Department of Cardiology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States.
Department of Radiology and Radiological Science, School of Medicine, Johns Hopkins University, Baltimore, MD, United States.
Front Endocrinol (Lausanne). 2021 Dec 13;12:785957. doi: 10.3389/fendo.2021.785957. eCollection 2021.
Anecdotal reports have suggested increased soft tissue calcification in individuals with long-term exposures to high blood glucose. The association of costal cartilage calcification (CCC), a reliably quantifiable marker obtainable from non-contrast cardiac computed tomography (CT) with cumulative fasting blood glucose (FBG) exposure, is unknown. In this study, we aimed to determine the association between quantified CCC and cumulative glucose exposure using non-contrast coronary artery calcium (CAC) scoring computed tomography (CT) images in the Multi-Ethnic Study of Atherosclerosis (MESA).
The volume of bilateral CCC was quantified in high-density pixels (threshold of Hounsfield Unit>180) using the CAC scoring CT images acquired in the 5 MESA exam. Prior long-term cumulative exposure to FBG was calculated by area under the FBG-time curve over ten years before the time of the CT exam.
A total of 2,305 participants (mean age: 69, female/male: 1.3) were included in this study. The median CCC volume was lower in females than males (1158 mm [IQR: 1751] vs. 3054 mm [3851], p<0.001). In cross-sectional analysis, quantified CCC was associated with FBG (9% increase per SD) and HbA1c (7% increase per SD) at the CT exam only in female participants after adjustment for age, race, BMI, and glomerular filtration rate. Only in female participants, quantified CCC was also associated with prior cumulative FBG (3% increase per decile change). In the subgroup of females with zero CAC scores, the adjusted CCC was still associated with FBG (13% increase per SD) at the time of CT exam and with prior cumulative FBG exposure (4% increase per decile change) before the CT exam.
The CCC, a reliably quantified marker in non-contrast cardiac CT, is associated with 10-year cumulative FBG exposure only in female participants, even those with zero CAC.
有传闻报道称，长期暴露于高血糖环境会导致软组织钙化。肋软骨钙化（CCC）是一种可靠的定量标志物，可以通过非增强型心脏 CT 检测到，而其与累积空腹血糖（FBG）暴露之间的关系尚不清楚。本研究旨在通过多民族动脉粥样硬化研究（MESA）中的非增强型冠状动脉钙（CAC）评分 CT 图像，确定定量 CCC 与累积葡萄糖暴露之间的相关性。
在 MESA 的 5 次检查中，使用 CAC 评分 CT 图像，通过高分辨率像素（体素 CT 值>180）来定量双侧 CCC 体积。在 CT 检查前 10 年内，通过 FBG 时间曲线下面积来计算先前的长期累积 FBG 暴露量。
本研究共纳入 2305 名参与者（平均年龄：69 岁，女性/男性：1.3）。女性的 CCC 体积中位数低于男性（1158mm [IQR：1751] 比 3054mm [3851]，p<0.001）。在横断面分析中，在调整年龄、种族、BMI 和肾小球滤过率后，仅在女性参与者中，定量 CCC 与 CT 检查时的 FBG（每标准差增加 9%）和 HbA1c（每标准差增加 7%）相关。仅在女性参与者中，定量 CCC 也与先前的累积 FBG 相关（每十位数变化增加 3%）。在女性 CAC 评分均为零的亚组中，校正后的 CCC 仍与 CT 检查时的 FBG（每标准差增加 13%）和 CT 检查前的累积 FBG 暴露相关（每十位数变化增加 4%）。
在非增强型心脏 CT 中，CCC 是一种可靠的定量标志物，仅在女性参与者中，即使是 CAC 评分均为零的女性，与 10 年累积 FBG 暴露相关。
