Division of Cardiology, University of California, Irvine, Irvine, CA, USA.
Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Diab Vasc Dis Res. 2023 Sep-Oct;20(5):14791641231204368. doi: 10.1177/14791641231204368.
South Asian (SA) persons have increased risks for diabetes mellitus (DM) and atherosclerotic cardiovascular disease (ASCVD). We examined whether the association of DM with subclinical atherosclerosis assessed by coronary artery calcium (CAC) differs in SA versus other ethnic groups.
We studied adults from the Multi-Ethnic Study of Atherosclerosis and the Mediators of Atherosclerosis in South Asians Living in America studies without ASCVD. CAC was examined among those normoglycemic, pre-DM and DM. Logistic regression examined pre-DM and DM with the odds of any CAC > 0 and CAC 100.
Among 7562 participants, CAC > 0 and CAC 100 in those with DM was highest in non-Hispanic White (NHW) (80% and 48%) and SA (72% and 41%) persons. Adjusted Ln (CAC + 1) was highest in NHW (3.68 ± 0.21) and SA (3.60 ± 0.23) ( < .01) DM patients. SA and NHW adults with DM (vs normoglycemic) had highest odds of CAC > 0 (2.13 and 2.27, respectively, < .01). For CAC 100, SA and Chinese adults had the highest odds (2.28 and 2.27, respectively, < .01). Fasting glucose and glycated hemoglobin were most strongly associated with CAC among SA.
Diabetes mellitus most strongly relates to any CAC in SA and NHW adults and CAC 100 in SA and Chinese adults, helping to explain the relation of DM with ASCVD in these populations.
南亚（SA）人群患糖尿病（DM）和动脉粥样硬化性心血管疾病（ASCVD）的风险增加。我们研究了 SA 人群与其他族裔人群相比，DM 与通过冠状动脉钙（CAC）评估的亚临床动脉粥样硬化的相关性是否不同。
我们研究了无 ASCVD 的动脉粥样硬化多民族研究（MESA）和生活在美国的南亚人中动脉粥样硬化的介质（MESA-SoA）研究中的成年人。在血糖正常、前驱糖尿病和糖尿病患者中检查 CAC。逻辑回归检查了前驱糖尿病和糖尿病患者 CAC > 0 和 CAC 100 的几率。
在 7562 名参与者中，DM 患者中 CAC > 0 和 CAC 100 在非西班牙裔白人（NHW）（80%和 48%）和 SA（72%和 41%）人群中最高。调整后的 Ln（CAC + 1）在 NHW（3.68 ± 0.21）和 SA（3.60 ± 0.23）（ <.01）DM 患者中最高。与血糖正常者相比，SA 和 NHW 患有 DM（与血糖正常者相比）的患者 CAC > 0 的几率最高（分别为 2.13 和 2.27，均<.01）。对于 CAC 100，SA 和中国成年人的几率最高（分别为 2.28 和 2.27，均<.01）。空腹血糖和糖化血红蛋白与 SA 人群的 CAC 相关性最强。
DM 与 SA 和 NHW 成年人的任何 CAC 以及 SA 和中国成年人的 CAC 100 相关性最强，有助于解释 DM 与这些人群 ASCVD 的关系。
