Relationship Between Bone Mineral Density And Atherosclerosis In Postmenopausal Women And Establishment Of A Prediction Model For Atherosclerosis

Objective:With the aggravation of the aging trend,changes of people’s life style,ASCVD and osteoporosis(OP)have become the important public health problem in the elderly.Several studies have found that bone mineral density and atherosclerosis not only have common risk factors,but also may have common pathogenesis,but the exact relationship between them is still unclear.The objective of this research is to explore the relationship between atherosclerosis and bone mineral density,exposit the effect of bone mineral density on atherosclerosis,and establish the prediction model of atherosclerosis.Method:In this study,we applied the Power and Sample Size calculation software to calculate the sample size.And we protocoled atherosclerosis as the main outcome,the sample size of each group was 42 cases by calculating,and the total sample size was 84 cases.During the period of July 2017 to December 2017,recruiting 127 patients from health promotion center and general medicine clinic,in Sir Run Run Shaw Hospital affiliated to Zhejiang University.According to the inclusion criteria and exclusion criteria,96 cases were collected.We collect their clinical data,including age,height,weight,family history,history of diseases,blood lipid,blood glucose,liver function,carotid ultrasonography,automatic arteriosclerosis determination,bone mineral density and other indicators.And then they were divided into two groups according to bone mineral density:normal bone mineral density group(T≥-1.0,52 cases)and bone mineral density reduction group(T<-1.0,44 cases).We compare the differences between the various indicators and the incidence of atherosclerosis,analyze the effect factors of atherosclerosis,and establish the atherosclerosis prediction model based on bone mineral densityResult:1.Bone mineral density was negatively correlated with age,FSH,brachial-ankle pulse wave velocity(baPWV),and carotid intima thickening/plaque formation,but BMI,E2 was positive correlated with bone mineral density(P<0.05);2.The prevalence rate of atherosclerosis of normal bone mineral density group and bone mineral density reduction group were 15.38%and 34.09%,the difference was statistically significant(X2=5.152,P<0.05);3.Single factor analysis showed that atherosclerosis was correlated with age,family history of cardiovascular disease,baPWV and bone mineral density(BMD)(P<0.05);4.Multivariate logistics regression analysis showed that family history of cardiovascular disease,bone mineral density(BMD)were independent effect factors of atherosclerosis,and BMD was protection factor for atherosclerosis(OR= 0.228,95%CI:0.071-0.735),family history of cardiovascular disease was risk factor(OR= 4.469,95%CI:1.354-14.745).And the regression equation model to predict atherosclerosis:Logit(P)= eZ/(1+eZ),Z=-0.803+(1.497*family history of cardiovascular disease))＋(-1.477*BMD),e was the natural logarithm,and through drawing the ROC curve of the prediction model,calculating the AUC=0.776(95%CI:0:649-0.903,P<0.001).5.The 10-year ASCVD risk of bone density reduction group was higher than that of normal bone mineral density group(t=-2.863,P<0.05),and the T value of bone density was negatively correlated with the 10-year ASCVD risk(P<0.05).Conclusion:The incidence of atherosclerosis of lower bone density patient was higher than that of normal bone density patient in postmenopausal women;baPWV and carotid intima thickening/plaque formation were negatively correlated with bone mineral density;bone mineral density was one of the independent predictors of atherosclerosis in postmenopausal women;A regression equation model for predicting atherosclerosis was established,and the application value of the model was determined by sensitivity and specificity analysis.