Age-related vessel calcification at distal extremities is a risk factor of osteoporosis

SummaryWe conducted a cohort study to investigate if the vessel calcifications (VCs) found in the distal extremities are an index of low bone mass at multiskeletal sites. A total of 332 healthy women aged 41–80 years were recruited for bone mineral content (BMC) and bone mineral density measurement using peripheral quantitative computed tomography (pQCT) and dual-energy X-ray absorptiometry (DXA). Seven percent of the women showed VC at both upper and lower distal extremities based on pQCT images. Women who had VC were then compared with their age-matched non-VC counterparts. Results showed that peripheral VC was mainly formed at distal lower extremities, and the prevalence of VC increased with advancing age, with 0%, 5.6%, 9.3%, and up to 34.5% in the age groups of 41–50 years, 51–60 years, 61–70 years, and 71–80 years, respectively. Compared with the control group, the VC group showed a significantly higher body mass index (25.2 vs. 23.2, p < 0.01), lower BMC at the spine (27.4 g vs. 31.3 g, p < 0.05), and lower BMC (1.8 g vs. 2.0 g, p < 0.05) and bone mineral density (0.57 g/cm2 vs. 0.66 g/cm2, p < 0.05) at the hip as measured by DXA. The diagnosis of VC in the distal extremities by pQCT increased the diagnosis sensitivity of osteoporosis by 50%. The significance of our findings imply that in clinical settings using pQCT for bone assessment and identification of patients with VC in the distal extremities, patients should also be referred for central DXA measurement at the femoral neck for diagnosis of osteoporosis as well as further assessment of vascular disorders.