Schousboe John T, Claflin Diane, Barrett-Connor Elizabeth
Park Nicollet Health Services, Minneapolis, Minnesota, USA.
Am J Cardiol. 2009 Aug 1;104(3):299-304. doi: 10.1016/j.amjcard.2009.03.041. Epub 2009 Jun 6.
The association of abdominal aortic calcium (AAC) on lateral spine bone densitometry with coronary artery calcium (CAC) has not been reported. We studied 33 men and 73 women who had CAC scored with electron beam computed tomography at the eighth visit of the Rancho Bernardo study and lateral spine dual-energy x-ray absorptiometry images fully evaluable for AAC at the ninth study visit. The association between CAC level and AAC tertile was assessed by ordinal logistic regression analysis. The odds ratio of having a greater CAC score for those with an AAC score in the top tertile (24-point scale score > or =5) was 6.42 (95% confidence interval 2.28 to 18.1) and using the 8-point scale (score > or =3) was 3.38 (95% confidence interval 1.26 to 9.07) compared with those with AAC scores in the bottom tertiles, adjusted for age, gender, systolic blood pressure, total and high-density lipoprotein cholesterol, smoking status, and diabetes. A 24-point AAC score of > or =5 had a sensitivity of 65% and specificity of 70% to detect a high CAC score (> or =400 points). An 8-point AAC score of > or =3 had a sensitivity of 45% and specificity of 78%. In conclusion, a high level of AAC on lateral spine dual-energy x-ray absorptiometry was strongly associated with coronary artery disease and might be commonly encountered because bone densitometry is indicated for all women aged > or =65 years and all men aged > or =70 years. Its presence should be reported to the patient's physician to identify and manage modifiable risk factors.
尚未有关于腰椎侧位骨密度测量中的腹主动脉钙化（AAC）与冠状动脉钙化（CAC）之间关联的报道。我们研究了33名男性和73名女性，这些人在兰乔贝纳多研究的第八次访视时接受了电子束计算机断层扫描以评估CAC，并在第九次研究访视时获得了可对AAC进行全面评估的腰椎侧位双能X线吸收测定图像。通过有序逻辑回归分析评估CAC水平与AAC三分位数之间的关联。与AAC得分处于最低三分位数的人相比，在最高三分位数（24分制得分≥5）的AAC得分者中，CAC得分更高的优势比为6.42（95%置信区间2.28至18.1）；使用8分制（得分≥3）时，优势比为3.38（95%置信区间1.26至9.07），对年龄、性别、收缩压、总胆固醇和高密度脂蛋白胆固醇、吸烟状况及糖尿病进行了校正。24分制的AAC得分≥5时，检测高CAC得分（≥400分）的敏感性为65%，特异性为70%。8分制的AAC得分≥3时，敏感性为45%，特异性为78%。总之，腰椎侧位双能X线吸收测定中高水平的AAC与冠状动脉疾病密切相关，并且可能很常见，因为骨密度测量适用于所有年龄≥65岁的女性和所有年龄≥70岁的男性。应将其情况告知患者的医生，以识别和管理可改变的风险因素。
