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CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(03): 521-526
DOI: 10.4103/ajns.AJNS_111_20
Original Article

Association of bone mineral density, Vitamin D, and serum calcium in intracranial aneurysm

Achal Sharma
Department of Neurosurgery, SMS Medical College, Jaipur, Rajasthan
,
Jitesh Sharma
Department of Neurosurgery, SMS Medical College, Jaipur, Rajasthan
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Aims: The objective of this study is to understand the association between bone mineral density (BMD), serum calcium, and Vitamin D in s (IA) patients. Subjects and Methods: A total of 100 patients with IA diagnosed at the department of neurosurgery between January 2019 and December 2019 were reviewed and analyzed in this study. Computed tomography angiography was used to confirm and locate the site of aneurysms. BMD, serum calcium, and Vitamin D levels were measured. Statistical Analysis Used: Linear or logistic regression statistical models were applied to found the association between BMD and IA size. To confirm the statistical significance, P < 0.05 (twos-tailed) was considered as statistically significant. Results: Of the studied 100 patients, 61 patients were female and 39 were male. According to the age group, patients were divided into five categories: below 30, 31–40, 41–50, 51–60, and ≥60 years. The most common site of aneurysm observed to be the anterior communicating artery (Acom); 39.25% of the patients had Acom aneurysm followed by the middle cerebral artery (18.69%). This clearly shows that the occurrence of aneurysm is more prominent in anterior circulation as compared to posterior circulation. The results showed that there is a negative linear correlation between BMD and size of aneurysm (P = 0.00043, r =−0.12). Sex-specific analysis showed that females have lower mean BMD value as compared to males (i.e., females 0.785 ± 0.13; males 0.887 ± 0.13; P = 0.0003). We also found that the multiplicity of IAs also shows an association with BMD (i.e. mean BMD: 0.825 ± 0.14, whereas BMD of patients with multiple aneurysms was 0.747 ± 0.08; P = 0.05). Of 100 patients, 66 were observed calcium deficient (normal range: 8.8–10.2 mg/dl). The obtained mean value of calcium was 8.56 ± 0.859 standard deviation (SD), i.e., below the normal range of calcium. In the case of Vitamin D, 85% of the patients were observed Vitamin D deficient, whereas 14 patients showed Vitamin D insufficiency and merely 1 patient has Vitamin D sufficiency. The mean 25-hydroxy Vitamin D level obtained in our study was 14.57 ± 5.60 (SD), which is considered as Vitamin D deficiency. Conclusions: The size and multiplicity of IA can be associated with BMD, calcium, and Vitamin D. The results from the research provide evidence of common pathophysiology between the development of IA and these factors.

Key-words:

Bone mineral density - calcium - intracranial aneurysm - Vitamin D

Financial support and sponsorship

Nil.




Publication History

Received: 24 March 2020

Accepted: 11 May 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Keedy A. An overview of intracranial aneurysms. Mcgill J Med 2006;9:141-6.
  • 2 Vlak MH, Rinkel GJ, Greebe P, van der Bom JG, Algra A. Trigger factors and their attributable risk for rupture of intracranial aneurysms: A case-crossover study. Stroke 2011;42:1878-82.
  • 3 Tomandl BF, Hammen T, Klotz E, Ditt H, Stemper B, Lell M. Bone-subtraction CT angiography for the evaluation of intracranial aneurysms. AJNR Am J Neuroradiol 2006;27:55-9.
  • 4 Lanzino G, Murad MH, d'Urso PI, Rabinstein AA. Coil embolization versus clipping for ruptured intracranial aneurysms: A meta-analysis of prospective controlled published studies. AJNR Am J Neuroradiol 2013;34:1764-8.
  • 5 Pierot L, Wakhloo AK. Endovascular treatment of intracranial aneurysms. Stroke 2013;44:2046-54.
  • 6 Baldwin MJ, Policha A, Maldonado T, Hiramoto JS, Honig S, Conte MS, et al. Novel association between bone mineral density scores and the prevalence of peripheral artery disease in both sexes. Vasc Med 2017;22:13-20.
  • 7 Shin YW, Park KI, Moon J, Lee ST, Chu K, Lee SK, et al. Association of bone mineral density with the risk of intracranial aneurysm. JAMA Neurol 2018;75:179-86.
  • 8 Poole KE, Loveridge N, Barker PJ, Halsall DJ, Rose C, Reeve J, et al. Reduced Vitamin D in acute stroke. Stroke 2006;37:243-5.
  • 9 Chung PW, Park KY, Kim JM, Shin DW, Park MS, Chung YJ, et al. 25-hydroxyvitamin D status is associated with chronic cerebral small vessel disease. Stroke 2015;46:248-51.
  • 10 Guan J, Karsy M, Eli I, Bisson EF, McNally S, Taussky P, et al. Increased incidence of hypovitaminosis D among patients requiring treatment for cerebral aneurysms. World Neurosurg 2016;88:15-20.
  • 11 You S, Han Q, Xu J, Zhong C, Zhang Y, Liu H, et al. Serum calcium and phosphate levels and short- and long-term outcomes in acute intracerebral hemorrhage patients. J Stroke Cerebrovasc Dis 2016;25:914-20.
  • 12 Can A, Rudy RF, Castro VM, Dligach D, Finan S, Yu S, et al. Low serum calcium and magnesium levels and rupture of intracranial aneurysms. Stroke 2018;49:1747-50.
  • 13 Jung KH. New pathophysiological considerations on cerebral aneurysms. Neurointervention 2018;13:73-83.
  • 14 Chalouhi N, Ali MS, Jabbour PM, Tjoumakaris SI, Gonzalez LF, Rosenwasser RH, et al. Biology of intracranial aneurysms: Role of inflammation. J Cereb Blood Flow Metab 2012;32:1659-76.
  • 15 Viguet-Carrin S, Garnero P, Delmas PD. The role of collagen in bone strength. Osteoporos Int 2006;17:319-36.
  • 16 Bruno G, Todor R, Lewis I, Chyatte D. Vascular extracellular matrix remodeling in cerebral aneurysms. J Neurosurg 1998;89:431-40.
  • 17 Hong EP, Jeon JP, Kim SE, Yang JS, Choi HJ, Kang SH, et al. A novel association between Lysyl oxidase gene polymorphism and intracranial aneurysm in Koreans. Yonsei Med J 2017;58:1006-11.
  • 18 Jamous MA, Nagahiro S, Kitazato KT, Satomi J, Satoh K. Role of estrogen deficiency in the formation and progression of cerebral aneurysms. Part I: Experimental study of the effect of oophorectomy in rats. J Neurosurg 2005;103:1046-51.
  • 19 Jamous MA, Nagahiro S, Kitazato KT, Tamura T, Kuwayama K, Satoh K. Role of estrogen deficiency in the formation and progression of cerebral aneurysms. Part II: Experimental study of the effects of hormone replacement therapy in rats. J Neurosurg 2005;103:1052-7.
  • 20 Ostergaard JR, Høg E. Incidence of multiple intracranial aneurysms. Influence of arterial hypertension and gender. J Neurosurg 1985;63:49-55.
  • 21 Norman PE, Powell JT. Vitamin D, shedding light on the development of disease in peripheral arteries. Arterioscler Thromb Vasc Biol 2005;25:39-46.
  • 22 Davies MR, Hruska KA. Pathophysiological mechanisms of vascular calcification in end-stage renal disease. Kidney Int 2001;60:472-9.
  • 23 Guillot X, Semerano L, Saidenberg-Kermanac'h N, Falgarone G, Boissier MC. Vitamin D and inflammation. Joint Bone Spine 2010;77:552-7.
  • 24 Rai V, Agrawal DK. Role of Vitamin D in cardiovascular diseases. Endocrinol Metab Clin North Am 2017;46:1039-59.
  • 25 Zhao D, Ouyang P, de Boer IH, Lutsey PL, Farag YM, Guallar E, et al. Serum Vitamin D and sex hormones levels in men and women: The multi-ethnic study of atherosclerosis (MESA). Maturitas 2017;96:95-102.
  • 26 Morotti A, Charidimou A, Phuah CL, Jessel MJ, Schwab K, Ayres AM, et al. Association between serum calcium level and extent of bleeding in patients with intracerebral hemorrhage. JAMA Neurol 2016;73:1285-90.