SAT0351 Calcium/vitamin D supplements do not deteriorate the increased vascular calcification in osteoporotic women
Authors: C.E. Lampropoulos, M. Konsta, P. Kalamara, I. Papaioannou, V. Niarou, E. Iliopoulou, A. Iliopoulos
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Vascular calcification (VC) is an independent risk factor for cardiovascular disease (CVD).<sup>1</sup> Many articles revealed common pathogenetic mechanisms between osteoporosis and VC, suggesting a causative role of osteoporosis in VC.<sup>2</sup> An important issue was raised recently about the safety of calcium/vitamin D supplements and their influence on VC and CVD.<sup>3,4</sup> <h3>Objectives</h3> To estimate the correlation between osteoporosis and VC in post-menopausal women and the influence of calcium/vitamin D supplements on VC. <h3>Methods</h3> A case-control study was performed including 29 women with osteoporosis (15 without supplements) and 18 with normal BMD (mean age 59.5±6.3). Patients were evaluated for cardiovascular risk factors: hypertension, smoking, diabetes, dyslipidemia, obesity, drinking habits, MedDiet score and IPAQ score. Patients performed blood tests (glucose, renal function, lipid profile, CRP), carotids' ultrasound [intima media thickness (IMT, abnormal when &gt;0.8mm) or calcified plaques], heart ultrasound and lateral x-ray of lumbar spine for abdominal aortic calcification (AAC) (range 0-24, abnormal when score ≥2). Clinical and demographic variables of patients were compared for categorical and continuous variables. Odds ratios (OR) were calculated and logistic regression analysis was performed to identify independent predictors for VC. <h3>Results</h3> In group with osteoporosis, 13/29 women had AAC and 22/29 increased IMT or plaques compared to 1/18 and 5/18 of non-osteoporotic women respectively. Osteoporotic women are 14 times more likely to develop AAC (OR=13.8, p=0.016) and 7.7 times increased IMT (OR=7.7, p=0.003), compared to non-osteoporotic. The odds of developing AAC are increased 14% per year after menopause (OR=1.14, p=0.009) and 37% per year increase (OR=1.37, p=0.001). Similarly, the odds of increased IMT are increased 17% per year after menopause (OR=1.17, p=0.006) and 18% per year increase (OR=1.18, p=0.008). The odds of developing AAC are 4-fold increased (OR=4.1, p=0.05) per each unit increase of calcium in serum. Comparison of cardiovascular risk factors between the 2 groups revealed no significant differences. Calcium/vitamin D supplements didn't aggravate AAC or IMT as there were no differences between the 2 subgroups of osteoporotic women (8/15 of women without supplements had AAC and 12/15 increased IMT compared to 5/14 and 10/14 of women with supplements respectively). <h3>Conclusions</h3> Osteoporosis is related with increased VC of abdominal aorta and carotids. This finding is in accordance with previous studies where osteoporosis is associated with AAC and increased IMT.<sup>5,6</sup> Calcium/vitamin D supplements do not deteriorate VC in osteoporotic women. Further studies are needed to establish osteoporosis as a cardiovascular risk factor and evaluate the role of supplements in osteoporosis treatment. <h3>References</h3> Rennenberg RJ, et al. Vasc Health Risk Manag 2009;5:185-97 Rajamannan NM, et al. Circulation 2003;107:2181-4 Hsia J, et al. Circulation 2007;115:846-54 Lewis JR, et al. J Bone Miner Res 2011;26:35-41 Kiel DP, et al. Calcif Tissue Int 2001;68:271-6 Sumino H, et al. Hypertens Res 2008;31:1191-7 <h3>Disclosure of Interest</h3> None Declared