Bauer Marcus, Möhlenkamp Stefan, Lehmann Nils, Schmermund Axel, Roggenbuck Ulla, Moebus Susanne, Stang Andreas, Mann Klaus, Jöckel Karl-Heinz, Erbel Raimund
Clinic of Cardiology, West-German Heart Center, University Duisburg-Essen, Germany.
Atherosclerosis. 2009 Aug;205(2):595-602. doi: 10.1016/j.atherosclerosis.2009.01.005. Epub 2009 Jan 15.
Increased arterial intima-media thickness (IMT) and coronary artery calcification (CAC) are measures of subclinical arteriosclerosis burden. Little is known, however, whether risk factors have an impact differently on atherosclerosis in these distinct vascular territories in the same individuals.
For 1620 men without coronary artery disease (CAD) and stroke, aged 45-75 years (59+/-8), IMT was measured 1cm proximal to the bulb in the common carotid artery (CCA). Both sides were measured and the average of the right and left artery were applied. Electron-beam CT was used to quantify coronary artery calcium (CAC). Cardiovascular risk factors were measured with standard techniques.
IMT increased with age from 0.64+/-0.12mm in the lowest decade (45-54 years) up to 0.76+/-0.14mm in the highest decade (65-74 years) (p<0.0001). CAC and IMT showed a significant correlation across the cohort. Individual variation in the extent of IMT and CAC was, however, high (r=0.26, p<0.0001). Standard risk factors had a similar impact on IMT and CAC relative to 5 years of ageing, except for diabetes and HDL, which had a higher impact on IMT than on CAC. The effect of diabetes mellitus on IMT exceeded the effect of 5 years of ageing.
IMT may be more sensitive to the atherosclerotic impact of diabetes than CAC, while blood pressure showed a higher effect on CAC. Thus, cardiovascular risk factors seem to have a different atherosclerotic impact on carotid arteries compared with coronary arteries.
动脉内膜中层厚度（IMT）增加和冠状动脉钙化（CAC）是亚临床动脉硬化负担的指标。然而，对于同一人群中这些不同血管区域的动脉粥样硬化，危险因素的影响是否不同，人们知之甚少。
对1620名年龄在45 - 75岁（平均59±8岁）且无冠心病（CAD）和中风的男性，在颈总动脉（CCA）球部近端1cm处测量IMT。两侧均进行测量，并采用左右动脉的平均值。使用电子束CT定量冠状动脉钙化（CAC）。采用标准技术测量心血管危险因素。
IMT随年龄增长而增加，从最低年龄段（45 - 54岁）的0.64±0.12mm增至最高年龄段（65 - 74岁）的0.76±0.14mm（p<0.0001）。整个队列中，CAC和IMT呈显著相关。然而，IMT和CAC程度的个体差异很大（r = 0.26，p<0.0001）。相对于5年的年龄增长，标准危险因素对IMT和CAC的影响相似，但糖尿病和高密度脂蛋白（HDL）对IMT的影响高于对CAC的影响。糖尿病对IMT的影响超过了5年年龄增长的影响。
与CAC相比，IMT可能对糖尿病的动脉粥样硬化影响更敏感，而血压对CAC的影响更大。因此，与冠状动脉相比，心血管危险因素对颈动脉的动脉粥样硬化影响似乎有所不同。
