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proLékaře.cz / Odborné časopisy / Clinical Osteology / 2019 - 4

Souvislost mezi kostní a cévní kalcifikací: důkazy z klinických studií

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Autoři: Szulc Pawel
Působiště autorů: INSERM UMR 1033, University of Lyon, France
Vyšlo v časopise: Clinical Osteology 2019; 24(4): 178-190
Kategorie: Přehledové články

Souhrn

Predošlá významná osteoporotická zlomenina a v menšej miere nižšia hustota kostného minerálu (BMD – Bone Mineral Density) súvisí s vyšším kardiovaskulárnym rizikom. Kardiovaskulárne ochorenia sú spojené s vyšším rizikom závažných osteoporotických zlomenín. Kalcifikáciu brušnej aorty (AAC – Abdominal Aortic Calcification) je možné vyhodnotiť pomocou tzv. Kauppilovho semikvantitatívneho skóre. Závažná AAC je spojená s vyšším rizikom zlomenín bedra a stavca, menej s vyšším rizikom iných zlomenín a nižší BMD. Väčší pomer intima-média karotíd bol v niektorých, ale nie vo všetkých štúdiách spojovaný s nižšou BMD. Kalcifikované karotické pláty boli často spojované s nižšou BMD a vyšším rizikom fraktúry. Závažná kalcifikácia koronárnych artérií súvisí predovšetkým s nižšou objemovou BMD trabekulárnej kosti (nie kortikálnej) u žien v menopauze (nevzťahuje sa na mužov). U pacientov/pacientiek s ťažkou osteoporózou teda môže jestvovať vyššie riziko kardiovaskulárneho ochorenia a naopak, pre klinické liečenie týchto pacientov ale nie sú k dispozícii žiadne oficiálne pokyny.

Klíčová slova:

kalcifikácia brušnej aorty – kalcifikácia karotídy – kalcifikácia koronárnych artérií – kardiovaskulárne ochorenia – osteoporotická zlomenina – osteoporóza

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