Vertebral fractures flag vascular disease risk

By Liam Davenport

Abdominal aortic calcification (AAC) in elderly men appears to be associated with vertebral fractures, say Moroccan scientists.

The study supports previous suggestions of an independent connection between atherosclerosis and osteoporosis.

Abdellah El Maghraoui and colleagues from Military Hospital Mohammed V, in Rabat, studied 709 Caucasian men with an average age of 62.4 years who had no prior osteoporosis history. A densitometer was used to obtain lateral vertebral fracture assessment (VFA) images and scans of the lumbar spine and proximal femur, and vertebral fractures were defined by using a combination of morphology and the Genant semi-quantitative approach.

The team reports in the journal Rheumatology that 14.2% of the participants had at least one grade 2 or 3 vertebral fracture, rising to 38.9% among the 15.2% of participants who were osteoporotic.

AAC was not detectable in 82% of the participants, while significant atherosclerotic burden, defined as a radiographic 24-point AAC score of at least 5, was found in 2.8% and confined to patients aged over 66 years.

Compared with men who did not have vertebral fractures, those with grade 2 or 3 fractures had a significantly higher AAC score, were more likely to have extended AAC (score ≥5), and had lower weight, height, and lumbar spine and hip bone mass density and T scores.

In multivariate analysis, having grade 2 or 3 vertebral fractures was significantly associated with AAC score of at least 5 and osteoporosis at any site, at respective odds ratios 4.5 and 5.2.

The team writes: "VFA imaging with a bone densitometer can simultaneously detect prevalent vertebral fractures and AAC, an important cardiovascular disease risk factor. Clinicians should be aware of the associations between AAC on VFA images and incident cardiovascular disease.

"If significant AAC is noted on VFA, follow-up assessment of the patient's overall cardiovascular disease risk management should be indicated."

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