SERUM PHOSPHATE AND HIP BONE MINERAL DENSITY AS ADDITIONAL FACTORS IN VASCULAR CALCIFICATION IN A COMMUNITY-DWELLING: SAO PAULO AGEING HEALTHY STUDY (SPAH)

Abstract

Aims: To analyze abdominal aortic calcification (AAC) and its possible association with bone metabolism parameters as well as others clinical and laboratory data in a São Paulo community-dwelling elderly (SPAH). Methods: This cross-sectional study included 815 subjects ≥ 65 years old. The risk factors for osteoporosis and cardiovascular disease as well as a wide array of demographic and lifestyle characteristics were collected using a standardized questionnaire. BMD was measured by DXA. Kauppila’ s method was used to quantify the AAC score (AACS) by spine X-rays. Laboratory analyses were also performed. Results: AAC was observed in 63.2 % of subjects with a mean AACS of 4.68±5.88. AACS was directly correlated with age, phosphorus, LDL-cholesterol, triglycerides, and inversely correlated with BMI, femoral neck BMD and total femur BMD (p<0.05). Regarding binary variables, the AACS was associated with previous fragility fractures, current smoking, low physical activity, falls and arterial hypertension (p<0.05). Multiple lin-ear regression analysis demonstrated that the AACS was positively associated with phosphate (p=0.005) and negatively associated with total femur BMD (p<0.001) after adjusting by age, triglycerides, current smoking, arterial hypertension and LDL-cholesterol. An increased of AACS was observed with the elevation of serum phosphorus levels [£ 2.4 mg/dL: AACS 01.9 (SD:3.9); 2.5-3.5 mg/dL: AACS04.5 (SD:5.6)and >3.5 mg/dL: AACS05.3 (SD:6.3), p=0.003]. Conclusion: Our study identified serum phosphate and hip BMD as additional players in the complex process of vascular calcification outside the setting of kidney failure in a community-dwelling elderly and extended the previous observations of well-known risk factors for cardiovascular disease.