Background Vascular calcification is a marker of endothelial cell damage and is associated with cardiovascular morbidity. Calcification of the abdominal aorta (AA) is occasionally noted as an incidental finding on lumbar spine x-rays, but the significance of this observation is unknown. We undertook a study of patients with osteoarthritis (OA) or rheumatoid arthritis (RA) who underwent lumbar spine radiography for evaluation of lower back pain. We used available laboratory data to investigate any possible links between AA calcification and cardiometabolic risk factors.
Methods Chart reviews were performed on sequential patients with RA and OA attending rheumatology out-patient clinics. Those who had recent plain films of their lumbosacral spine were included in our analysis. Co-morbid conditions, medication use, available laboratory and radiology results were recorded. Each lumbar spine x-ray was evaluated for aortic calcification by 2 investigators (FI and GC) using the following scoring system: nil: no calcification; minimal: calcification measuring less than the height of 1 vertebral body; moderate: calcification measuring <2 vertebral bodies; extensive: calcification measuring >2 vertebral bodies. Statistical assessment was performed using SPSS version 18. Categorical variables were compared using a chi squared test and continuous variables were compared using the students t test.
Results 214 patients were included in the analysis of which 144 were female. Mean age was 65.7 years (range 40 to 92).RA was the underlying diagnosis in 110, while 104 had OA. No patient had been diagnosed with gout. There was no statistically significant difference between these groups in terms of age, gender, vascular calcification, body mass index (BMI), dyslipidemia or hyperglycemia. However, hyperuricemia was more prevalent in the OA group (p=0.023). Almost half the total cohort (47.2%) had evidence of moderate or extensive AA calcification. As expected, the incidence of vascular calcification increased with age (p<0.00001). AA calcification also correlated significantly with hyperuricaemia (P<0.04), but not with other cardiometabolic risk factors such as BMI or dyslipidemia.
Conclusions Aortic calcification increased with age and was associated with hyperuricemia, but not other laboratory-based cardiometabolic factors. Chronic inflammatory disease did not confer additional risks for vascular calcification. Hyperuricemia, known to have adverse effects on vascular health, correlated significantly with AA calcification and may therefore have a similar deleterious effect on blood vessels as chronic inflammation.
Disclosure of Interest None Declared
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