Arq. Bras. Cardiol. 2018; 110(3): 217-218
The Interface between Osteoporosis and Atherosclerosis in Postmenopausal Women
DOI: 10.5935/abc.20180050
This Short Editorial is referred by the Research article "Association of Severity of Coronary Lesions with Bone Mineral Density in Postmenopausal Women".
In recent years, the association between osteoporosis and atherosclerotic disease has been described, regardless of patients’ age, and highlighted epidemiologic and pathophysiologic similarities between arterial wall calcification and osteogenesis., Cross-sectional, prospective studies have pointed out significant negative association between cardiovascular mortality and low bone mass, osteoporotic fractures, vascular calcification, extension of coronary artery disease and abdominal aortic injury.– Concomitant occurrence of both diseases seems to result from common pathophysiologic and molecular mechanisms between these conditions. However, it is still controversial whether a low bone mass is caused by arterial calcification or vice-versa, or whether these conditions only have the same pathophysiological mechanism.
Risk factors for osteoporosis and atherosclerotic disease include estrogen, parathyroid hormone, homocysteine and vitamin K deficiency, lipid oxidation products, inflammatory process, vitamin D excess, molecular pathways involved in both bone and vascular mineralization, and similar mechanisms of calcification involving vascular and bone structures. Arterial calcification is found in more than 90% of atherosclerotic lesions. The process starts with formation of vesicles in the endothelial matrix, followed by proliferation and mineralization of the arterial intima-media wall, similarly to the bone tissue. Many bone remodeling regulators have been described in calcified atherosclerotic lesions, including osteocalcin, hydroxyapatite crystals, osteopontin, bone morphogenetic protein 2 osteoprotegerin, sclerostin, dickkopf factor (DKK), leptin, oxidized lipids and calcium sensor-related factor.
[…]
973