Deas Dale S, Marshall Andre P, Bian Aihua, Shintani Ayumi, Guzman Raul J
University of Alabama School of Medicine, Birmingham, AL, USA.
Division of Vascular Surgery, Vanderbilt Medical Center, Nashville, TN, USA.
Vasc Med. 2015 Aug;20(4):326-31. doi: 10.1177/1358863X15581448. Epub 2015 Apr 23.
The cardiovascular risk factors that contribute to coronary calcification have been extensively studied while those related to tibial artery calcium are less well defined. We sought to determine the associations between cardiovascular risk factors and tibial artery calcification in a cohort of patients with and without significant peripheral atherosclerosis. A total of 222 patients without end-stage renal disease were identified in a prospectively maintained database containing tibial artery calcification (TAC) scores, and demographic, cardiovascular, and biochemical risk factor information. Patients with prevalent tibial artery calcification were more likely to be older, male, and have a history positive for hypertension, hyperlipidemia, diabetes, and tobacco use. Patients with an abnormal ankle-brachial index (ABI) or symptoms of peripheral artery disease (PAD) were also more likely to have higher calcium values. In analyses using multivariable logistic regression, age, gender, diabetes, and tobacco use maintained their association with prevalent tibial calcification while hypertension, hyperlipidemia and body mass index did not. These associations remained when PAD was added to the model. After adjusting for relevant cardiovascular risk factors, we found that only abnormal ABI, current PAD symptoms, and lower serum calcium values were associated with the presence of tibial artery calcification. In conclusion, in patients without end-stage renal disease, tibial artery calcification has risk factors that are similar but not identical to those for coronary artery calcification and peripheral atherosclerosis.
导致冠状动脉钙化的心血管危险因素已得到广泛研究，而与胫动脉钙化相关的危险因素则不太明确。我们试图在一组有或没有明显外周动脉粥样硬化的患者中确定心血管危险因素与胫动脉钙化之间的关联。在一个前瞻性维护的数据库中，共识别出222例无终末期肾病的患者，该数据库包含胫动脉钙化（TAC）评分以及人口统计学、心血管和生化危险因素信息。患有胫动脉钙化的患者更有可能年龄较大、为男性，并有高血压、高脂血症、糖尿病和吸烟史阳性。踝臂指数（ABI）异常或有外周动脉疾病（PAD）症状的患者也更有可能有较高的钙值。在使用多变量逻辑回归的分析中，年龄、性别、糖尿病和吸烟与现患胫动脉钙化保持关联，而高血压、高脂血症和体重指数则不然。当将PAD添加到模型中时，这些关联仍然存在。在调整了相关心血管危险因素后，我们发现只有ABI异常、当前PAD症状和较低的血清钙值与胫动脉钙化的存在相关。总之，在无终末期肾病的患者中，胫动脉钙化的危险因素与冠状动脉钙化和外周动脉粥样硬化的危险因素相似但不完全相同。
