Background Cardiovascular disease is the most common cause of mortality among men. Vertebral fracture assessment (VFA) imaging with a bone densitometer can simultaneously detect prevalent VFs and AAC an important cardiovascular disease risk factor independent of clinical risk factors.
Objectives to study the relation between the prevalence and severity of VFs using VFA in asymptomatic men and the prevalence and severity of AAC.
Methods we enrolled 709 men with mean ± SD (range) age, weight and BMI of 62.4±8.6 (45 to 89) years, 75.9±12.9 (40 to 163) and 26.4±4.0 (16.6 to 43.8) kg/m2, respectively. Lateral VFA images and scans of the lumbar spine and proximal femur were obtained using a GE Healthcare Lunar Prodigy densitometer. VFs were defined using a combination of Genant semiquantitative (SQ) approach and morphometry. VFA images were scored for AAC using a previously validated 24 point scale.
Results VFs were identified using VFA in 475 (40.3%): 166 (26.0%) had grade 1 and 68 (14.2%) had at least one grade 2 or 3 vertebral fracture. The prevalence of grade 2/3 vertebral fractures was 42 (38.9%) in men with osteoporosis and was higher (p<0.0001) compared to 15 (5.9%) in men with normal BMD and to 39 (11.2%) with osteopenia. VFA images showed that 82% of the evaluable participants did not have any detectable AAC whereas the AAC score distribution ranged between 1 and 15. Conversely, the prevalence of significant atherosclerotic burden, defined as a radiographic 24-point AAC score of 5 or higher, was 2.8% and concerned essentially patients over 66 years. The group of men with moderate/severe vertebral fractures had a statistically significant higher AAC score and higher proportion of subjects with extended AAC, and lower weight, height, and lumbar spine and total hip BMD and T-scores than those without a VFA-identified vertebral fracture. A positive statistical correlation was noted between age and the SDI, and a statistical negative correlation between the AAC score and lumbar spine and total hip BMD. Multiple regression analysis showed that the presence of grade 2/3 VFs was associated to AAC and osteoporosis in any site.
Conclusions VFA imaging has the potential to contribute to identification of sub-clinical cardiovascular disease in men.
Disclosure of Interest None Declared