Division of Public Health Sciences, Wake Forest University Health Sciences, Winston-Salem, NC 27157, USA.
Ann Epidemiol. 2011 Jan;21(1):34-41. doi: 10.1016/j.annepidem.2010.10.007.
To examine whether the relationship between cardiovascular disease risk factors and coronary artery calcification (CAC) is modified by race among those with diabetes.
Data were pooled data from three studies (Multi-Ethnic Study of Atherosclerosis, Family Heart Study, Diabetes Heart Study) for a total of 835 blacks and 1122 whites with diabetes. CAC was quantified by cardiac computed tomography and risk factors were obtained using standard methods. Regression models examined the relationship between risk factors and presence and quantity of CAC.
The average age of the cohort was 60 years; 57% were women. Presence of CAC was lower in blacks compared to whites (odds ratio = 0.22 for men, 0.57 for women, p <0.01). Hemoglobin A1c, duration of diabetes, low-density lipoprotein, smoking, and body mass index were independently associated with presence of CAC; high-density lipoprotein, triglycerides, and C-reactive protein were not. Race did not modify these associations. Adjustment for multiple risk factors did not explain the race disparity in CAC.
CAC was reduced in blacks compared to whites in persons with diabetes. This effect was most pronounced in men. The relationship between risk factors and CAC did not differ between races. Racial differences in CAC are likely due to unmeasured risk factors and/or genetic susceptibility.
研究在患有糖尿病的人群中，心血管疾病危险因素与冠状动脉钙化（CAC）之间的关系是否因种族而异。
本研究的数据来自三项研究（动脉粥样硬化多民族研究、家庭心脏研究、糖尿病心脏研究），共纳入 835 名黑人患者和 1122 名白人患者。采用心脏计算机断层扫描定量 CAC，采用标准方法获取危险因素。回归模型检验了危险因素与 CAC 存在和数量之间的关系。
队列的平均年龄为 60 岁；57%为女性。与白人相比，黑人的 CAC 发生率较低（男性的比值比=0.22，女性的比值比=0.57，p<0.01）。糖化血红蛋白、糖尿病病程、低密度脂蛋白、吸烟和体重指数与 CAC 的存在独立相关；高密度脂蛋白、甘油三酯和 C 反应蛋白则不然。种族并未改变这些关联。调整多种危险因素并不能解释 CAC 种族差异。
与白人相比，糖尿病患者中的黑人 CAC 减少。这种影响在男性中更为明显。危险因素与 CAC 之间的关系在不同种族之间没有差异。CAC 的种族差异可能归因于未测量的危险因素和/或遗传易感性。
