Bone Mineral Density Is Positively Related to Carotid Intima-Media Thickness: Findings From a Population-Based Study in Adolescents and Premenopausal Women

Osteoporosis and cardiovascular disease(CVD) are both common causes of morbidity and mortality. Previous studies, mainly of people over 60 years, suggest a relationship between these conditions. Our aim was to determine the association between bone characteristics and CVD markers in younger and middle-aged individuals. Women (n=3,366) and their adolescent offspring (n= 4,368) from the UK population-based cohort study, Avon Longitudinal Study of Parents and Children(ALSPAC), were investigated. We measured total body(TB) and hip BMD, TB bone area(BA) and bone mineral content(BMC) by DXA, and carotid intima-media thickness(cIMT) by high-resolution ultrasound. Arterial distensibility was calculated as the difference between systolic and diastolic arterial diameters. Linear regression determined associations between bone exposures and cIMT (in adolescents), and both cIMT and arterial distensibility (in women), generating partial correlation coefficients. Mean(SD) age of women was 48(4.2) years, BMI 26.2(5.0)kg/m2, 71% were premenopausal. In confounder-adjusted analyses (age, height, lean mass, fat mass, menopause, smoking, estrogen replacement, calcium/vitamin D supplementation and education) TB and hip BMD were both positively associated with cIMT (0.071 [0.030, 0.112], p=0.001; 0.063 [0.025, 0.101], p=0.001, respectively). Femoral neck BMD and TB BMD, BMC and BA were positively associated with arterial distensibility. Mean(SD) age of adolescents was 17(0.4) years, BMI 23(4.1)kg/m2 and 44.5% were male. Total hip and TB measurements were positively associated with cIMT, with similar magnitudes of association to those seen in their mothers. In contrast to most published findings we identified weak positive associations between BMD and cIMT in predominantly premenopausal women and their adolescent offspring. We found greater femoral neck BMD and TB DXA measurements to be associated with reduced arterial stiffness. Rather than a relationship with pre-clinical atherosclerosis, in these relatively young populations, we speculate our associations between BMD, cIMT and arterial distensibility may reflect a shared relationship between bone and vascular growth and development.