Predicting coronary artery calcification by using the difference in bone mineral densities of the spine and hip: A retrospective crosssectional study in Korea

Abstract

Background/Purpose: The T-score of the lumbar spine rather than that of the hip can be affected by coronary artery calcification because of the anatomic location of these structures. Thus, the discordance in the T-score between the lumbar spine and hip, as assessed using dual-energy X-ray absorptiometry (DXA), may reflect the coronary artery calcium score (CACS). This study aimed to develop a new method for predicting coronary artery calcification based on discordance of the T-score between the lumbar spine and hip. Methods: This study enrolled 468 asymptomatic participants without a history of cardiovascular disease and osteoporosis between March 2012 and March 2017. Participants were screened using multi-detector computed tomography to determine CACS, and bone health was assessed using DXA. Results: The differences in T-scores of the lumbar spine and femoral neck were 0.14±0.92, 0.51±1.11, and 0.55±0.93 in the CACS groups <100, 100–399, and ≥400, respectively; the difference in the T-score was statistically significant according to the CACS group (P=0.006). Differences in T-scores between the lumbar spine and femoral neck were significantly associated with CACS (r=0.113, P=0.014). After adjusting for age, sex, body mass index, smoking status, current treatment for hypertension or dyslipidemia, uric acid, and C-reactive protein, the adjusted odds ratio of CACS >100 for the difference in the T-score was 1.36 (95% CI: 1.02–1.80, P=0.046). Conclusion: Clinicians can use information about T-score discordance between the lumbar and femoral neck region to select participants who need further assessment of the coronary arteries.