Superior mesenteric artery calcification is associated with cardiovascular risk factors, systemic calcified atherosclerosis, and increased mortality.
Superior mesenteric artery calcification is associated with cardiovascular risk factors, systemic calcified atherosclerosis, and increased mortality.
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DOI：
10.1016/j.jvs.2017.08.081
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发表时间：
2018-05
影响因子：
4.3
通讯作者：
Allison MA
中科院分区：
文献类型：
--
作者：
Lin TC;Wright CM;Criqui MH;Allison MA
动脉粥样硬化是发病率和死亡率的主要危险因素。然而，关于上级肠系膜动脉钙化（SMAC）的危险因素、SMAC与其他动脉床疾病之间的相关性或SMAC对死亡风险的独立贡献的流行病学数据很少。检验以下假设：SMAC的存在和程度与心血管疾病（CVD）风险因素、其他动脉床钙化以及心血管和全因死亡率相关，独立于经典风险因素和其他动脉床钙化。在无已知CVD的成人中，通过计算机断层扫描评价SMA、腹腔干、冠状动脉、胸主动脉、腹主动脉和髂动脉中的动脉钙化。多元逻辑回归模型研究了SMAC的危险因素相关性，以及SMAC作为其他动脉床钙化的危险因素。考克斯模型用于检查SMAC和死亡率之间的关联。受试者的平均年龄为56岁; 43.7%（1877/4300）为女性，6.7%（290）患有SMAC。年龄（OR：1.09，95%CI：1.06-1.11）、男性（1.79，1.08-3.03）、血脂异常（1.38，1.01-1.88）和吸烟（1.60，1.20-2.14）与SMAC的存在相关。值得注意的是，无论是体重指数、体脂百分比、高血压、糖尿病还是冠心病家族史，都不是SMAC存在的显著危险因素。SMAC的存在与所有其他5个动脉床的钙化相关（6.02，3.76-9.66）。在9.4年的中位随访时间内，有234例死亡，其中76例与CVD相关。SMAC程度，表示为log[SMAC评分+1]（1.31，1.01-1.71）的每单位增加，在完全校正其他动脉床的风险因素和钙化后，与CVD死亡率显著相关。SMAC的存在（1.52，1.10-2.12）和程度（1.25，1.06-1.48）也与完全校正后的全因死亡率显著相关。SMAC与特定的CVD风险因素以及所有其他动脉床的钙化相关。SMAC程度与心血管事件死亡率显著相关，而SMAC的存在和程度与全因死亡率显著相关，即使在调整其他动脉床的风险因素和钙化后。需要进一步的研究来确定SMAC是否只是晚期和全身性疾病的标志物，或者它是否通过独立的机制增加死亡风险。
Atherosclerosis is a major risk factor for morbidity and mortality. However, there is sparse epidemiologic data regarding risk factors for superior mesenteric artery calcification (SMAC), the association between SMAC and disease in other arterial beds, or the independent contribution of SMAC to risk of mortality. To test the hypothesis that presence and extent of SMAC are associated with cardiovascular disease (CVD) risk factors, calcification in other arterial beds, and both cardiovascular and all-cause mortality, independent of classic risk factors and calcification in other arterial beds. Arterial calcification in the SMA, celiac trunk, coronaries, thoracic aorta, abdominal aorta and iliac arteries was evaluated by computed tomography in adults with no known CVD. Multiple logistic regression models examined risk factor associations for SMAC, and SMAC as a risk factor for calcification in other arterial beds. Cox models were used to examine the association between SMAC and mortality. The average age of subjects was 56 years; 43.7% (1877 of 4300) were women, and 6.7% (290) had SMAC. Age (OR: 1.09, 95%CI: 1.06–1.11), male sex (1.79, 1.08–3.03), dyslipidemia (1.38, 1.01–1.88) and any smoking (1.60, 1.20–2.14) were associated with SMAC presence. Notably, neither body mass index, body fat percentage, hypertension, diabetes nor family history of coronary heart disease were significant risk factors for the presence of SMAC.SMAC presence was associated with calcification in all five other arterial beds (6.02, 3.76–9.66). Over a median follow-up time of 9.4 years, there were 234 deaths, 76 of which were CVD-related. SMAC extent, represented as per-unit increase in log[SMAC score+1] (1.31, 1.01–1.71), was significantly associated with CVD mortality after full adjustment for risk factors and calcification in other arterial beds. SMAC presence (1.52, 1.10–2.12) and extent (1.25, 1.06–1.48) were also both significantly associated with all-cause mortality after full adjustment. SMAC is associated with specific CVD risk factors as well as calcification in all other arterial beds. SMAC extent was significantly associated with incident cardiovascular mortality, while both SMAC presence and extent were significantly associated with all-cause mortality, even after adjustment for risk factors and calcification in other arterial beds. Further studies are needed to determine if SMAC is simply a marker for advanced and systemic disease, or if it confers increased mortality risk through an independent mechanism.
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影响因子：
2.7
作者：
Odink, A. E.;van der Lugt, A.;Witteman, J. C. M.
通讯作者：
Witteman, J. C. M.
DOI：
10.1016/0735-1097(90)90282-t
发表时间：
1990-03-15
影响因子：
24
作者：
AGATSTON, AS;JANOWITZ, WR;DETRANO, R
通讯作者：
DETRANO, R
影响因子：
5
作者：
ROOBOTTOM, CA;DUBBINS, PA
通讯作者：
DUBBINS, PA
影响因子：
37.8
作者：
Fernandez-Friera, Leticia;Penalvo, Jose L.;Fuster, Valentin
通讯作者：
Fuster, Valentin
DOI：
10.1016/j.bpg.2004.11.002
发表时间：
2005-04-01
影响因子：
3.2
作者：
Sreenarasimhaiah, J
通讯作者：
Sreenarasimhaiah, J