Progression of coronary artery calcification is stronger in poorly than in well controlled diabetes: Results from the Heinz Nixdorf Recall Study

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• 作者：Bernd Kowall^a ; ^{bernd.kowall@uk-essen.de} ; Nils Lehmann^b ; Amir-Abbas Mahabadi^c ; Susanne Moebus^d ; Thomas Budde^e ; Rainer Seibel^f ; Dietrich Grö ; nemeyer^g ; Raimund Erbel^b ; Karl-Heinz Jö ; ckel^b ; Andreas Stang^a ; ^h
• 关键词：Type 2 diabetes ; HbA1c ; Coronary artery calcification ; Coronary artery calcium ; Glycemic control
• 刊名：Journal of Diabetes and its Complications
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：31
• 期：1
• 页码：234-240
• 全文大小：304 K
• 卷排序：31

文摘

To assess associations between HbA1c and progression of coronary artery calcification (CAC) in persons with and without diabetes.MethodsIn the Heinz Nixdorf Recall Study, a population-based cohort study in Germany (N = 3453, aged 45–74 years), CAC was assessed by electron-beam tomography at baseline and at 5-year follow-up. At baseline, participants were divided into five groups: poorly (HbA1c ≥ 7.0%) and well (HbA1c < 7.0%) controlled previously known diabetes (group I/II); no previously known diabetes with HbA1c ≥ 6.5% (group III), HbA1c 5.7–6.4% (group IV), and HbA1c < 5.7% (group V). We fitted linear, logistic and robust Poisson regression models to assess associations between diabetes group and PF5 (factor by which CAC after 5-year follow-up is larger than baseline CAC), and categories of CAC change, respectively.ResultsRelative to group V, adjusted percentage increase of the geometric mean of PF5 (95% CI) was: 69.1% (33.9%;113.6%), 15.4% (− 5.6%;41.1%), − 4.1% (− 22.2%;18.2%), 4.2% (− 5.4%;14.8%) for groups I–IV, respectively. The corresponding odds ratios for annual CAC increase ≥ 100 Agatston units (reference: < 10) were 10.0 (4.8;20.6), 4.0 (2.1;7.6), 1.5 (0.7;3.2), and 1.1 (0.7;1.8).ConclusionsIn known diabetes, CAC progression was stronger in poor diabetes control. For newly detected diabetes diagnosed by HbA1c ≥ 6.5%, associations with CAC progression were weak.