Szulc P, Samelson EJ, Sornay-Rendu E, Chapurlat R, Kiel DP.
INSERM UMR 1033, University of Lyon, Hospices Civils de Lyon, Lyon, France, firstname.lastname@example.org.
In older men, severe abdominal aortic calcification and vertebral fracture (both assessed using dual-energy X-ray absorptiometry) were positively associated after adjustment for confounders including bone mineral density. INTRODUCTION: Abdominal aortic calcification (AAC) is associated with higher fracture risk, independently of low bone mineral density (BMD). Dual-energy X-ray absorptiometry (DXA) can be used to assess both vertebral fracture and AAC and requires less time, cost, and radiation exposure. METHODS: We conducted a cross-sectional study of the association between AAC and prevalent vertebral fractures in 901 men ≥50 years old. We used DXA (vertebral fracture assessment) to evaluate BMD, vertebral fracture, and AAC. RESULTS: Prevalence of vertebral fracture was 11 %. Median AAC score was 1 and 12 % of men had AAC score >6. After adjustment for age, weight, femoral neck BMD, smoking, ischemic heart disease, diabetes, and hypertension, AAC score >6 (vs ≤6) was associated with 2.5 (95 % CI, 1.4-4.5) higher odds of vertebral fracture. Odds of vertebral fracture for AAC score >6 increased with vertebral fracture severity (grade 1, OR = 1.8; grade 2, OR = 2.4; grade 3, OR = 4.4; trend p < 0.01) and with the number of vertebral fractures (1 fracture, OR = 2.0, >1 fracture, OR = 3.5). Prevalence of vertebral fracture was twice as high in men having both a T-score < -2.0 and an AAC score > 6 compared with men having only one of these characteristics. CONCLUSIONS: Men with greater severity AAC had greater severity and greater number of vertebral fractures, independently of BMD and co-morbidities. DXA can be used to assess vertebral fracture and AAC. It can provide a rapid, safe, and less expensive alternative to radiography. DXA may be an important clinical tool to identify men at high risk of adverse outcomes from osteoporosis and cardiovascular disease.