Correlates of coronary artery calcified plaque in blacks and whites with type 2 diabetes.
OBJECTIVE
To examine whether the relationship between cardiovascular disease risk factors and coronary artery calcification (CAC) is modified by race among those with diabetes.


METHODS
Data were pooled data from three studies (Multi-Ethnic Study of Atherosclerosis, Family Heart Study, Diabetes Heart Study) for a total of 835 blacks and 1122 whites with diabetes. CAC was quantified by cardiac computed tomography and risk factors were obtained using standard methods. Regression models examined the relationship between risk factors and presence and quantity of CAC.


RESULTS
The average age of the cohort was 60 years; 57% were women. Presence of CAC was lower in blacks compared to whites (odds ratio = 0.22 for men, 0.57 for women, p <0.01). Hemoglobin A1c, duration of diabetes, low-density lipoprotein, smoking, and body mass index were independently associated with presence of CAC; high-density lipoprotein, triglycerides, and C-reactive protein were not. Race did not modify these associations. Adjustment for multiple risk factors did not explain the race disparity in CAC.


CONCLUSIONS
CAC was reduced in blacks compared to whites in persons with diabetes. This effect was most pronounced in men. The relationship between risk factors and CAC did not differ between races. Racial differences in CAC are likely due to unmeasured risk factors and/or genetic susceptibility.
Division of Public Health Sciences, Wake Forest University Health Sciences, Winston-Salem, NC 27157, USA. lwgnkcht@wfubmc.edu
Lynne E
LE
Wagenknecht
Jasmin
J
Divers
Alain G
AG
Bertoni
Carl D
CD
Langefeld
J Jeffrey
JJ
Carr
Donald W
DW
Bowden
Steven C
SC
Elbein
Steven
S
Shea
Cora E
CE
Lewis
Barry I
BI
Freedman
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000453:epidemiology* / Q000208:ethnology; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000208:ethnology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D020022:Genetic Predisposition to Disease; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014057:Tomography, X-Ray Computed