影像学检测到的动脉粥样硬化的患病率和特征的性别差异：一项基于人群的研究。

Sex differences in prevalence and characteristics of imaging-detected atherosclerosis: a population-based study.

机构信息

Department of Cardiology, Linköping University, SE-58185 Linköping, Sweden.

Department of Health, Medicine and Caring Sciences, Linköping University, SE-58183 Linköping, Sweden.

出版信息

Eur Heart J Cardiovasc Imaging. 2024 Nov 27;25(12):1663-1672. doi: 10.1093/ehjci/jeae217.

DOI:10.1093/ehjci/jeae217

PMID:39158095

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11601724/

Abstract

AIMS

Men are more likely to suffer a myocardial infarction than women, but population-based studies on sex differences in imaging-detected atherosclerosis are lacking. The aims were to assess sex differences in the prevalence of imaging-detected coronary and carotid atherosclerosis, as well as multivariable adjusted associations between sex and atherosclerosis.

METHODS AND RESULTS

Participants aged 50-65, recruited from the general population to the Swedish Cardiopulmonary bioImage Study (SCAPIS), were included in this population-based cross-sectional study. Comprehensive diagnostics, including coronary computed tomography angiography and carotid ultrasound, were performed. The image findings were any coronary atherosclerosis, coronary stenosis ≥ 50%, segment involvement score (SIS) ≥ 4, coronary artery calcium score (CACS) > 100, and any ultrasound-detected carotid plaque. In 25 580 participants (50% women), men had more hypertension (20.3% vs. 17.0%), hyperlipidaemia (9.0% vs. 5.5%), and diabetes (8.5% vs. 4.7%). The prevalence was 56.2% vs. 29.5% for any coronary atherosclerosis (P < 0.01), 9.0% vs. 2.3% for coronary stenosis ≥ 50% (P < 0.01), 20.2% vs. 5.3% for SIS ≥ 4 (P < 0.01), 18.2% vs. 5.6% for CACS > 100 (P < 0.01), and 60.9% vs. 48.7% for carotid plaque (P < 0.01), in men vs. women, respectively. Multivariable adjustment only marginally changed these associations: odds ratios (ORs) (95% confidence interval): 2.75 (2.53-2.99) for coronary atherosclerosis, 2.88 (2.40-3.45) for coronary stenosis ≥ 50%, 3.99 (3.50-4.55) for SIS ≥ 4, 3.29 (2.88-3.75) for CACS > 100, and 1.57 (1.45-1.70) for carotid plaque.

CONCLUSION

Men had higher prevalence of imaging-detected carotid and coronary atherosclerosis with prevalence in women aged 65 corresponding to men 11-13 years younger. The associations remained after extensive multivariable adjustment.

摘要

目的

男性比女性更易发生心肌梗死，但缺乏基于人群的影像学检测动脉粥样硬化性别差异研究。本研究旨在评估影像学检测到的冠状动脉和颈动脉粥样硬化的性别差异，以及性别与动脉粥样硬化之间的多变量调整关联。

方法和结果

本研究纳入了来自瑞典心肺生物影像学研究（SCAPIS）的年龄在 50-65 岁之间的一般人群参与者，进行了全面的诊断，包括冠状动脉计算机断层扫描血管造影和颈动脉超声检查。影像学结果包括任何冠状动脉粥样硬化、冠状动脉狭窄≥50%、节段受累评分（SIS）≥4、冠状动脉钙评分（CACS）>100 和任何超声检测到的颈动脉斑块。在 25580 名参与者（50%为女性）中，男性有更多的高血压（20.3%比 17.0%）、高脂血症（9.0%比 5.5%）和糖尿病（8.5%比 4.7%）。男性任何冠状动脉粥样硬化的患病率为 56.2%比 29.5%（P<0.01），冠状动脉狭窄≥50%的患病率为 9.0%比 2.3%（P<0.01），SIS≥4 的患病率为 20.2%比 5.3%（P<0.01），CACS>100 的患病率为 18.2%比 5.6%（P<0.01），颈动脉斑块的患病率为 60.9%比 48.7%（P<0.01），男性与女性相比。多变量调整仅略微改变了这些关联：比值比（OR）（95%置信区间）：冠状动脉粥样硬化为 2.75（2.53-2.99），冠状动脉狭窄≥50%为 2.88（2.40-3.45），SIS≥4 为 3.99（3.50-4.55），CACS>100 为 3.29（2.88-3.75），颈动脉斑块为 1.57（1.45-1.70）。