Markers of bone metabolism in premature myocardial infarction (<= 40 years of age)

作者：Goliasch Georg; Bles**erger Hermann; Azar Danyel; Heinze Georg; Wojta Johann; Bieglmayer Christian; Wagner Oswald; Schillinger Martin; Huber Kurt; Maurer Gerald; Haas Martin; Wie**auer Franz^*

来源：Bone, 2011, 48(3): 622-626.

DOI：10.1016/j.bone.2010.11.005

• Premature coronary artery disease
• Myocardial infarction
• Vitamin D
• Osteocalcin
• Bone metabolism

Introduction: Acute myocardial infarction (AMI) at young age is a rare disease with a poor prognosis. Bone metabolism parameters such as 1,25 (OH)(2) vitamin D(3), 25 (OH) vitamin D(3) and osteocalcin have been recently implicated in the development of coronary heart disease (CHD). We evaluated the role of these serum markers in a study population of very young AMI survivors (<= 40 years).
Methods and results: We prospectively enrolled 302 subjects into our multi-center case control study, including 102 young myocardial infarction patients (<= 40 years) and 200 control subjects who were frequency-matched on gender and age in an approximate 2:1 ratio per case patient. In the adjusted logistic regression analysis, we used baseline laboratory measurements for the first analysis (acute phase analysis) and measurements from one-year follow-up visits (stable phase analysis). In both, elevated levels of 25 (OH) vitamin D(3) (acute phase: OR per IQR 2.02, 95% CI 1.13-3.58, p = 0.017; stable phase: OR 4.07. 95% CI 1.8-9.21, p = 0.001) and 1,25 (OH)(2) vitamin D(3) (acute phase: OR 2.82, 95% CI 1.7-4.7, p < 0.001 stable phase: OR 4.57, 95% CI 2.31-9.05, p < 0.001) were associated with premature AMI. Conversely, osteocalcin was inversely associated with premature myocardial infarction (acute phase: OR 0.53, 95% CI 0.28-1.03, p = 0.059; stable phase: OR 0.26,95% CI 0.12-0.6, p < 0.001). The observed associations were independent of the acute phase of myocardial infarction.
Conclusion: In our study, elevated levels of 25 (OH) vitamin D(3) and 1,25 (OH)(2) vitamin D(3), as well as decreased levels of osteocalcin were associated with myocardial infarction in very young patients. The precise mechanism and implications of these findings will have to be elucidated in future studies.

• 出版日期2011-3-1