Postmenopausal Osteoporosis, Endothelial Dysfunction, and Cardiovascular Risk

Q: What are the key findings of this study?

Previous osteoporosis treatment was independently associated with a 1.40 percentage point higher flow-mediated dilation compared to no previous treatment in postmenopausal women with osteoporosis.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Postmenopausal osteoporosis (n=111). Intervention: Previous osteoporosis treatment vs. No previous osteoporosis treatment. Primary outcome: Flow-mediated dilation (FMD) percentage (Regression coefficient 1.40, 95% CI 0.43-2.37, p=0.005).

Q: What does this research mean for the field?

In postmenopausal women with osteoporosis, endothelial dysfunction provides additional cardiovascular risk information beyond traditional determinants, and prior bisphosphonate use is associated with better endothelial function. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Marie‐Eva Pickering; C. Heiss; Véronique Morel; G T Pickering; Marion Couderc; Sylvain Mathieu; Sandrine Malochet-Guinamand; Julie Durif; Vincent Sapin; Bruno Pereira; Anne Tournadre; Roland Chapurlat

doi:10.1097/rhu.0000000000002352

June 8, 2026JCR Journal of Clinical RheumatologyOpen Access

Postmenopausal Osteoporosis, Endothelial Dysfunction, and Cardiovascular Risk

View Full Paper

Ask AI

Bookmark

Share

Key result

Prior osteoporosis treatment linked to ~1.4 percentage point higher flow-mediated dilation in postmenopausal women.

Regression coefficient +1.40
95% CI 0.43-2.37
P=0.005
n=111

Figures

Key Points

To investigate associations between endothelial function assessed by flow-mediated dilation (FMD), bone turnover, and cardiovascular disease risk in women with postmenopausal osteoporosis.
Conducted a cohort study of N=111 consecutive postmenopausal osteoporosis outpatients from the Rheumatology Department of Clermont-Ferrand University Hospital, France.
Assessed brachial artery FMD, bone mineral density via dual x-ray absorptiometry, bone turnover markers (CTX, P1NP, osteocalcin, periostin), and 10-year cardiovascular disease risk using SCORE2/2-OP algorithms.
No significant associations were detected between FMD and bone-related parameters, including bone mineral density and bone turnover markers.
FMD was inversely associated with SCORE2/2-OP (r=-0.212, p=0.035), particularly in participants aged <65 years (r=-0.428, p=0.012 vs. r=-0.066, p=0.60 in ≥65 years).
Prior bisphosphonate use was positively associated with FMD (4.20 ± 2.5% vs. 2.9 ± 2.17%, p=0.032; r=0.270, p=0.007), while 55% of patients classified as low/intermediate SCORE2/2-OP exhibited low FMD (<3.1%).

Study Design

Type

Cohort (n=111)

Multicenter

No

Structured PICO

P

Population

111 postmenopausal women aged 50 years or older with osteoporosis were evaluated cross-sectionally to assess associations between endothelial function, bone parameters, and cardiovascular risk.

O

Outcome

Associations between endothelial function assessed by flow-mediated dilation (FMD) and bone-related parameters (bone mineral density, bone markers, fracture history, treatments) as well as Cardiovascular disease risk (SCORE2/2-OP)surrogate

Main Result

Mean Difference: 1.4 (95% CI 0.43–2.37)

Absolute Event Rate: 3.89% vs 2.67%

p-value: p=0.005

Endothelial dysfunction assessment using flow-mediated dilation provides additive cardiovascular risk stratification beyond traditional SCORE2/2-OP in postmenopausal women with osteoporosis, and suggests possible vascular benefits of prior bisphosphonate treatment.

Limitations

Exploratory bivariate analyses were performed without multiple testing adjustments, requiring cautious interpretation of unadjusted p-values.
Comparison with literature-based reference values may introduce bias due to differences in protocols, device calibration, or population characteristics.
Other clinical variables that may influence endothelial function, such as physical activity, inflammatory status, and treatment duration, were not available.
Exploratory bivariate analyses whose p-values should be interpreted with caution without adjustment for multiple testing
Comparison with literature-based reference values may introduce bias due to differences in protocols, device calibration, or population characteristics
Unavailability of other clinical variables that may influence endothelial function (e.g., duration of osteoporosis treatment, menopausal hormone exposure duration, physical activity, inflammatory status)

Implication

Prior bisphosphonate use may support better endothelial function; leaves open whether treatment modifies CV risk in postmenopausal osteoporosis.

Abstract

BACKGROUND/OBJECTIVES: Bone and cardiovascular health are interconnected, yet their relationship with endothelial function in postmenopausal osteoporosis remains insufficiently understood. This study aimed to investigate, in women with osteoporosis, the associations between endothelial function, assessed by flow-mediated dilation (FMD), bone turnover, and cardiovascular disease risk. METHODS: This cohort study included consecutive postmenopausal osteoporosis outpatients from the Rheumatology Department of Clermont-Ferrand University Hospital, France. FMD was measured at the brachial artery and values contextualized with age-matched healthy women's data reported in the literature. Associations between FMD and bone-related parameters (bone mineral density, bone markers, fracture history, and treatments), and Systematic Coronary Risk Evaluation (SCORE2/2-OP) were analyzed. RESULTS: A total of 111 postmenopausal women with osteoporosis (mean age 69.4 ± 7.9 y; mean FMD=3.14 ± 2.28%) were included. No significant associations were found between FMD and bone-related parameters. FMD was positively associated with prior bisphosphonate use (r=0.270, p=0.007) and inversely associated with SCORE2/2-OP (r=-0.212, p=0.035), particularly among younger participants. Overall, 49.5% of patients had high/very high SCORE2/2-OP, and 55% of those classified as low/intermediate SCORE2/2-OP exhibited low FMD values. CONCLUSIONS: Measurement of the endothelial function in postmenopausal osteoporosis brings additional information to cardiovascular risk calculation, suggesting that factors beyond traditional cardiovascular risk determinants contribute to vascular impairment. In clinical practice, our findings support cautious cardiovascular follow-up even in osteoporotic patients with low cardiovascular risk and underline possible positive effects of bisphosphonates on endothelial function.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Pickering et al. (2026) conducted a cohort in Postmenopausal osteoporosis (n=111). Previous osteoporosis treatment vs. No previous osteoporosis treatment was evaluated on Flow-mediated dilation (FMD) percentage (Regression coefficient 1.40, 95% CI 0.43-2.37, p=0.005). Previous osteoporosis treatment was independently associated with a 1.40 percentage point higher flow-mediated dilation compared to no previous treatment in postmenopausal women with osteoporosis.

synapsesocial.com/papers/6a2901886f82f25be989dcb3 https://doi.org/10.1097/rhu.0000000000002352

Topics

Women and heart disease

View Full Paper

Ask AI

Bookmark

Share

Postmenopausal Osteoporosis, Endothelial Dysfunction, and Cardiovascular Risk

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Topics

Postmenopausal Osteoporosis, Endothelial Dysfunction, and Cardiovascular Risk

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Keep reading

Topics

Keep reading