| Objective To investigate the relationship between bone mineral density (BMD) and carotid atherosclerosis in elderly patients with chronic kidney disease (CKD) at different stages, and to provide theoretical and clinical guidance for the prevention and treatment of osteoporosis and cardiovascular diseases in elderly people with different stages of CKD. Methods The elderly CKD non-dialysis patients in outpatient and inpatient of our hospital were research subjects. The healthy elderly people were in the control group. BMD of the lumbar spine and the femoral region was measured using dual energy X-ray absorptiometry (DXA). The intimal media thickness (IMT) and atherosclerosis plaque of the carotid artery were measured using a color Doppler ultrasonography. SPSS 18.0 software package was used for statistical analysis of the relationship between BMD and carotid atherosclerosis. Results BMD in CKD patients was significantly lower than that in healthy control group (-2.4SD±0.18 vs. -0.8SD±0.24, P<0.01). In non-dialysis CKD patients, glomerular filtration rate (GFR) was positively correlated with BMD, and there were significant differences among groups (P<0.05 or P<0.01). IMT (0.78±0.21 vs. 0.71±0.24 mm, P<0.01) and plaque formation (66.6% vs. 36%, P<0.01) increased in CKD patients. The prevalence of carotid atherosclerosis increased in CKD patients compared to healthy controls (66.6% vs 36%, P<0.01). The linear correlation analysis showed that BMD was positively correlated with hsCRP, TG, serum phosphorus, iPTH, and hemoglobin (P<0.05 or P<0.01), but was negatively correlated with GFR, serum calcium, SAlb, IMT, plaque, and the prevalence of carotid atherosclerosis (P<0.05 or P<0.01). The stepwise regression analysis showed that age, systolic blood pressure, diabetes, smoking, drugs, and BMD were independent risk factors of carotid artery disease in CKD patients. The IMT of CKD patients was significantly thicker than that in the control group (P<0.01). The total detectable rate of carotid atherosclerotic plaques was 66%, which was significantly higher than that of the control group (36%, P<0.01). The positive detectable rate of carotid IMT thickening and atheromatous plaque was more obvious in the middle and late stage of CKD (P<0.05). Conclusion BMD is significantly lower in patients with CKD at various stages and is associated with carotid artery disease. Osteoporosis may be one of the risk factors for atherosclerosis in CKD patients. The formation of atherosclerotic plaque is closely related to age, blood lipid, CKD different stages, and BMD, and has obvious similarities with the risk factors of osteoporosis. There is a close relationship between osteoporosis and atherosclerosis. The two can be either cause or effect and can be affected by a common factor. |