship between trabecular bone volumetric BMD in the spine and CACS. However, the association between cortical vBMD (Ct.vBMD) in the long bones and CACS might be different from the association for Tb.vBMD as the 2 bone compartments are largely differentially regulated. In simpler words higher the trabecular volumetric BMD in the spine lower is the coronary-artery calcium score (CACS) but the relationship between cortical volumetric BMD with CACS has not been reported before.
Claes Ohlsson, Sahlgrenska University Hospital, Gothenburg, Sweden, and colleagues compared the associations of trabecular and cortical volumetric BMD with CACS in the study involving 541 women and 519 men aged 50 to 64 years.
Key findings of the study include:
As previously shown, trabecular volumetric BMD was independently inversely associated with CACS.
Cortical volumetric BMD, on the other hand, was independently directly associated with CACS greater than 0.
A high ratio of cortical to trabecular volumetric BMD was significantly associated with an increased risk of CACS greater than 0 and with CACS greater than 100.
All these associations between BMD and CACS were significant in women, but not in men.
"We propose that distinct pathophysiologic mechanisms exist for the trabecular versus cortical bone in the bone-vascular axis," wrote the authors.
"Validation in independent cohorts should be performed to determine whether the cortical to trabecular volumetric BMD ratio, integrating information from both bone compartments, may be used as a risk marker for coronary artery disease in women," they concluded.
"Associations of Trabecular and Cortical Volumetric Bone Mineral Density With Coronary Artery Calcification Score: The Swedish Cardiopulmonary Bioimage Study Pilot Study," is published in the journal JAMA Cardiology.
DOI: https://jamanetwork.com/journals/jamacardiology/article-abstract/2771676