Background: Relationship between bone fragility fracture (BFF) and abdominal aortic calcification (AAC) has been discussed in recent decade.

Objectives: Now we investigated the relationship between the two and a new factor of BFF: serum creatinine-to cystatin C ratio (Cr/CysC).

Methods: A total of nine-hundred and thirty one osteoporotic patients were recruited. Diagnosis of osteoporosis was indexed by the criteria of Japanese Primary Osteoporosis Diagnostic Criteria. Patient’s lumbar spine X-ray pictures were taken and dual-energy X-ray absorptiometry (DXA) of lumbar spine and hip joint were tested at the same time, and all of them were followed us for more than one year up to nine years with at least an administration of vitamin D. Anti-osteoporotic drugs were administrated for 660 patients.

Vertebral compression fracture (VF) and AAC were evaluated with lateral view of X-ray picture. VF was classified in accordance with Semi-quantified method (SQ), and AAC was classified as follows: Grade0; No calcification, Grade1; Partial calcification not continued over one vertebral height, Grade2; Calcification continuous over one vertebral height. BFF history of the patients except of VF was harvested from the medical record and with interview. Patients’ background at first measurement were measured and Cr/CysC was calculated as well. Prevalence of BFF at the baseline for each grade with SQ was compared according to the grade of AAC. Background factors including bone mineral densities (BMD) of the lumbar spine and hip joint measured using DXA were compared for each AAC grade.

Occurrence of BFF was picked up during following up (BFF_F/U) of the patients. Prevalence of BFF_F/U for each ACC grade was statistically compared, and relationship between BFF_F/U and factors at the baseline was statistically evaluated.

Results: A total of 219 of Grade0, 428 of Grade1, and 278 of Grade2 were recruited. Prevalence of BFF at baseline for each VF group was 182, 16, 9, and 12 for Grade0, 138, 98, 122, and 70 for Grade1, and 53, 45, 82, and 144 for Grade2, with Grade-0, Grade-1, Grade-2, and Grade-3 by SQ, respectively (p<0.01). Factors that demonstrated significant correlation with occurrence of BFF were sex, age, BMD of the lumbar spine and the hip joint, and Cr/CysC with univariate mode binary logistic regression anaysis. However, Cr/CysC did not demonstrate significant correlation using multivariate model.

Occurrence of BFF_F/U for each AAC group was 26, 90, and 82 for Grade0, Grade1, and Grade2, respectively (p<0.01). The only factor that demonstrated significantly correlated with occurrence of BFF_F/U was Cr/CysC in the Grade1 and the Grade2 of the AAC classification.

Conclusion: ACC grade significantly correlates with occurrence of BFF. Cr/CysC also significantly correlates with occurrence of BFF after follow up under presence of AAC.

Disclosure of Interests: None declared.