Bone Mineral Density Associated With Intracranial Aneurysm Presence, Size

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Bone mineral density affects risk of and size of intracranial aneurysm.
Bone mineral density affects risk of and size of intracranial aneurysm.

A lower bone mineral density in the lumbar spine, femoral neck, and hip is associated with an increased risk for intracranial aneurysm, according to study findings published in JAMA Neurology.

Researchers of this cross-sectional analysis evaluated a total of 12,785 patients undergoing brain magnetic resonance angiography and bone mineral densitometry in Seoul, South Korea. A total of 472 patients in this cohort had intracranial aneurysms (3.7%). The researchers stratified results of the bone mineral densitometry by T scores, which included normal T score (≥−1 standard deviation [SD]), osteoporosis (≤−2.5 SD), and osteopenia (between −1 and −2.5 SD).

Overall, participants with intracranial aneurysms were more likely to have low bone mineral density. Following adjustment for age, gender, and vascular risk factors, the investigators found odds ratios of intracranial aneurysm for the highest vs the lowest bone mineral density tertiles of 1.30 (95% CI, 1.03-1.64), 1.30 (95% CI, 1.03-1.64), and 1.27 (95% CI, 1.01-1.60) in the lumbar spine, femoral neck, and total hip, respectively.

In the lumbar spine, the lowest tertile of bone mineral density significantly correlated with an increased log-transformed size of aneurysm (β, 0.196; standard error, 0.047; P <.001). A T score of <-1 was also shown to correlate with multiple aneurysms (odds ratio 1.84; 95% CI, 1.05-3.30) following adjustment for baseline characteristics.

The retrospective nature of the study and the potential for selection bias represent possible limitations of the study's design and subsequent findings. In addition, the study population had a higher number of vascular risk factors than the general patient population, further reducing the generalizability of the results.

One explanation for the association between bone mineral density and intracranial aneurysm includes “local hemodynamic stress and a mounting inflammatory response on the vessel wall as well as pathologic extracellular matrix remodeling,” the researchers suggested.

Reference

Shin YW, Park KI, Moon J, et al. Association of bone mineral density with the risk of intracranial aneurysm [published online October 16, 2017]. JAMA Neurol. doi:10.1001/jamaneurol.2017.3431

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