Key result
Osteopenia and osteoporosis are linked to ~3-fold higher carotid plaque prevalence in postmenopausal women.
Why the study?
Estrogen deficiency is strongly related to osteoporosis, but its role in cardiovascular disease is unclear, prompting assessment of the relationship between osteopenia and subclinical atherosclerosis in asymptomatic non-diabetic postmenopausal women.
Is decreased bone mineral density associated with subclinical atherosclerosis in asymptomatic non-diabetic postmenopausal women?
Is decreased bone mineral density associated with subclinical atherosclerosis in asymptomatic non-diabetic postmenopausal women?
Decreased bone mineral density is significantly associated with subclinical atherosclerosis and independently predicts the presence of carotid plaques in asymptomatic non-diabetic postmenopausal women.
Association may inform integrated risk assessment in postmenopausal women; leaves open causal inference and need for prospective validation.
Background and Aim Estrogen deficiency is strongly related to severity of osteoporosis, but its role in the development of cardiovascular diseases (CVD) is unclear. Postmenopausal women carry a significant risk of subclinical atherosclerosis as shown by increased carotid intima-media thickness (CIMT) and carotid plaque formation. The aim of this study was to assess the relationship between osteopenia and subclinical atherosclerosis in asymptomatic non-diabetic postmenopausal women. Methods This prospective study included consecutive postmenopausal women between September 2021 and December 2022 (mean age 59 ± 7 years). Clinical, biochemical, bone mineral density (BMD), carotid ultrasound and coronary CT angiography data were analyzed. Subclinical atherosclerosis was diagnosed as plaque and/or carotid intima-media thickness (CIMT)>1.00 mm. Results Of the 117 included postmenopausal women, 83 (71%) had osteopenia/osteoporosis based on the T-score <1SD, who had higher percentage of carotid artery plaques (27.7% vs. 8.8%, P=0.019), compared to those without osteopenia/osteoporosis. Postmenopausal women with atherosclerotic carotid plaques were older (P<0.001), had longer menopause (P=0.004) and higher CAC score in their coronary arteries (P<0.019), compared to those without plaques. In multivariate analysis [OR (95% confidence interval)], only age [1.244 (1.052-1.470), P=0.001], the presence of osteoporosis [0.197 (0.048-0.806), P=0.024] and CAC score >10HU [0.174 (0.058-0.806), P=0.006] independently predicted the presence of carotid plaques in the studied cohort Conclusions Decreased bone mineral density is very common in asymptomatic non-diabetic postmenopausal women. A higher percentage of these women had carotid plaques, compared to those with normal bone mineral density. Age, the presence of osteoporosis and CAC score >10HU independently predicted the presence of carotid plaques in those postmenopausal women.
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Bajraktari et al. (2025) studied this question. In asymptomatic non-diabetic postmenopausal women, osteopenia/osteoporosis was linked to a higher prevalence of carotid plaques (27.7% vs. 8.8%, P=0.019).
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