Iribarren Carlos, Sanchez Gabriela, Lu Meng, Bidgoli Fatemeh Azamian, Cho Hyo-Min, Ding Huanjun, Molloi Sabee
Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA 94612, USA.
Department of Radiological Sciences, University of California Irvine School of Medicine, Irvine, CA 92697, USA.
Eur J Cardiovasc Med. 2018 Nov;5(5):544-551. Epub 2018 Nov 16.
To examine the association of breast arterial calcification (BAC) with the ankle brachial index (ABI), a sensitive metric of peripheral arterial disease (PAD), among postmenopausal women. Background: BAC is an emerging risk marker of cardiovascular disease (CVD).
MINERVA (MultIethNic study of brEast aRterial calcium gradation and cardioVAscular disease) is a cohort of women aged 60 to 79 at baseline (10/24/2012 - 2/13/2015) who were free of symptomatic CVD at baseline. The analytical sample comprised 3,800 women with available ABI, BAC assessment and covariates. We performed cross-sectional logistic regression analysis.
203 women (5.3%) had an ABI < 0.90 indicative of PAD, 26 (0.7%) had an ABI > 1.3 and 94% (n=3,571) had an ABI within normal limits. After adjustment for age, race/ethnicity, body mass index, smoking status, diabetes, hypertension, LDL-C, HDL-C, hs-CRP, estimated-GFR, urinary albumin/creatinine ratio, serum calcium, serum vitamin D and serum PTH, BAC presence remained significantly associated with ABI < 0.90 (OR=1.37; 95% CI, 1.01-1.87; p=0.04). After further adjustment for menopausal hormone therapy, parity and history of breast feeding, the association became marginally significant (OR=1.36; 95% CI, 0.99-1.85; p=0.05). No clear pattern of association was observed for increased gradation of BAC and ABI<0.9, and no significant associations were noted between BAC presence vs. absence or BAC gradation with ABI > 1.3.
Among asymptomatic postmenopausal women, presence of BAC was associated with PAD independently of traditional risk factors. Additional prospective studies are required to establish the value of BAC for prediction of incident PAD in the general population.
研究绝经后女性乳腺动脉钙化（BAC）与踝臂指数（ABI）（一种外周动脉疾病（PAD）的敏感指标）之间的关联。背景：BAC是心血管疾病（CVD）一种新出现的风险标志物。
MINERVA（乳腺动脉钙分级与心血管疾病多民族研究）是一个队列研究，研究对象为基线时（2012年10月24日至2015年2月13日）年龄在60至79岁、基线时无CVD症状的女性。分析样本包括3800名有可用ABI、BAC评估及协变量的女性。我们进行了横断面逻辑回归分析。
203名女性（5.3%）ABI<0.90，提示存在PAD；26名（0.7%）ABI>1.3；94%（n=3571）的ABI在正常范围内。在调整年龄、种族/民族、体重指数、吸烟状况、糖尿病、高血压、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、高敏C反应蛋白、估算肾小球滤过率、尿白蛋白/肌酐比值、血清钙、血清维生素D和血清甲状旁腺激素后，BAC的存在仍与ABI<0.90显著相关（比值比=1.37；95%置信区间，1.01 - 1.87；p=0.04）。在进一步调整绝经后激素治疗、产次和母乳喂养史后，该关联变得接近显著（比值比=1.36；95%置信区间，0.99 - 1.85；p=0.05）。未观察到BAC分级增加与ABI<0.9之间有明确的关联模式，且在BAC存在与否或BAC分级与ABI>1.3之间未发现显著关联。
在无症状绝经后女性中，BAC的存在与PAD相关，且独立于传统风险因素。需要更多前瞻性研究来确定BAC在一般人群中预测新发PAD的价值。
