Background Arterial calcification might be an important determinant of arterial stiffness. It has been suggested that vascular calcification might occur in parallel with demineralization of bone, with a reciprocal relationship between arterial stiffening and osteoporosis explaining the epidemiological association of osteoporosis with cardiovascular events. Patients with psoriatic arthritis (PsA) have increased risk of osteoporosis and arterial stiffness. Whether there is any association between volumetric BMD (vBMD)/microstructure and arterial stiffness has never been explored in PsA patients.
Objectives The aim of this study is to examine the association between vBMD/microstructural features and arterial stiffness in PsA patients.
Methods 85 PsA patients (43 males; age: 54±12 years) were included. Arterial stiffness was determined by branchial-ankle pulse wave velocity (PWV). vBMD and microstructural features of the distal radius were measured using high-resolution peripheral quantitative computed tomography (HR-pQCT).
Results No patients had overt cardiovascular diseases (CVD). Patients were divided into 2 groups based on whether their PWV value is < (Low PWV, N=40) or ≥1450 cm/s (High PWV, N=45). Patients in High PWV group were older (60±10 vs 49±10 years, p<0.001), and had more active disease [damaged joint count: 4 (1-9) vs 1 (0-4), p=0.002; ESR: 28 (13-44) vs 11 (6-21) mm/1st hr, p<0.001; CRP: 0.4 (0.2-0.8) vs 0.2 (0.1-0.5) mg/dl, p=0.018]. They also had more hypertension (76% vs 40%, p=0.001), diabetes (36% vs 13%, p=0.014), and overall higher CV risk according to the Framingham risk score (FRS) (FRS 10-year CVD risk >10% in 69% vs 25%, p<0.001), although the body mass index (BMI) was lower (24±4 vs 26±4 kg/m2, p=0.041). Total, cortical (ct.) and trabecular (tb.) vBMD were 15.0% (p=0.002), 4.9% (p<0.001) and 18.3% (p=0.002) less in the High PWV group (Table 1); bone microstructure were also inferior as tb. bone volume fraction and thickness were 18.3% (p=0.002), 14.7% (p=0.001) lower; while ct. porosity was 65.6% (p=0.002) higher. The differences in tb. vBMD, bone volume fraction and thickness remained significant after adjustment for age, gender and CVD/osteoporosis risk factors. Patients in High PWV group also had significantly lower biomechanical indices including stiffness, failure load and tb. average stress after adjustment.
Conclusions PsA patients with increased arterial stiffness have lower vBMD, compromised bone microstructure and strength in the distal radius even after adjustment for age, gender and CVD/osteoporosis risk factors, supporting linkage of molecular pathways between bone disease and progression of arterial stiffness.
Disclosure of Interest None declared
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