Impact of serum calcium and phosphate on coronary atherosclerosis detected by cardiac computed tomography
Impact of serum calcium and phosphate on coronary atherosclerosis detected by cardiac computed tomography
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DOI：
10.1093/eurheartj/ehs152
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发表时间：
2012-11-01
影响因子：
39.3
通讯作者：
Chung, Namsik
中科院分区：
文献类型：
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作者：
Shin, Sanghoon;Kim, Kwang-Joon;Chung, Namsik
高钙(Ca)、高磷(P)和高钙产物(CPP)与慢性肾脏疾病患者的心血管疾病有关。这种关系在肾功能正常的个体中是否持续尚不清楚。本研究通过心脏CT血管成像(CCTA)对7553例肾功能接近正常(估计肾小球滤过率60mL/min/1.73m(2))肾功能接近正常的受试者进行心脏CT血管成像(CCTA)检查，探讨血中钙、磷和CPP与冠状动脉粥样硬化的关系。评价钙、磷和CPP与冠状动脉粥样硬化[冠状动脉钙评分(CACS)100和冠状动脉疾病(CAD)的存在]的关系。更高的钙、磷和CPP与CACS100持续相关[调整后的优势比(OR)每mg/dL：CA1.21，P 0.026；P1.29，P 0.001；CPP1.03，P 0.001]。然而，它们与冠心病的存在只有微弱的相关性(OR：CA1.17，P 0.001；P1.05，P 0.173；CPP1.01，P 0.034)。这种差异是因为CAD包括钙化斑块或混合斑块和非钙化斑块(NCP)。钙化斑块或混合斑块与钙化、磷化、CPP显著相关(OR：CA1.20，P 0.001；P1.13，P 0.003；CPP1.02，P 0.001)，而与NCPP无关。目前还不清楚两者之间是否存在因果关系。这种关系被认为有助于血管钙化，但与NCP的关系不那么密切。
High calcium (Ca), phosphate (P), and CaP product (CPP) are associated with cardiovascular disease in patients with chronic kidney disease. Whether this relationship persists in individuals with normal kidney function is not yet elucidated. We explored the relationship of serum Ca, P, and CPP to coronary atherosclerosis assessed by cardiac computed tomography angiography (cCTA) in participants with normal kidney function.This study included 7553 participants (52 10 years, male 57) with near-normal kidney function (estimated glomerular filtration rate 60 mL/min/1.73 m(2)) who underwent cCTA. The relationship of Ca, P, and CPP to coronary atherosclerosis [coronary artery Ca score (CACS) 100 and the presence of coronary artery disease (CAD)] was evaluated. Higher Ca, P, and CPP were significantly associated with CACS 100 continuously [adjusted odds ratio (OR) per mg/dL: Ca 1.21, P 0.026; P 1.29, P 0.001; CPP 1.03, P 0.001]. However, they correlate only weakly with the presence of CAD (OR: Ca 1.17, P 0.001; P 1.05, P 0.173; CPP 1.01, P 0.034). This discrepancy was because calcified or mixed plaque and non-calcified plaque (NCP) were included in CAD. A significant relationship was demonstrated between calcified or mixed plaque and Ca, P, and CPP (OR: Ca 1.20, P 0.001; P 1.13, P 0.003; CPP 1.02, P 0.001), but not NCP.Elevated serum levels of Ca, P, and CPP are significantly associated with the presence of calcified coronary atherosclerotic plaque. It is unclear if there is a causal relationship. This relationship is thought to contribute to vascular calcification, but is less closely associated with NCP.