title: The relationship between cephalometric carotid artery calcification and Framingham Risk Score profile in patients with obstructive sleep apnea.
abstract: OBJECTIVE
  The morbidity rate of arteriosclerosis becomes clinically manifested as acute cardiovascular events. In the progress of atherosclerosis, the carotid artery calcifies and sometimes appears as a calcified mass on a cephalometric radiograph. This study was designed to evaluate cardiovascular risks according to the Framingham Risk Score (FRS) between subjects with and without visible carotid artery calcification on a cephalogram.
  
  
  METHODS
  Subjects diagnosed with obstructive sleep apnea (OSA) were divided into two groups according to whether or not calcification was visible on a cephalometric radiograph in the carotid artery area, and the characteristic differences between the two groups were analyzed. The evaluated variables included age, BMI, apnea-hypopnea index (AHI), SpO2, ESS, blood pressure, medication history, diabetes mellitus (DM), drinking, smoking, and lipid-related measurements. FRSs for stroke, general cardiovascular disease (GCD), and coronary heart disease (CHD) were calculated. Statistical analyses were performed (SPSS 18.0) with significance defined as a two-tailed p value less than 0.05.
  
  
  RESULTS
  A total of 811 subjects completed the data collection (727 males, age 53.0 ± 12.5 years, AHI 31.7 ± 22.6, times/h). From FRSs, probabilities of a GCD, stroke, and CHD within 10 years were 16.0 ± 9.7, 9.8 ± 6.7, and 11.9 ± 8.3 %, respectively. Some 84 subjects exhibited calcification in the carotid arterial area. Calcification subjects were higher GCD risk and older than subjects who had no identified calcification (20.3 ± 10.1 vs 15.6 ± 20.3 %, p = 0.013, 58.8 ± 11.4 vs. 52.3 ± 12.5 years, p < 0.001). Although there is no significant difference in OSA-related variables and FRSs, subjects with visible calcifications have higher prevalence of high blood pressure medication and DM (p < 0.01).
  
  
  CONCLUSIONS
  While the presence of a calcified mass on a cephalometric radiograph is not diagnostic of atherosclerosis, this information indicates some cardiovascular risk.
authors.affiliation: Division of General Oral Care, Kyushu University Hospital, 3-1-1 Maidashi Higashi-ku, Fukuoka, Japan. htsuda@dent.kyushu-u.ac.jp
authors.forename: Hiroko
authors.initials: H
authors.lastname: Tsuda
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Moritsuchi
authors.forename: Fernanda R
authors.initials: FR
authors.lastname: Almeida
authors.forename: Alan A
authors.initials: AA
authors.lastname: Lowe
authors.forename: Toru
authors.initials: T
authors.lastname: Tsuda
mesh_terms: D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000000981:diagnostic imaging*; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000000981:diagnostic imaging*; D002508:Cephalometry; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011859:Radiography; D020181:Sleep Apnea, Obstructive / Q000000981:diagnostic imaging*