Division of General Oral Care, Kyushu University Hospital, 3-1-1 Maidashi Higashi-ku, Fukuoka, Japan.
Sleep Breath. 2013 Sep;17(3):1003-8. doi: 10.1007/s11325-012-0790-3. Epub 2012 Dec 4.
The morbidity rate of arteriosclerosis becomes clinically manifested as acute cardiovascular events. In the progress of atherosclerosis, the carotid artery calcifies and sometimes appears as a calcified mass on a cephalometric radiograph. This study was designed to evaluate cardiovascular risks according to the Framingham Risk Score (FRS) between subjects with and without visible carotid artery calcification on a cephalogram.
Subjects diagnosed with obstructive sleep apnea (OSA) were divided into two groups according to whether or not calcification was visible on a cephalometric radiograph in the carotid artery area, and the characteristic differences between the two groups were analyzed. The evaluated variables included age, BMI, apnea-hypopnea index (AHI), SpO2, ESS, blood pressure, medication history, diabetes mellitus (DM), drinking, smoking, and lipid-related measurements. FRSs for stroke, general cardiovascular disease (GCD), and coronary heart disease (CHD) were calculated. Statistical analyses were performed (SPSS 18.0) with significance defined as a two-tailed p value less than 0.05.
A total of 811 subjects completed the data collection (727 males, age 53.0 ± 12.5 years, AHI 31.7 ± 22.6, times/h). From FRSs, probabilities of a GCD, stroke, and CHD within 10 years were 16.0 ± 9.7, 9.8 ± 6.7, and 11.9 ± 8.3 %, respectively. Some 84 subjects exhibited calcification in the carotid arterial area. Calcification subjects were higher GCD risk and older than subjects who had no identified calcification (20.3 ± 10.1 vs 15.6 ± 20.3 %, p = 0.013, 58.8 ± 11.4 vs. 52.3 ± 12.5 years, p < 0.001). Although there is no significant difference in OSA-related variables and FRSs, subjects with visible calcifications have higher prevalence of high blood pressure medication and DM (p < 0.01).
While the presence of a calcified mass on a cephalometric radiograph is not diagnostic of atherosclerosis, this information indicates some cardiovascular risk.
动脉硬化的发病率在临床上表现为急性心血管事件。在动脉粥样硬化的进展过程中，颈动脉发生钙化，有时在头影测量片中表现为钙化团块。本研究旨在根据 Framingham 风险评分（FRS）评估头影片中可见和不可见颈动脉钙化的患者的心血管风险。
根据头影片中颈动脉区域是否可见钙化，将诊断为阻塞性睡眠呼吸暂停（OSA）的患者分为两组，并分析两组之间的特征差异。评估的变量包括年龄、BMI、呼吸暂停低通气指数（AHI）、SpO2、ESS、血压、用药史、糖尿病（DM）、饮酒、吸烟和血脂相关测量值。计算中风、一般心血管疾病（GCD）和冠心病（CHD）的 FRS。采用统计学分析（SPSS 18.0），双侧 p 值<0.05 为差异有统计学意义。
共有 811 名患者完成了数据收集（727 名男性，年龄 53.0±12.5 岁，AHI 31.7±22.6 次/小时）。从 FRS 来看，10 年内 GCD、中风和 CHD 的概率分别为 16.0±9.7%、9.8±6.7%和 11.9±8.3%。84 名患者的颈动脉区域出现钙化。钙化患者的 GCD 风险较高，且年龄大于无钙化患者（20.3±10.1%比 15.6±20.3%，p=0.013；58.8±11.4 岁比 52.3±12.5 岁，p<0.001）。虽然 OSA 相关变量和 FRS 无显著差异，但有钙化的患者高血压药物治疗和 DM 的患病率更高（p<0.01）。
虽然头影片中钙化团块的存在不能诊断为动脉粥样硬化，但这一信息表明存在一定的心血管风险。
