Progression of coronary artery calcium in type 1 diabetes mellitus
Progression of coronary artery calcium in type 1 diabetes mellitus
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DOI：
10.1016/j.amjcard.2007.06.050
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发表时间：
2007-11-15
影响因子：
2.8
通讯作者：
Orchard, Trevor J.
中科院分区：
文献类型：
--
作者：
Costacou, Tina;Edmundowicz, Daniel;Orchard, Trevor J.
冠状动脉钙化（CAC）以前与动脉粥样硬化斑块疾病和冠状动脉事件有关。因此，确定CAC进展的预测因子可能为早期风险因素干预和随后降低更严重动脉粥样硬化疾病的发生率提供新的见解。本研究的目的是在1型糖尿病（DM）患者队列中确定CAC进展的危险因素，并评估危险因素的变化是否与CAC进展相关。匹兹堡EDC研究的参与者，一项对儿童期发病的1型DM的前瞻性研究，他们接受了2次电子束断层扫描筛查，间隔4年，被选为研究对象（n = 222）。使用Agatston评分方法计算CAC，进展定义为平方根转换的CAC评分增加> 2.5。调整DM持续时间和初始CAC评分、体重指数（BMI;优势比[OR] 1.13，95%可信区间[CI] 1.01 - 1.26）、非高密度脂蛋白胆固醇（OR 1.01，95%CI 1.003 - 1.03）和白蛋白排泄率（OR 1.30，95%CI 1.03 - 1.63）与CAC进展相关。当考虑到风险因素的变化时，BMI的增加（OR 1.38，95% CI 1.10至1.72）也与调整后的CAC进展相关。总之，在这个1型DM队列中，除了基线BMI、非高密度脂蛋白胆固醇、白蛋白排泄率和所有已知的冠状动脉疾病危险因素外，体重增加进一步增加了CAC进展的预测。因此，除了血脂和肾脏管理外，体重控制可能有助于延缓1型糖尿病患者的动脉粥样硬化进展。(c)2007年爱思唯尔公司All rights reserved.
Coronary artery calcium (CAC) has been previously associated with atherosclerotic plaque disease and coronary events. Thus, identifying predictors of CAC progression may provide new insights for early risk-factor intervention and subsequent reduction of the rates of more severe atherosclerotic disease. The aim of this study was to identify risk factors for CAC progression and evaluate whether risk-factor change was related to CAC progression in a cohort of patients with type 1 diabetes mellitus (DM). Participants in the Pittsburgh EDC Study, a prospective investigation of childhood-onset type 1 DM, who underwent 2 electron beam tomographic screenings 4 years apart were selected for study (n = 222). CAC was calculated using the Agatston method of scoring, and progression was defined as an increase > 2.5 in the square root-transformed CAC score. Adjusting for DM duration and initial CAC score, body mass index (BMI; odds ratio [OR] 1.13, 95% confidence interval [CI] 1.01 to 1.26), non-high-density lipoprotein cholesterol (OR 1.01, 95% CI 1.003 to 1.03), and albumin excretion rate (OR 1.30,95% CI 1.03 to 1.63) were associated with CAC progression. When considering change in risk factors, an increase in BMI (OR 1.38, 95% CI 1.10 to 1.72) was also associated with CAC progression After adjustment. In conclusion, in this cohort with type 1 DM, in addition to baseline BMI, non-high-density lipoprotein cholesterol, albumin excretion rate, and all known coronary artery disease risk factors, weight gain further added to the prediction of CAC progression. Thus, weight control, in addition to lipid and renal management, may help retard atherosclerosis progression in persons with type 1 DM. (c) 2007 Elsevier Inc. All rights reserved.