UC San Diego

Molecular and cell biology studies have demonstrated an association between bone and arterial wall disease, but epidemiologic evidence of an independent bone-artery association has been inconclusive. We tested the cross- sectional associations of volumetric trabecular lumbar bone mineral density (vBMD) with multiple measures of structural and functional cardiovascular disease in the context of shared determinants including inflammatory markers and sex hormones. Participants were 946 women and 963 men free of clinical cardiovascular disease upon enrollment in the Multi-Ethnic Study of Atherosclerosis between 2000 and 2002. In women, vBMD was inversely and significantly associated with presence and extent of coronary calcium, the extent of aortic calcium, and greater carotid artery plaque echogenicity but not with the ankle-brachial index or carotid artery intima-media thickness. In men, lower vBMD was significantly associated with presence of aortic calcium, lower ankle-brachial index, and greater internal carotid intima-media thickness but not with common carotid intima-media thickness. In all models, adjustment for standard and novel cardiovascular disease and osteoporosis risk factors did not materially affect results. These findings suggest that bone loss and atherosclerosis may be related processes and that low bone density may reflect cardiovascular disease risk. We further demonstrated in a sub-sample of 423 women and 670 men nȧive to lipid-modifying medications that dyslipidemia, defined by total cholesterol to high density lipoprotein cholesterol ratio, significantly modified the associations between bone density and coronary and aortic calcified atherosclerosis in men and women. Associations between bone density and atherosclerosis were positive in those with dyslipidemia and inverse in those without dyslipidemia