Bone mineral density and progression of subclinical atherosclerosis in African-Americans with type 2 diabetes

Abstract

Context: Relative to European Americans, calcified atherosclerotic plaque (CP) is less prevalent and severe in African-Americans (AAs). Objective: Predictors of progression of CP in the aorta, carotid, and coronary arteries were examined in AAs over a mean 5.3 ± 1.4-year interval. Design: This is the African American-Diabetes Heart Study. Setting: A type 2 diabetes (T2D)-affected cohort was included. Participants: A total of 300 unrelated AAs with T2D; 50%female, mean age 55 ± 9 years, baseline hemoglobin A1c 8.1 ± 1.8%was included. Main outcome measures: Glycemic control, renal parameters, Vitamin D, and computed tomography-derived measures of adiposity, vascular CP, and volumetric bone mineral density (vBMD) in lumbar and thoracic vertebrae were obtained at baseline and follow-up. Results: CP increased in incidence and quantity/mass in all three vascular beds over the 5-year study (P = .0001). Lower baseline lumbar and thoracic vBMD were associated with progression of abdominal aorta CP (P = .008), but not progression of carotid or coronary artery CP. Lower baseline estimated glomerular filtration rate was associated with progression of carotid artery CP (P