Кардиоваскулярная терапия и профилактика (Oct 2023)
Bone mineral density and parameters of bone metabolism in men with heart failure of various origins
Abstract
Aim. To evaluate bone mineral density (BMD) and parameters of bone metabolism in men with heart failure (HF) of various origins.Material and methods. The study included 100 men aged 20-70 years. The main group consisted of 60 men with HF, while the control group — 40 men without HF. BMD was measured using dual energy X-ray absorptiometry. The levels of C-terminal telopeptide type I collagen (CTx) and N-terminal propeptide type 1 procollagen (P1NP) were determined in blood serum by electrochemiluminescence immunoassay.Results. Analysis in the group with HF showed a significant inverse correlation for the BMD of the spine, femoral neck and proximal femur with HF class, the independent nature of which was confirmed by multivariate regression analysis: BMD L1-L4 (β=-0,135, p=0,001), femoral neck (β=-0,122, p=0,001), proximal femur (β=-0,127, p=0,001). However, the average values of BMD in all measured areas did not differ in the main and control groups. The mean P1NP level was significantly lower in the HF group compared to the control group — 42,5±15,0 vs 52,6±19,8 ng/ml (p=0,007). The bone resorption marker CTx was independently associated with HF stage (β=0,137, p=0,001) and N-terminal pro-brain natriuretic peptide level (β=0,128, p=0,001), and also negatively correlated with the left ventricular ejection fraction (r=-0,36, p<0,01) and positively — with left ventricular end-diastolic volume (r=0,34, p<0,01).Conclusion. In men with HF, BMD is inversely related to HF class, which acts as an independent factor in reducing bone mass. There were no differences in the frequency of low bone mass in men with HF and in the control group. A significant decrease in bone formation marker in patients with HF compared with the control group and an association of bone resorption marker with HF severity were noted.
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