Vascular calcification progression has been associated with the loss of trabecular bone in chronic kidney disease (CKD) patients. There are few data evaluating the relationship between cortical bone loss and vascular calcification in this population. The aim of this study was to prospectively evaluate the association between changes in cortical bone density and coronary artery calcification (CAC) progression in non-dialyzed CKD patients. Changes of cortical and trabecular bone, and changes of calcium score, were analyzed using vertebral tomographic images from a prospective study. Automatic delineation of the cortical bone layer was performed by Image J software, and trabecular bone was determined by selecting a region of interest using Vitrea 2® software. Cortical and trabecular bone density (BD) were expressed in Hounsfield Units (HU), and coronary artery calcium score in Agatston Units (AU). Seventy asymptomatic patients [57.8 ± 10.2 years, 63% males, 20% diabetic, estimated glomerular filtration rate (eGFR) = 37.3 (24.8–51.3) mL/min/1.73m2] were followed for 24 months. The mean cortical and trabecular BD did not change over time. While 49 patients lost either bone, 29 (41%) patients lost cortical [− 4.4%/year (ranging from − 7.15 to − 0.5)] and 39 (56%) lost trabecular bone [− 3.15%/year (− 13.7 to − 0.25)]. There was no association between cortical and trabecular BD changes (p = 0.12). CAC was observed in 33 (46%) patients at baseline, and 30 (91%) of them showed CAC progression. While an inverse correlation between trabecular bone and calcium score changes was observed (p = 0.001), there was no correlation between cortical bone and calcium score changes (p = 0.34). CKD patients experience either cortical or trabecular bone loss over time, but these changes do not take place simultaneously in all patients. Cortical, unlike trabecular bone loss, is not associated with vascular calcification progression in these patients.

中文翻译：

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皮质骨与小梁骨丢失与 CKD 患者的血管钙化进展无关

血管钙化进展与慢性肾病 (CKD) 患者的骨小梁丢失有关。很少有数据评估该人群中皮质骨丢失与血管钙化之间的关系。本研究的目的是前瞻性评估非透析 CKD 患者皮质骨密度变化与冠状动脉钙化 (CAC) 进展之间的关联。使用来自前瞻性研究的椎体断层扫描图像分析皮质骨和小梁骨的变化以及钙评分的变化。皮质骨层的自动描绘由 Image J 软件执行，小梁骨通过使用 Vitrea 2® 软件选择感兴趣的区域来确定。皮质和小梁骨密度 (BD) 以 Hounsfield 单位 (HU) 表示，和冠状动脉钙化评分，单位为 Agatston Units (AU)。70 名无症状患者 [57.8 ± 10.2 岁，63% 男性，20% 糖尿病，估计肾小球滤过率 (eGFR) = 37.3 (24.8–51.3) mL/min/1.73m2] 随访 24 个月。平均皮质和小梁 BD 没有随时间变化。虽然 49 名患者丢失了任何一种骨，但 29 名 (41%) 患者丢失了皮质 [- 4.4%/年（范围从 - 7.15 到 - 0.5）] 和 39 (5​​6%) 名患者丢失了小梁骨 [- 3.15%/年（- 13.7 到 - − 0.25)]。皮质和小梁 BD 变化之间没有关联（p = 0.12）。在基线时在 33 (46%) 名患者中观察到 CAC，其中 30 (91%) 名患者出现 CAC 进展。虽然观察到小梁骨和钙评分变化之间呈负相关（p = 0.001），但皮质骨和钙评分变化之间没有相关性（p = 0.34）。随着时间的推移，CKD 患者会出现皮质骨或小梁骨丢失，但这些变化不会在所有患者中同时发生。与小梁骨丢失不同，皮质与这些患者的血管钙化进展无关。