The indicators of the bone tissue mineralization abnormalities in women with coronary artery disease in the post-menopausal period
DOI:
https://doi.org/10.14739/2310-1237.2018.2.141408Keywords:
coronary artery disease, postmenopausal period, osteoporosis, osteopenia, metabolic diseases, correlation of data.Abstract
Objective. To determine the indicators of the bone mineral density (BMD) abnormalities in women with coronary artery disease in the post-menopausal period (СAD).
Methods. An open cross-sectional study in parallel groups involved 80 women with coronary artery disease (CAD): stable exertional angina of II–III functional class (mean age 64.59 ± 1.02 years). Depending on the degree of BMD they were divided into 3 groups: group 1 – 19 CAD women with normal BMD; group 2 – 27 CAD women with osteopenia; group 3 – 34 CAD women with osteoporosis. The control selected group consisted of 11 healthy women of the corresponding age. With the help of ultrasound densitometry, FRAX algorithm and bone biomarkers levels assessment we investigated structural and functional state of the bone tissue.
Results. It was acknowledged that in women with CAD in the postmenopausal period, depending on the severity of BMD loss, there is a significant decrease in the T- and Z-criteria and an increase in the 10-year risk of developing osteoporosis fractures. The development of postmenopausal osteoporosis (PMOS) combined with CAD was accompanied with an increase in the level of inflammation, neoangiogenesis and bone remodeling biomarkers (osteoprotegerin, ostecalcin, VEGF-A), which also have multi-directional correlative interrelationships with the structural and functional indicators of the BMD state (T, Z-criterion, 10-year risk of osteoporosis fractures). ROC-analysis results show the cut-off values at the osteopenia and osteoporosis stage for osteoprotegerin level equal to 223.76 pg/ml and 224.44 pg/ml; for osteocalcin level – 15.89 ng/ml and 16.71 ng/ml, for VEGF-A level – 112.52 pg/ml and 123.31 pg/ml correspondingly.
Conclusions. The levels of osteoprotegerin and/or ostecalcine and/or VEGF-A can be used as a screening method for early diagnosis of BMD loss and stratification of patients in the category of increased risk of osteopenia and osteoporosis.
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