腹主动脉钙与多部位动脉粥样硬化：动脉粥样硬化多民族研究。
Abdominal aortic calcium and multi-site atherosclerosis: the Multiethnic Study of Atherosclerosis.
机构信息
Department of Medicine, University of CA, Irvine, CA 92697-4101, United States.
出版信息
Atherosclerosis. 2011 Feb;214(2):436-41. doi: 10.1016/j.atherosclerosis.2010.09.011. Epub 2010 Sep 18.
BACKGROUND
Abdominal aortic calcification (AAC) is a measure of subclinical cardiovascular disease (CVD). Data are limited regarding its relation to other measures of atherosclerosis.
METHODS
Among 1812 subjects (49% female, 21% black, 14% Chinese, and 25% Hispanic) within the population-based Multiethnic Study of Atherosclerosis, we examined the cross-sectional relation of AAC with coronary artery calcium (CAC), ankle brachial index (ABI), and carotid intimal medial thickness (CIMT), as well as multiple measures of subclinical CVD.
RESULTS
AAC prevalence ranged from 34% in those aged 45-54 to 94% in those aged 75-84 (p < 0.0001), was highest in Caucasians (79%) and lowest in blacks (62%) (p < 0.0001). CAC prevalence, mean maximum CIMT ≥ 1mm, and ABI < 0.9 was greater in those with vs. without AAC: CAC 60% vs. 16%, CIMT 38% vs. 7%, and ABI 5% vs. 1% for women and CAC 80% vs. 37%, CIMT 43% vs. 16%, and ABI 4% vs. 2% for men (p < 0.01 for all except p < 0.05 for ABI in men). The substantially greater prevalence for CAC in men compared to women all ages is not seen for AAC. By age 65, 97% of men and 91% of women have AAC, CAC, increased CIMT, and/or low ABI. The presence of multi-site atherosclerosis (≥ 3 of the above) ranged from 20% in women to 30% in men (p < 0.001), was highest in Caucasians (28%) and lowest in Chinese (16%) and ranged from 5% in those aged 45-54 to 53% in those aged 75-84 (p < 0.01 to p < 0.001). Finally, increased AAC was associated with 2-3-old relative risks for the presence of increased CIMT, low ABI, or CAC.
CONCLUSIONS
AAC is associated with an increased likelihood of other vascular atherosclerosis. Its additive prognostic value to these other measures is of further interest.
背景
腹主动脉钙化（AAC）是亚临床心血管疾病（CVD）的一种衡量标准。关于其与动脉粥样硬化其他指标的关系，数据有限。
方法
在人群为基础的动脉粥样硬化多民族研究中，共有 1812 名受试者（49%为女性，21%为黑人，14%为中国人，25%为西班牙裔），我们检测了 AAC 与冠状动脉钙（CAC）、踝臂指数（ABI）和颈动脉内膜中层厚度（CIMT）的横断面关系，以及亚临床 CVD 的多个指标。
结果
AAC 的患病率范围从 45-54 岁的 34%到 75-84 岁的 94%（p<0.0001），白种人患病率最高（79%），黑人最低（62%）（p<0.0001）。有 AAC 的患者比没有 AAC 的患者 CAC 患病率更高（60% vs. 16%），最大 CIMT 均值≥1mm，ABI<0.9 的情况也更多见（38% vs. 7%；5% vs. 1%）；女性患者 CIMT 患病率更高（43% vs. 16%），ABI<0.9 的情况也更多见（4% vs. 2%）；男性患者 CAC 患病率更高（80% vs. 37%），ABI<0.9 的情况也更多见（4% vs. 2%）（p<0.01，除了男性 ABI 的 p<0.05）。与女性相比，男性在各个年龄段的 CAC 患病率都要高得多，但这种情况在 AAC 中并不明显。到 65 岁时，97%的男性和 91%的女性都患有 AAC、CAC、增加的 CIMT 和/或低 ABI。多部位动脉粥样硬化（≥3 种）的患病率在女性中为 20%，在男性中为 30%（p<0.001），白种人最高（28%），中国人最低（16%），在 45-54 岁的人群中为 5%，在 75-84 岁的人群中为 53%（p<0.01 至 p<0.001）。最后，AAC 增加与 CIMT 增加、ABI 降低或 CAC 存在的相对风险增加 2-3 倍有关。
结论
AAC 与其他血管动脉粥样硬化的发生几率增加有关。它对这些其他指标的附加预后价值值得进一步研究。
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