Coronary artery calcification at electron beam computed tomography is increased in asymptomatic type 2 diabetics independent of traditional risk factors.
BACKGROUND
The risk of cardiovascular disease (CVD) is two- to fourfold greater in type 2 diabetics than in non-diabetics and cannot be accounted for by traditional risk factors alone. Coronary artery calcification (CAC) at electron beam computed tomography (EBCT) is a non-invasive index of coronary atherosclerosis. We hypothesized that the presence and extent of CAC would be greater in asymptomatic type 2 diabetics than in non-diabetics independent of traditional risk factors.


METHODS
We reviewed CAC data of all asymptomatic subjects referred for EBCT between 1996-1999 and compared CAC scores in type 2 diabetics ( n= 71) to all non-diabetics ( n= 1481) and to a randomly selected group of non-diabetics matched for all traditional CVD risk factors ( n= 71).


RESULTS
CAC scores were greater in type 2 diabetics (272 +/- 472, median 41) than in all non-diabetics (104 +/- 288, median 4; < 0.01) and matched non-diabetics (188 +/- 354; < 0.05, median 12; < 0.05). The odds ratio (OR) for the presence of CAC (scores > 0) in type 2 diabetics was 2.9 [95% confidence intervals (CI) 1.1-7.8] after adjustment for traditional CVD risk factors. Type 2 diabetes was also associated (adjusted OR 2.15, 95%CI 1.3-3.6) with the extent of CAC when categorized as an ordinal outcome (CAC scores 0, 1-79, 80-399 and > 400). In type 2 diabetics, age, sex and body mass index were associated with extent of CAC.


CONCLUSIONS
CAC scores at EBCT are greater in type 2 diabetics than non-diabetic subjects, cannot be accounted for by traditional risk factors alone and may be useful for identifying novel factors for coronary atherosclerosis in type 2 diabetes.
Wolfe
Megan L
ML
Department of Medicine, University of Pennsylvania, 421 Curie Boulevard, 815 BRB2/3, Philadelphia, PA 19104, USA.
Iqbal
Nayyar
N
Gefter
Warren
W
Mohler
Emile R
ER
Rader
Daniel J
DJ
Reilly
Muredach P
MP
D000367:Age Factors; D015992:Body Mass Index; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D016022:Case-Control Studies; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003331:Coronary Vessels / Q000473:pathology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000379:methods; D014280:Triglycerides / Q000097:blood
D008078:Cholesterol, LDL; D014280:Triglycerides