MINERAL'NAYa PLOTNOST' KOSTI I SOSTOYaNIE SOSUDISTOY STENKI V ZAVISIMOSTI OT STATUSA REPLIKATIVNOGO KLETOChNOGO STARENIYa U ZhENShchIN V POSTMENOPAUZAL'NOM PERIODE

Abstract

Objective: to examine the relationship between bone mineral density (BMD), the parameters of vascular stiffness and biomarkers of cellular aging in postmenopausal women. Materials and Methods: In a cross-sectional study107 patients were included: women at the age range of 45 to 82 years who were observed outpatient and signed a written informed consent. Assessment of BMD was performed using DXA (Delphi W, Hologic, USA). The intima-media thickness (IMT), the presence and quantity of atherosclerotic plaques (AP), and the degree of carotid stenosis were examined by duplex scanning. The pulse wave velocity (PWV), augmentation index (Aix) were measured by applanation tonometry (SphygmoCor).To determine telomere length (DT) in leukocytes the method of real-time PCR was used. This was done by measuring the relative telomere length in the genomic DNA. Determination of telomerase activity (Aix) was carried out on pure monocyte fraction of isolated blood cells on the basis of telomerase polymerase reaction.Statistical analysis was performed using the software application Statistical Analysis System (USA). Results: With the increase in duration of menopause a gradual increase in the stiffness rate (PWV, AI), IMT and decrease of BMD was noticed in all examined parts of the skeleton. The maximal values of vascular stiffness, minimal values of BMD and the shortest telomeres were found in patients with 10+ years of menopause. The risk of bone mass loss and osteoporosis increased by 3 times in patients with high values of PWV ≥10 m/sec[OP-3,1, 95%CI, 1,13-9,89 (p<0,05)], by more than 4 times in patients with AI≥ 20% [OP-4,35, 95%CI, 1,02-11,0 (p<0,05)]and the IMT >0,9 mm by 2,45 times in patients with presence of AP in the carotid arteries and with the shortest telomeres [OP-2,45, 95%CI, 1,05-6,08 (p<0,05)]. During multivariate regression analysis after adjusting for age and menopause duration the negative relationship between IA, IMT and BMD remained highly significant, while in relation to PWV, AP presence and telomere length, such a correlation was not confirmed. Conclusion: In postmenopausal women low BMD is associated with high rates of Aix and the thickness of the IMT. The independent relationship of BMD with Aix, rather than with PWV, apparently could be explained by the involvement of small vessels -arterioles. Short telomeres are 2.45 times more frequent in patients with low bone mass, but the relationship has not been confirmed in the regression analysis, which excludes the independent nature of this aging marker with BMD.