Abdominal aortic calcification was inversely associated with CT-derived vertebral bone density (r = -0.19, p = 0.032), but this was attenuated after age and sex adjustment (β = -0.68, p = 0.127).
Cohort (n=172)
Is abdominal aortic calcification associated with CT-derived vertebral bone density in patients with osteoporotic vertebral fractures?
Abdominal aortic calcification is inversely associated with CT-derived vertebral bone density in patients with osteoporotic vertebral fractures, though this relationship is largely driven by age.
Effect estimate: β -0.68 (95% CI -1.55 to 0.20)
p-value: p=0.127
Background Osteoporotic vertebral fractures (OVFs) frequently occur in patients without osteoporotic bone mineral density (BMD) on dual-energy X-ray absorptiometry (DXA), highlighting limitations of densitometry in capturing skeletal fragility. Abdominal aortic calcification (AAC) reflects cumulative cardiometabolic burden and may serve as a marker of impaired bone quality. This study evaluated the association between AAC and CT-derived vertebral bone density in patients with OVFs. Methods In this retrospective cohort study, 172 patients with OVFs (median age 79 years, 72.7% female) underwent DXA, CT-based Hounsfield Unit (HU) assessment, and lateral lumbar radiography. AAC was quantified using the Kauppila 24-point score. Associations between AAC and bone parameters were assessed using correlation and multivariable linear regression adjusted for age and sex. Sensitivity analyses included severe AAC (≥16) and low bone quality (HU ≤90). Results AAC was inversely associated with HU in unadjusted analyses (r = −0.19, p = 0.032), with a stepwise decline across AAC categories (p = 0.038). This association was attenuated after adjustment (β = −0.68, 95% CI −1.55 to 0.20, p = 0.127), while age remained independently associated with lower HU (p = 0.030). No association was observed between AAC and DXA T-scores. Sensitivity analyses demonstrated a consistent but non-significant inverse relationship. Conclusion AAC demonstrates a consistent inverse relationship with CT-derived vertebral bone density in OVF patients; however, this association is largely driven by age. These findings support AAC as an opportunistic imaging marker of skeletal fragility in older adults rather than an independent determinant of bone density.
Bekele et al. (Mon,) conducted a cohort in Osteoporotic vertebral fractures (n=172). Abdominal aortic calcification (AAC) was evaluated on CT-derived vertebral bone density (Hounsfield Units) (β -0.68, 95% CI -1.55 to 0.20, p=0.127). Abdominal aortic calcification was inversely associated with CT-derived vertebral bone density (r = -0.19, p = 0.032), but this was attenuated after age and sex adjustment (β = -0.68, p = 0.127).