Type 2 diabetes does not attenuate racial differences in coronary calcification.
OBJECTIVE
Coronary artery calcification (CAC) is a strong predictor of atherosclerotic cardiovascular disease (CVD). Whites appear to have a higher prevalence of CAC than African-Americans (AAs), but it is unknown if type 2 diabetes, a major cardiovascular risk factor, attenuates this difference. We investigated the relationship of race and CAC in a sample of patients with type 2 diabetes without clinical CVD.


METHODS
multivariable analyses of self-reported ethnicity and CAC scores, stratified by gender, in 861 subjects [32% AA, 66.9% male] with type 2 diabetes.


RESULTS
AA race was associated with lower CAC scores in age-adjusted models in males [Tobit ratio for AAs vs. Whites 0.14 (95% CI 0.08-0.24, p<0.001)] and females [Tobit ratio 0.26 (95% CI 0.09-0.77, p=0.015)]. This persisted in men after adjustment for traditional, metabolic and inflammatory risk factors, but adjustment for plasma triglycerides [0.48 (95% CI 0.15-1.49, p=0.201)] and HOMA-IR [0.28 (95% CI 0.08-1.03, p=0.055)] partially attenuated the association in women.


CONCLUSIONS
relative to African-Americans, White race is a strong predictor of CAC, even in the presence of type 2 diabetes. The relationship in women appears less robust possibly due to gender differences in metabolic risk factors.
Cardiovascular Institute, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-6160, United States.
Alisha N
AN
Wade
Sean
S
Fedyna
Nehal N
NN
Mehta
Caitlin
C
St Clair
Naeema
N
Ginwala
Rama K
RK
Krishna
Atif N
AN
Qasim
Seth
S
Braunstein
Nayyar
N
Iqbal
Mark H
MH
Schutta
Muredach P
MP
Reilly
D000328:Adult; D001741:Black or African American; D000368:Aged; D000375:Aging; D002114:Calcinosis / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology* / Q000503:physiopathology; D003324:Coronary Artery Disease / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D010414:Pennsylvania / Q000453:epidemiology; D012307:Risk Factors; D012720:Severity of Illness Index; D012727:Sex Characteristics; D044465:White People