Influence of Homocysteine and Vertebral Fractures on Prevalent Abdominal Aortic Calcification in Postmenopausal Women - A Multicentric Cross-Sectional Study
PDF

Keywords

Homocysteine
Vertebral Fracture
Abdominal Aortic Calcification
Postmenopausal Women

Categories

How to Cite

1.
Ghozlani I, El Maataoui A, Mounach A, Ghazi M, Kherrab A, Ouzzif Z, Niamane R, El Maghraoui A. Influence of Homocysteine and Vertebral Fractures on Prevalent Abdominal Aortic Calcification in Postmenopausal Women - A Multicentric Cross-Sectional Study. Integr J Med Sci [Internet]. 2017 Feb. 3 [cited 2024 Mar. 29];4. Available from: https://mbmj.org/index.php/ijms/article/view/71

Abstract

The main of this study was to examine the relationship between plasma homocysteine (Hcy), asymptomatic osteoporotic vertebral fractures (VFs) using vertebral fracture assessment (VFA), and prevalent abdominal aortic calcification (AAC) in Moroccan postmenopausal women. The study cohort consisted of 188 consecutive postmenopausal women with no prior known diagnosis of osteoporosis or taking medication interfering with bone metabolism. Mean age, weight, height, body mass index, and plasma homocysteine were determined. Lateral VFA images and scans of the lumbar spine and proximal femur were obtained using a Lunar Prodigy Vision densitometer (GE Healthcare Inc., Waukesha, WI). VFs were defined using a combination of Genant’s semiquantitative approach and morphometry. VFA images were also scored for prevalent AAC using a validated 24 point scale. Fifty-eight (30.9%) patients had densitometric osteoporosis. VFs were identified using VFA in 76 (40.4%) patients: 61 women had grade 1 VFs and 15 had grade 2 or 3 VFs. One hundred twenty-nine women (68.6%) did not have any detectable AAC, whereas the prevalence of significant atherosclerotic burden defined as AAC score of 5 or higher, was 13.8%. A significant positive correlation between AAC score and homocysteine was observed. Women with extended AAC were older, had a lower weight, BMI, and BMD, higher homocysteine levels, and more prevalent VFs than women without extended AAC. Multiple regression analysis showed that the presence of extended AAC was significantly associated with Age and grade 2/3 VFs and not independently associated with homocysteine levels.
This study did not confirm that homocysteine is an important determinant of extended AAC in postmenopausal women. However, this significant atherosclerotic marker is independently associated with VFs regardless of age. 

https://doi.org/10.15342/ijms.v4ir.125
PDF

References

El Maghraoui A, Guerboub AA, Achemlal L, Mounach A, Nouijai A, Ghazi M, et al. Bone mineral density of the spine and femur in healthy Moroccan women. J Clin Densitom. Oct-Dec 2006; 9(4):454-60. https://doi.org/10.1016/j.jocd.2006.07.001

Szulc P. Vascular calcification and fracture risk. Clin Cases Miner Bone Metab. May-Aug 2015; 12(2):139-41. https://doi.org/10.11138/ccmbm/2015.12.2.139

El Maghraoui A, Guerboub AA, Mounach A, Ghozlani I, Nouijai A, Ghazi M, et al. Body mass index and gynecological factors as determinants of bone mass in healthy Moroccan women. Maturitas. 2007 Apr 20;56(4):375-82.https://doi.org/10.1016/j.maturitas.2006.10.004

El Maghraoui A, Koumba BA, Jroundi I, Achemlal L, Bezza A, Tazi MA. Epidemiology of hip fractures in 2002 in Rabat, Morocco. Osteoporos Int. 2005 Jun;16(6):597-602. https://doi.org/10.1007/s00198-004-1729-8

European Medicines Agency recommends that Protelos/Osseor remain available but with further restrictions. Eur Med Age. 2014. [Accessed 25 June 2021]. Available From: https://www.ema.europa.eu/en/news/european-medicines-agency-recommends-protelososseor-remain-available-further-restrictions

El Maghraoui A, Roux C. DXA scanning in clinical practice. QJM. 2008 Aug;101(8):605-17. https://doi.org/10.1093/qjmed/hcn022

Genant HK, Wu CY, van Kuijk C, Nevitt MC. Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res. 1993; 8(9):1137-48. https://doi.org/10.1002/jbmr.5650080915

Jiang G, Eastell R, Barrington NA, Ferrar L. Comparison of methods for the visual identification of prevalent vertebral fracture in osteoporosis. Osteoporos Int. 2004 Nov; 15(11):887-96. https://doi.org/10.1007/s00198-004-1626-1

El Maghraoui A, Morjane F, Nouijai A, Achemlal L, Bezza A, Ghozlani I. Vertebral fracture assessment in Moroccan women: prevalence and risk factors. Maturitas. 2009 Feb;62 (2):171-5. https://doi.org/10.1016/j.maturitas.2008.11.020

El Maghraoui A, Mounach A, Rezqi A, Achemlal L, Bezza A, Ghozlani I. Vertebral fracture assessment in asymptomatic men and its impact on management. Bone. 2012 Apr; 50(4):853-7. https://doi.org/10.1016/j.bone.2011.12.018

Iwamoto J, Matsumoto H, Takeda T, Sato Y, Uzawa M. A radiographic study on the associations of age and prevalence of vertebral fractures with abdominal aortic calcification in Japanese postmenopausal women and men. J Osteoporos. 2010; 2010:748380. https://doi.org/10.4061/2010/748380

El Maghraoui A, Rezqi A, Mounach A, Achemlal L, Bezza A, Dehhaoui M, et al. Vertebral fractures and abdominal aortic calcification in postmenopausal women. A cohort study. Bone. 2013 Sep; 56(1):213-9. https://doi.org/10.1016/j.bone.2013.05.022

El Maghraoui A, Rezqi A, Mounach A, Achemlal L, Bezza A, Ghozlani I. Relationship between vertebral fracture prevalence and abdominal aortic calcification in men. Rheumatology (Oxford). 2012 Sep;51(9):1714-20. https://doi.org/10.1093/rheumatology/kes126

Farhat GN, Cauley JA. The link between osteoporosis and cardiovascular disease. Clin Cases Miner Bone Metab. 2008 Jan ;5(1):19-34. [Accessed 25 June 2021]. Available From : https://core.ac.uk/download/pdf/33152111.pdf

Unnanuntana A, Gladnick BP, Donnelly E, Lane JM. The Assessment of Fracture Risk. J Bone Joint Surg Am. 2010 Mar; 92 (3):743-53. https://doi.org/10.2106/jbjs.i.00919

El Maataoui A, El Maghraoui A, Biaz A, Elmachtani SI, Dami A, Bouhsain S, et al. Relationships between vertebral fractures, sex hormones and vitamin D in Moroccan postmenopausal women: a cross sectional study. BMC Womens Health. 2015 May 13;15:41. https://doi.org/10.1186/s12905-015-0199-9

El Maghraoui A, Rezqi A, Mounach A, Achemlal L, Bezza A, Ghozlani I. Prevalence and risk factors of vertebral fractures in women with rheumatoid arthritis using vertebral fracture assessment. Rheumatology (Oxford). 2010 Jul;49(7):1303-10. https://doi.org/10.1093/rheumatology/keq084

Garnero P, Sornay-Rendu E, Claustrat B, Delmas PD. Biochemical markers of bone turnover, endogenous hormones and the risk of fractures in postmenopausal women: the OFELY study. J bone Miner Res. 2000 Aug ;15(8):1526-36. https://doi.org/10.1359/jbmr.2000.15.8.1526

Selhub J. Homocysteine metabolism. Annu Rev Nutr. 1999; 19:217-46. https://doi.org/10.1146/annurev.nutr.19.1.217

Ji Y, Song B, Xu Y, Fang H, Wu J, Sun S, et al. Prognostic Significance of Homocysteine Levels in Acute Ischemic Stroke: A Prospective Cohort Study. Curr Neurovasc Res. 2015; 12(4):334-40. https://doi.org/10.2174/1567202612666150807112205

Shi Z, Guan Y, Huo YR, Liu S, Zhang M, Lu H, et al. Elevated Total Homocysteine Levels in Acute Ischemic Stroke Are Associated With Long-Term Mortality. Stroke. 2015 Sep; 46(9):2419-25. https://doi.org/10.1161/strokeaha.115.009136

Ouzzif Z, Oumghar K, Sbai K, Mounach A, Derouiche el M, El Maghraoui A. Relation of plasma total homocysteine, folate and vitamin B12 levels to bone mineral density in Moroccan healthy postmenopausal women. Rheumatol Int. 2012 Jan; 32(1):123-8. https://doi.org/10.1007/s00296-010-1551-x

LeBoff MS, Narweker R, LaCroix A, Wu L, Jackson R, Lee J, et al. Homocysteine Levels and Risk of Hip Fracture in Postmenopausal Women. The Journal of Clinical Endocrinology and Metabolism. 2009;94(4):1207-13. https://doi.org/10.1210/jc.2008-1777

McLean RR, Hannan MT. B vitamins, homocysteine, and bone disease: epidemiology and pathophysiology. Curr Osteoporos Rep. 2007 Sep;5(3):112-9. https://doi.org/10.1007/s11914-007-0026-9

El Maghraoui A, Achemlal L, Bezza A. Monitoring of dual-energy X-ray absorptiometry measurement in clinical practice. J Clin Densitom. Jul-Sep 2006;9(3):281-6. https://doi.org/10.1016/j.jocd.2006.03.014

El Maghraoui A, Do Santos Zounon AA, Jroundi I, Nouijai A, Ghazi M, Achemlal L, et al. Reproducibility of bone mineral density measurements using dual X-ray absorptiometry in daily clinical practice. Osteoporos Int. 2005 Dec;16(12):1742-8. https://doi.org/10.1007/s00198-005-1916-2

Kauppila LI, Polak JF, Cupples LA, Hannan MT, Kiel DP, Wilson PW. New indices to classify location, severity and progression of calcific lesions in the abdominal aorta: a 25-year follow-up study. Atherosclerosis. 1997 Jul 25;132(2):245-50. https://doi.org/10.1016/s0021-9150(97)00106-8

Pariente-Rodrigo E, Sgaramella GA, Garcia-Velasco P, Hernandez-Hernandez JL, Landeras-Alvaro R, Olmos-Martinez JM. Reliability of radiologic evaluation of abdominal aortic calcification using the 24-point scale. Radiologia. Jan- Feb 2016;58(1):46-54. https://doi.org/10.1016/j.rx.2015.03.002

Van Der Meer IM, Bots ML, Hofman A, del Sol AI, van der Kuip DA, Witteman JC. Predictive value of noninvasive measures of atherosclerosis for incident myocardial infarction: the Rotterdam Study. Circulation. 2004 Mar 9;109(9):1089-94. https://doi.org/10.1161/01.cir.0000120708.59903.1b

Wald DS, Wald NJ, Morris JK, Law M. Folic acid, homocysteine, and cardiovascular disease: judging causality in the face of inconclusive trial evidence. BMJ. 2006;333 (7578):1114-7. https://doi.org/10.1136/bmj.39000.486701.68

Loscalzo J. Homocysteine trials--clear outcomes for complex reasons. N Engl J Med. 2006 Apr 13;354(15):1629-32. https://doi.org/10.1056/nejme068060

Li J, Chai S, Tang C, Du J. Homocysteine potentiates calcification of cultured rat aortic smooth muscle cells. Life Sci. 2003 Dec 12;74(4):451-61. https://doi.org/10.1016/j.lfs.2003.06.028

Jamal SA, Leiter RE, Bauer DC. Hyperhomocysteinaemia and aortic calcification are associated with fractures in patients on haemodialysis. QJM. 2005 Aug; 98(8):575-9. https://doi.org/10.1093/qjmed/hci092

Cannata-Andia JB, Roman-Garcia P, Hruska K. The connections between vascular calcification and bone health. Nephrol Dial Transplantat. 2011 Nov;26(11):3429-36. https://doi.org/10.1093/ndt/gfr591

Kiel DP, Kauppila LI, Cupples LA, Hannan MT, O'Donnell CJ, Wilson PW. Bone loss and the progression of abdominal aortic calcification over a 25 year period: the Framingham Heart Study. Calcif Tissue Int. 2001 May;68(5):271-6. https://doi.org/10.1007/bf02390833

Naves M, Rodriguez-Garcia M, Diaz-Lopez JB, Gomez-Alonso C, Cannata-Andia JB. Progression of vascular calcifications is associated with greater bone loss and increased bone fractures. Osteoporos Int. 2008 Aug;19(8):1161-6. https://doi.org/10.1007/s00198-007-0539-1

Samelson EJ, Cupples LA, Broe KE, Hannan MT, O'Donnell CJ, Kiel DP. Vascular calcification in middle age and long-term risk of hip fracture: the Framingham Study. J Bone Miner Res. 2007 Sep;22(9):1449-54. https://doi.org/10.1359/jbmr.070519

Flipon E, Liabeuf S, Fardellone P, Mentaverri R, Ryckelynck T, Grados F, et al. Is vascular calcification associated with bone mineral density and osteoporotic fractures in ambulatory, elderly women? Osteoporos Int. 2012 May;23(5):1533-9. https://doi.org/10.1007/s00198-011-1762-3

Szulc P, Kiel DP, Delmas PD. Calcifications in the abdominal aorta predict fractures in men: MINOS study. J Bone Mineral Res. 2008 Jan;23(1):95-102. https://doi.org/10.1359/jbmr.070903

Naves-Diaz M, Cabezas-Rodriguez I, Barrio-Vazquez S, Fernandez E, Diaz-Lopez JB, Cannata-Andia JB. Low calcidiol levels and risk of progression of aortic calcification. Osteoporos Int. 2012 Mar;23(3):1177-82. https://doi.org/10.1007/s00198-011-1550-0

El Maghraoui A, Rezqi A, El Mrahi S, Sadni S, Ghozlani I, Mounach A. Osteoporosis, vertebral fractures and metabolic syndrome in postmenopausal women. BMC Endocr Disord. 2014 Dec 10; 14:93. https://doi.org/10.1186/1472-6823-14-93

Warburton DER, Nicol CW, Gatto SN, Bredin SSD. Cardiovascular disease and osteoporosis: Balancing risk management. Vasc Health Risk Manag. 2007; 3(5):673-89. [Accessed 25 June 2021]. Available From: https://core.ac.uk/download/pdf/7971705.pdf

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright (c) 2020 Imad Ghozlani et al.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...