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Abstract
Background Carotid Atherosclerosis is associated with compromised volumetric bone mineral density and microstructures in patients with inflammatory arthritis
Objectives The aim of this study was to explore the relationship between volumetric bone mineral density (vBMD)/microstructural features and presence of carotid plaque (CP) in patients with inflammatory arthritis.
Methods 175 inflammatory arthritis patients (81 [46%] PsA, 94 [54%] RA; 70 [40%] males; age: 53±12 years) were recruited into an ongoing prospective study assessing the relationship between inflammation, osteoporosis and carotid atherosclerosis. Carotid plaque and intima-media thickness (IMT) were measured by carotid ultrasound. Areal BMD (aBMD) was measured by dual energy X-ray absorptiometry (DXA). Microstructure features and vBMD of distal radius were measured using high-resolution peripheral quantitative computed tomography (HR-pQCT).
Results No patients had established cardiovascular disease (CVD). Data from 172 patients at baseline were analyzed for this cross-sectional study. Patients were sub grouped according to the presence or absence of carotid plaque (CP+ group, n=68 [40%]) and CP- group, n=132 [60%]). CP+ group were older (59±10 vs 49±11, p<0.001), more likely to be male (54% vs 31%, p=0.002), had higher systolic blood pressure (130±19 vs 124±17 mmHg, p=0.034) and CVD risk (15.7±14.2 vs 7.9±8.6, p<0.001) according to the Framingham Risk Score (FRS) then the CP- group. aBMD, vBMD and microstructure were significantly compromised in the CP+ group. Distal radius aBMD, distal radius total vBMD, trabecular (Tb) vBMD, Tb thickness, cortical (Ct.) vBMD, Ct. thickness and bone volume fraction were 5% (p=0.004), 12% (p<0.001), 8% (p=0.007), 8% (p=0.004), 4% (p=0.007), 10% (p=0.001) and 8% (p=0.007) lower in the CP+ group. The differences remained significant after adjustment for gender, disease type and FRS (Table 1).
Conclusions Inflammatory arthritis patients with carotid plaque had lower aBMD, vBMD and compromised bone microstructure in the distal radius even after adjustment for gender, disease type and FRS, suggesting that inflammation may be the common link for both conditions.
Disclosure of Interest None declared