Significance of Carotid Intima-media Thickness and Bone Mineral Density in Cerebrovascular Disease in Health Screening Examinees

Background: Carotid intima-media thickness (CIMT) and bone mineral density (BMD) are key markers of vascular and skeletal health, respectively. While each has been linked to cerebrovascular disease individually, their combined effect remains unclear. This study assessed the independent and interactive roles of CIMT and BMD in cerebrovascular disease among asymptomatic adults undergoing health screening. Methods: We retrospectively analyzed data of 1447 participants who underwent CIMT measurement, BMD testing, and brain magnetic resonance (MR) imaging with MR angiography at a general hospital between January 2020 and March 2022. Multivariable logistic regression was employed to assess associations, adjusting for age, sex, hypertension, diabetes mellitus, smoking status, and hyperlipidemia. Stratified analysis was conducted according to BMD categories. Results: Increased CIMT, older age, hypertension, and diabetes were independently associated with cerebrovascular disease. Compared with those with CIMT <0.8 mm, participants with CIMT 0.8–1.0 mm and ≥1.0 mm had progressively higher risks for developing cerebrovascular disease (odds ratios [OR] 3.82 and 5.70, respectively; both P < 0.001). In the stratified analysis, the association between CIMT and cerebrovascular disease was amplified in the lower BMD groups, with the OR associated with a CIMT ≥1.0 mm rising from 3.81 in the normal BMD group to 7.10 and 12.36 in the osteopenia and osteoporosis groups, respectively. Conclusion: Increased CIMT and lower BMD were significantly associated with cerebrovascular disease. CIMT, which can be measured noninvasively, may serve as a predictive marker in health screenings for individuals with low BMD.