Korean Circ J.  2013 Jul;43(7):453-461. 10.4070/kcj.2013.43.7.453.

Gender Difference in Bone Loss and Vascular Calcification Associated with Age

• Lee DH
• Youn HJ
• Yi JE
• Chin JY
• Kim TS
• Jung HO
• Chang K
• Choi YS
• Jung JI

• KMID: 2145500
• DOI: http://doi.org/10.4070/kcj.2013.43.7.453

Abstract

BACKGROUND AND OBJECTIVES
It is widely known that both bone loss and vascular calcification are age-related processes. The purpose of this study was to investigate the relationship between coronary artery calcium (CAC) score or bone mineral density (BMD) with age and whether there is a gender difference factoring in the two conditions among healthy subjects.
SUBJECTS AND METHODS
Between March 2009 and August 2011, participants included 1727 subjects (mean age: 55+/-10 years, M : F=914 : 813) with routine health check-ups. After being categorized into three groups (normal, osteopenia, and osteoporosis) according to the World Health Organization (WHO) diagnostic classification, we estimated BMD by dual energy X-ray absorptiometry (DEXA) and CAC score by dual-source CT (DSCT).
RESULTS
There was a significant gender difference among the risk factors, including total-lumbar spine (1.213+/-0.176 g/cm2 : 1.087+/-0.168 g/cm2, p<0.001) and femur (1.024+/-0.131 g/cm2 : 0.910+/-0.127 g/cm2, p<0.001) in BMD by DEXA, and CAC score (68+/-227 : 27+/-116, p<0.001) in coronary artery calcification by DSCT. Age in male [odds ratio (OR): 1.138 {95% confidence interval (CI): 1.088-1.190}, p<0.001] and menopause in female subjects {OR: 12.370 (95% CI: 3.120-49.047), p<0.001} were, respectively, independently associated with osteopenia.
CONCLUSION
Although our results do not demonstrate a direct association between CAC score and BMD in both genders, there is a gender difference of CAC score in normal and osteopenia groups according to the WHO diagnostic classification. Additionally, we suggest that more specific therapeutic strategies be considered during any early bone loss period, especially in female subjects.

Keyword

Gender; Osteoporosis; Coronary vessels; Calcium; Bone density

MeSH Terms

Absorptiometry, Photon
Bone Density
Bone Diseases, Metabolic
Calcium
Coronary Vessels
Female
Femur
Humans
Male
Menopause
Osteoporosis
Risk Factors
Spine
Vascular Calcification
World Health Organization
Calcium

Figure

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  Fig. 1 Association with age in bone loss (A and B) and vascular calcification (C and D). BMD: bone mineral density, CAC: coronary artery calcium.

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  Fig. 2 Gender difference of each measurement for the three categorical groups according to the WHO diagnostic T-score criteria. Total CAC score (A) and volume score (B) by 64-channel DSCT. *The analysis for the three categorical groups according to the WHO diagnostic classification: normal, osteopenia and osteoporosis, was performed using analysis of variance test for continuous variables, †The analysis of gender difference was performed using an unpaired t-test for continuous variables. WHO: World Health Organization, CAC: coronary artery calcium, DSCT: dual source computed tomography, BMD: bone mineral density, DEXA: dual energy X-ray absorptiometry.

• 

  Fig. 3 Comparison of mean value of total BMD at the level of femur and total CAC score according to age distribution. The mean value of BMD at the level of femur decreases progressively, but total CAC score for vascular calcification increases sequentially through all ages in male subjects (A), while females aged 50 to 59 was a turning point for the abrupt decrease of BMD, but the sudden increase of total CAC score (B). p<0.05, the analysis for mean value of BMD and total CAC score according to age distribution was performed using analysis of variance test. BMD: bone mineral density, CAC: coronary artery calcium.

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