Osteoporosis and increased carotid intima-media thickness (IMT) have been associated with
atherosclerosis. We investigated the correlation between carotid IMT and lumbar spine bone mineral density (BMD) in postmenopausal women. We studied the carotid IMT in 175 postmenopausal women, including 43 women (control) with normal spinal BMD, 73 women with
osteopenia, and 59 women with
osteoporosis. Carotid IMT was assessed by ultrasonography. BMD at the lumbar spine (lumbar 2 to 4 vertebrae) was measured by dual-energy X-ray absorptiometry. Age, years since menopause, and carotid IMT were significantly greater in the
osteoporosis group than in the control (all p<0.01) and
osteopenia groups (all p<0.01).
Estradiol was significantly lower in the
osteoporosis group than in the control group (p<0.05). BMD was significantly lower in the
osteoporosis group than in the
osteopenia or control group (both p<0.01) and in the
osteopenia group than in the control group (p<0.01). After adjusting for age, years since menopause, and
estradiol, women with
osteoporosis had significantly greater carotid IMT than controls (p<0.05). The univariate linear regression analysis revealed that carotid IMT was significantly positively correlated with age, years since menopause, and
low-density lipoprotein (
LDL) cholesterol (all p<0.05) and was significantly negatively correlated with
estradiol and BMD (all p<0.05), but showed no significant association with other clinical variables. In multivariate regression analysis, the carotid IMT was significantly positively correlated with
LDL cholesterol (p<0.01) and negatively correlated with BMD (p<0.01), but not with other variables.
Carotid atherosclerosis might be associated with lumbar spine bone mass in postmenopausal women, suggesting that postmenopausal women with
osteoporosis may have more advanced
carotid atherosclerosis than those with a normal bone mass.