Calcified Large Arteries, Osteoporosis & Acute Stroke: What is the Relationship?

Introduction: Atherosclerosis and osteoporosis are currently considered unrelated diseases. As age advances, osteoporosis is more frequently found in women than men; atherosclerosis is an illness predominantly affecting men [1]. A parallel relationship has been noted between spinal osteoporosis and aortic calcification due to atherosclerosis [2]. Osteoporosis and stroke share several risk factors, such as age, smoking, low level of physical activity, and hypertension [3]. Thus Low bone mineral density (BMD) and a high risk of stroke may thus be related, but studies on this relationship are sparse. Both bone and atherosclerotic arteries contain osteopontin, matrix gla protein, bone morphogenetic protein collagen I, osteonectin, Osteocalcin, nitric oxide, and matrix vesicles [4]. Atherosclerosis and osteoporosis both involve recruitment and differentiation of monocytic cells that differentiate into macrophage-foam cells in artery and osteoclasts in bone [5]. The artery wall contains cells capable of differentiation into osteoblasts, following the same stages of differentiation as occur in bone-derived osteoblasts, and ultimately producing bone mineral [6]. Objectives: To examined the relationship between Calcified large arteries, BMD and acute stroke in hospitalized patients aged > 60 years. Methods: Seventy-five stroke patients (40 women and 35 men) in addition to sixty-five ages matched control group were included in the study. Careful family history, full clinical exam. Radiological examination for both lumbar & pelvic regions . Routine lab, Lipid profile investigations were done. The atherogenic index was calculated as the ratio of (total cholesterol-HDL cholesterol) to HDL cholesterol. Body mass index (BMI) was calculated for the entire studied group. BMD was measured by using dual-energy x-ray absorptiometry GE Healthcare Lunar Prodigy Primo. BMD measurements of the stroke patients were performed one week after the onset of stroke. Results: There was a highly significant difference between the stroke patients and their controls as regards Total cholesterol, LDL, HDL and BMD. However in males; no difference was found between the stroke patients and their controls regarding BMD. As regards aortic calcifications, the noncalcified aorta was significantly higher in controls than stroke group. The advanced calcified aorta &moderate one was significantly higher among stoke group than controls, despite the mild aortic calcification show a non significant difference between both groups. Conclusion: High Total cholesterol& LDL, but Low HDL& BMD in addition to aortic calcification whatever moderate or advanced may early predict stroke both in females and males. This may be an important explanation for the increased incidence of hip fracture in stroke patients. Background: Atherosclerosis and osteoporosis are currently considered unrelated diseases. As age advances, osteoporosis is more frequently found in women than men; atherosclerosis is an illness predominantly affecting men [1]. A parallel relationship has been noted between spinal osteoporosis and aortic calcification due to atherosclerosis1. Osteoporosis and stroke share several risk factors, such as age, smoking, low level of physical activity, and hypertension [3]. Thus Low bone mineral density (BMD) and a high risk of stroke may thus be related, but studies on this relationship are sparse. Both bone and atherosclerotic arteries contain osteopontin, matrix gla protein, bone morphogenetic protein collagen I, osteonectin, Osteocalcin, nitric oxide, and matrix vesicles [4]. Atherosclerosis and osteoporosis both involve recruitment and differentiation of monocytic cells that differentiate into macrophage-foam cells in artery and osteoclasts in bone [5]. There are cells in the artery wall that can differentiate into bone forming cells, exactly as occur in bone-osteoblasts [6].