Ethnic differences in coronary calcification - The multi-ethnic study of atherosclerosis (MESA)
Ethnic differences in coronary calcification - The multi-ethnic study of atherosclerosis (MESA)
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DOI：
10.1161/01.cir.0000157730.94423.4b
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发表时间：
2005-03-15
期刊：
影响因子：
37.8
通讯作者：
Saad, MF
中科院分区：
文献类型：
--
作者：
Bild, DE;Detrano, R;Saad, MF
背景-有大量证据表明，冠状动脉钙化--冠状动脉粥样硬化的存在和数量的标志--在美国白人中比黑人更高；然而，还没有大规模的基于人群的研究比较美国种族之间的冠状动脉钙化。方法和结果-我们使用计算机断层扫描技术，测量了6814名年龄在45-84岁之间、没有临床心血管疾病的中国男性和女性的冠状动脉钙化，这些人参加了多种族动脉粥样硬化研究(MESA)。在这4个民族中，冠状动脉钙化(Agatston评分和0)的患病率男性分别为70.4%、52.1%、56.5%和59.2%(P<；0.001)，女性分别为44.6%、36.5%、34.9%和41.9%(P<；0.001)。在调整了年龄、教育程度、血脂、体重指数、吸烟、糖尿病、高血压、高胆固醇血症治疗、性别和扫描中心后，与白人相比，黑人发生冠状动脉钙化的相对危险度为0.78(95%CI为0.74~0.82)，西班牙裔为0.85(95%CI为0.79~0.91)，华人为0.92(95%CI为0.85~0.99)。经过类似的调整后，白人的冠状动脉钙化程度最高，其次是华人(77%；95%可信区间62%至96%)、西班牙裔(74%；95%可信区间61%至90%)和黑人(69%；95%可信区间59%至80%)。结论--我们观察到冠状动脉钙化的存在和数量存在种族差异，但不能用冠状动脉危险因素来解释。识别这些差异的机制将进一步加深我们对冠状动脉钙化的病理生理学及其临床意义的理解。需要关于不同民族冠脉钙化预测价值的数据。
Background - There is substantial evidence that coronary calcification, a marker for the presence and quantity of coronary atherosclerosis, is higher in US whites than blacks; however, there have been no large population-based studies comparing coronary calcification among US ethnic groups.Methods and Results - Using computed tomography, we measured coronary calcification in 6814 white, black, Hispanic, and Chinese men and women aged 45 to 84 years with no clinical cardiovascular disease who participated in the Multi-Ethnic Study of Atherosclerosis (MESA). The prevalence of coronary calcification (Agatston score > 0) in these 4 ethnic groups was 70.4%, 52.1%, 56.5%, and 59.2%, respectively, in men (P < 0.001) and 44.6%, 36.5%, 34.9%, and 41.9%, respectively, (P < 0.001) in women. After adjustment for age, education, lipids, body mass index, smoking, diabetes, hypertension, treatment for hypercholesterolemia, gender, and scanning center, compared with whites, the relative risks for having coronary calcification were 0.78 (95% CI 0.74 to 0.82) in blacks, 0.85 (95% CI 0.79 to 0.91) in Hispanics, and 0.92 (95% CI 0.85 to 0.99) in Chinese. After similar adjustments, the amount of coronary calcification among those with an Agatston score > 0 was greatest among whites, followed by Chinese (77% that of whites; 95% CI 62% to 96%), Hispanics (74%; 95% CI 61% to 90%), and blacks (69%; 95% CI 59% to 80%).Conclusions - We observed ethnic differences in the presence and quantity of coronary calcification that were not explained by coronary risk factors. Identification of the mechanism underlying these differences would further our understanding of the pathophysiology of coronary calcification and its clinical significance. Data on the predictive value of coronary calcium in different ethnic groups are needed.