Aortic calcification and bone metabolism: The relationship between aortic calcification, BMD, vertebral fracture, 25-hydroxyvitamin D, and osteocalcin

Kwang Joon Kim, Kyoung Min Kim, Kyeong Hye Park, Han Seok Choi, Yumie Rhee, Yong Ho Lee, Bong Soo Cha, Myong Jin Kim, Sun Min Oh, J. Keenan Brown, Sung Kil Lim

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35 Citations (Scopus)


The aim of this study was to investigate the relationship between aortic calcification (AC) and low bone mineral density (BMD), 25(OH)D, C-terminal telopeptide (CTx), and osteocalcin levels in Asian women. We also tried to find the association between AC and the risk of vertebral fracture. We included 769 patients in this study. All patients underwent QCT. Aortic calcium score (ACS) was quantified by the Agatston scoring method. Spinal fracture was defined by lumbar spine radiography. Among 769 subjects, 96 had at least one vertebral fracture and 345 had AC. ACS positively correlated with age. Osteocalcin, CTx, 25(OH)D, total-hip trabecular BMD (tBMD), femoral neck tBMD, and vertebral tBMD were inversely related with ACS. However, cortical BMD (cBMD) did not correlate with ACS. Among these parameters, only osteocalcin significantly correlated with ACS, even after adjusting for age. We divided the subjects into two groups based on the presence of AC to determine the association between AC and vertebral fracture. Multivariate logistic regression analysis showed that age, tBMD of each site, and AC were associated with vertebral fractures. After adjusting for confounding factors, patients with AC had more than a threefold increased risk of vertebral fracture (OR = 3.29-3.57, P<0.05 according to site). This study suggests that high ACS is related to low tBMD but not cBMD. Furthermore, our findings indicate that this relationship is definitely age-dependent. Finally, we found that AC is significantly associated with the prevalence of vertebral fracture in Asian women.

Original languageEnglish
Pages (from-to)370-378
Number of pages9
JournalCalcified Tissue International
Issue number6
Publication statusPublished - 2012 Dec

Bibliographical note

Funding Information:
We thank Michael McClung, MD, director of the Oregon Osteoporosis Center, for reviewing the manuscript. This work was supported by a grant to the Bone Metabolism Research Center from the Science Research Center (2009-0063265) and by the Korean Ministry of Education, Science and Technology, Republic of Korea.

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine
  • Endocrinology


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