TY - JOUR
T1 - Coronary artery calcium and bone mineral density by serial CTA
T2 - Does menopausal hormone therapy modify the association?
AU - Cherukuri, Lavanya
AU - Kinninger, April
AU - Birudaraju, Divya
AU - Jayawardena, Eranthi
AU - Manubolu, Venkat Sanjay
AU - Brinton, Eliot A.
AU - Black, Dennis
AU - Miller, Virginia
AU - Kearns, Ann E.
AU - Manson, Jo Ann E.
AU - Budoff, Matthew J.
AU - Roy, Sion K.
N1 - Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/10
Y1 - 2022/10
N2 - Introduction: Both osteoporosis and cardiovascular disease (CVD) increase in women after menopause. Estrogen deficiency is thought to be an underlying mechanism for both these conditions. Methods: Healthy menopausal women (n = 374, age 42–58 years) underwent cardiac CT scans over four years as participants in the Kronos Early Estrogen Prevention Study (KEEPS), a randomized, controlled trial to Women randomized to either oral conjugated equine estrogens (o-CEE, n = 104), transdermal 17β-estradiol (t-E2, n = 119) or placebo (n-115). CAC (Agatston units, AU), and BMD (mg/cm3) were measured from thoracic vertebrae at baseline and at the 4 years of the study using validated software. ANOVA and multiple linear regression analyzed the association between incident CAC or progression of CAC and BMD among the treatment groups. Results: At baseline 374 women, 40 participants with CAC >0 had greater decrements in BMD than the 334 participants with CAC = 0 at baseline, The average change in BMD in o-CEE group with CAC was −9.6 ± 13.3 versus −3.1 ± 19.5 in those with zero CAC, p = 0.0018. With t-E2, BMD changed by −11.7 ± 26.2 in those with CAC versus +5.7 ± 26.2 in the zero CAC group, p ≤ 0. 0001. Similarly in the 66 participants that showed progression of CAC >1, had more BMD loss, than those with stable CAC regardless of the treatment. Conclusion: Progression of bone loss is reduced among women treated with o-CEE or t-E2. Progression of CAC is associated with greater BMD loss, a relationship that is differentially modified by t-E2 and o-CEE.
AB - Introduction: Both osteoporosis and cardiovascular disease (CVD) increase in women after menopause. Estrogen deficiency is thought to be an underlying mechanism for both these conditions. Methods: Healthy menopausal women (n = 374, age 42–58 years) underwent cardiac CT scans over four years as participants in the Kronos Early Estrogen Prevention Study (KEEPS), a randomized, controlled trial to Women randomized to either oral conjugated equine estrogens (o-CEE, n = 104), transdermal 17β-estradiol (t-E2, n = 119) or placebo (n-115). CAC (Agatston units, AU), and BMD (mg/cm3) were measured from thoracic vertebrae at baseline and at the 4 years of the study using validated software. ANOVA and multiple linear regression analyzed the association between incident CAC or progression of CAC and BMD among the treatment groups. Results: At baseline 374 women, 40 participants with CAC >0 had greater decrements in BMD than the 334 participants with CAC = 0 at baseline, The average change in BMD in o-CEE group with CAC was −9.6 ± 13.3 versus −3.1 ± 19.5 in those with zero CAC, p = 0.0018. With t-E2, BMD changed by −11.7 ± 26.2 in those with CAC versus +5.7 ± 26.2 in the zero CAC group, p ≤ 0. 0001. Similarly in the 66 participants that showed progression of CAC >1, had more BMD loss, than those with stable CAC regardless of the treatment. Conclusion: Progression of bone loss is reduced among women treated with o-CEE or t-E2. Progression of CAC is associated with greater BMD loss, a relationship that is differentially modified by t-E2 and o-CEE.
KW - Atherosclerosis
KW - Bone mineral density (BMD)
KW - Cardiac CT
KW - Cardiovascular disease (CVD)
KW - Cellular, endocrine and metabolic mechanisms
KW - Osteoporosis
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U2 - 10.1016/j.clinimag.2022.06.023
DO - 10.1016/j.clinimag.2022.06.023
M3 - Article
C2 - 35908457
AN - SCOPUS:85134887983
SN - 0899-7071
VL - 90
SP - 26
EP - 31
JO - Clinical Imaging
JF - Clinical Imaging
ER -