THE RELATIONSHIP OF BIOCHEMICAL MARKERS OF BONE METABOLISM, OSTEOPENIC SYNDROME AND CORONARY ATHEROSCLEROSIS IN MEN WITH STABLE CORONARY HEART DISEASE
O.L. Barbarash1, N.B. Lebedeva2, A.N. Kokov1, A.A. Novitskaya1, O.N. Khryachkova1, A.V. Voronina2, T.A. Raskina2, I.A. Shubanova3
1Research Institute for Complex Issues of Cardiovaskular Disease, 650002, Kemerovo, Sosnovy Blvd., 6
2Kemerovo State Medical Academy of Minzdrav of Russia, 650039, Kemerovo, Voroshilov str., 22A
3Regional Clinical Hospital for War Veterans, 650000, Kemerovo, 50 Years of October, 10
Keywords: coronary atherosclerosis, calcification, osteopenic syndrome, cathepsin K, osteocalcin
Abstract
Aim: To assess the levels of bone metabolism markers in patients with stable coronary artery disease according to the severity of osteoporosis, coronary atherosclerosis and coronary artery calcification. Material and Methods: 112 males with angiographically verified stable coronary artery disease with an average age of 59.8 (55; 70) years were included in the study. All the patients underwent coronary angiography, multislice computed tomography (MSCT) and densitometry. The levels of mineral metabolism markers were measured by enzyme-linked immunosorbent assay. The allocation of comparison groupswas based on the severity of coronary atherosclerosis (the Syntax Score), the degree of coronary artery calcification (the Agatston score), the presence and absence of osteopenic syndrome defined by the femoral neck T-score in accordance with the guidelines of the International Society for Clinical Densitometry (ISCD, 2007). Results: Osteopenic syndrome has been reported in 90 (80.4 %) patients: 34 (30.4 %) patients with signs of osteoporosis, and 56 (50 %) with osteopenia. A significant decrease in cathepsin K and an increase inosteocalcinhave been found in the group with radiographically verified osteopenic syndrome compared to the group with normal bone mineral density (BMD). The assessment of coronary artery disease severity reported that multivessel coronary artery disease and severe lesions were more commonly found in patients with osteopenic syndrome. Moreover, this group of patients had more pronounced calcification compared with patients with normal BMD. Patients with severe coronary atherosclerosis had the lowest cathepsin K levels. Severe coronary artery calcification was significantly associated with lower levels of cathepsin K and osteoprotegerin, elevated alkaline phosphatase and parathyroid hormone levels. Conclusion: A significant association between osteopenic syndrome and severe coronary atherosclerosis and calcification has been found in males with stable coronary artery disease. Biochemical markers of bone metabolism were more likely associated with the calcification of the existing vascular lesions than with the development of coronary atherosclerosis. The findings of the study suggest that the most significant markers are cathepsin K whichsignificantly reduced in all cases, i. e. in patients with osteopenic syndrome, severe atherosclerosis and severe coronary calcification, and osteocalcin which elevated levels are associated with decreased BMD.
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