| Part 1Metabolic Syndrome on Coronary Artery Calcium ——A Community-based Study in BeijingObjectives To describe the prevalence of metabolic syndrome (MS) and its related risk factors, the distribution of coronary artery calcification (CAC) in a community-based natural population of Beijing, and analyze the influence of MS on CAC.Methods From April 2008 to January 2010, shougang and xishan machinery factory community were selected by typical sampling. Two thound and 438 residents, aged 35-74 years for male and 40-74 years for female, met the inclusion criteria.Two thound and 136 subjects(87.6%) answered the cardiovascular risk factor survey by questionnaires, anthropometric measurement, and blood biochemical tests.1647 subjects underwent 64-MDCT coronary calcium scans, coronary artery calcium score (CACS, Agatston scoring) were measured.Results The mean age for the 1647 subjects was 53.5 years, male 819, the prevalence of CAC were 33.9%. The prevalence of MS was 34.7%, abdominal obesity (Female 68.4%; male 52%) and elevated blood pressure (Female54.6%; male 60.6%) were the most common risk factors. The prevalence and amount of CAC in those younger than 65 years was higher in MS as compared to those without MS in both males and females (all p< 0.05),whereas, the CAC burden did not increase significantly in those older than 65 years ((male:nonMS 80.3% vs. MS58.6%, p=0.027; female:nonMS 65.4% vs. MS71%, p=0.524). The risk of CAC increases with increasing number of risk factors, after sex and age were adjusted,-odds ratio (OR) for predicting positive CAC for subjects with 2,3 and ≥4 risk factors were 1.49 (95%CI 1.01-2.20),1.68 (95%CI 1.12-2.52),2.59 (95%CI 1.68-3.99) respectively (all p< 0.05). Elevated blood pressure, hyperglycemia, hypertriglyceridemia and overweight increased the risk of CAC, yielding the adjusted OR of 1.88 (95%CI 1.48-2.39),1.32 (95%CI 1.01-1.74),1.33 (95%CI 1.05-1.68) and 1.31 (95%CI 1.04-1.65) respectively (all p< 0.05).Conclusions In the Beijing community-based natural population, MS increase the risk of CAC in those younger than 65 years, and the risk of metabolic syndrome might diminish for those older than 65 years. The risk of CAC increases with increasing number of risk factors. Not only the number, also the variety of risk factor for MS is correlated with the risk of CAC. Elevated blood pressure, hyperglycemia, hypertriglyceridemia and overweight increase the risk of CAC.Part 2Uric Acid on Coronary Artery Calcium ——A Community-based Study in BeijingObjectives To investigate the influence of uric acid on coronary artery calcium (CAC) in community-based population.Methods From December 2009 to January 2010, xishan community was selected by typical sampling.1438 residents, aged 35-74 years for male and 40-74 years for female, were met the inclusion criteria.1256 subjects answered (answer rate 87.3%). From April to June 2012, all the 1256 residents were followed up for cardiovascular risk factor survey, anthropometric measurement, blood biochemical tests.163 subjects were lost to follow-up (13%).1093 subjects answered,903 subjects accepted 64 multi-detector computed tomography (64-MDCT) coronary calcium scans, coronary artery calcium score (CACS, Agatston scoring) were measured.Results The mean age for the 903 subjects was 60.30 years, male 47.7%(431), the mean of uric acid level was 314.27±91.52ummol/L, the prevalence of CAC were 47.2%. For 1 quartile,2-3 quartile and 4 quartile of uric acid level, the prevalence of coronary artery calcium were 37.2%,45.5%,60.6%(P<0.001), coronary artery calcium scores were 109.7±333.1AU,133.9±356.9 AU,200.8±459.4 AU (P<0.001). Univariate logistic regression analysis showed that with the increasing of uric acid, the prevalence of coronary artery calcium increased [OR2-3quartiie 1.41,95%CI (1.02-1.95), p=0.040; OR4 quartile 2.60,95%CI (1.78-3.80),p<0.001], however, the relationship between uric acid and coronary artery calcium disappeared in multivariate logistic regression analysis [OR2-3quartile 0.92,95% CI (0.60-1.43), p=0.713; OR4quartile 1.38,95% CI [0.80-2.39], p=0.247]. Increasing age (OR1.11,95%CI [1.09-1.14]), male (OR3.01, 95%CI[1.74-5.19]), creatinine (OR1.01,95%CI [1.00-1.03]), systolic blood pressure (OR 1.03,95%CI [1.01-1.04]), fast glucose (OR 1.02,95%CI [1.01-1.03]), total cholesterol (OR1.01,95%CI [1.00-1.01]), smoking (OR1.83,95%CI [1.14-2.93])were independence risk factors for coronary artery calcium.Conclusions Uric acid is not an independence risk factor for coronary artery calcium, although the prevalence and extent of coronary artery calcium increased with the increasing of uric acid. Part 3Coronary Artery Calcium Progression and Its Risk Factors ——A Community-based Study in BeijingObjectives To describe the progression of coronary artery calcification (CAC) in a community-based population of Beijing, and analyze the influence of cardiovascular risk factors on the progression of CAC.Methods From December 2009 to January 2010, xishan machinery factory community was selected by typical sampling.1438 residents, aged 35-74 years for male and 40-74 years for female, were met the inclusion criteria.1256 subjects answered (answer rate 87.3%) cardiovascular risk factor survey, anthropometric measurements, blood biochemical tests.945 subjects of them accepted 64-MDCT coronary calcium scans. From April to June 2012, all the 1256 residents were followed up for cardiovascular risk factor survey, anthropometric measurement, blood biochemical tests.163 subjects were lost to follow-up (13%).1093 subjects answered,903 subjects accepted 6464-MDCT coronary calcium scans, coronary artery calcium score (CACS, Agatston scoring) were measured.814 subjects had undergone the baseline and follow-up CT calcium scan.Results The mean of follow-up time was 2.4 years for the 814 subjects. The mean progression rate of CAC was 26.2%(men 34.3% versus women 18.2%, p< 0.001). In the age subgroups of 35-44,45-54,55-64,>65 years, progression rate of CAC were 25%, 30.9%,40.4% and 40.7% for man and 0%,7.2%,19.8% and 44.3%for woman, respectively (all p< 0.001). Annualized progression of CACS were 4.9±12.7 AU,22.6 ±80.6 AU,23.3±47.2 AU and 50.2±83.4 AU for man; 0.2±0.6 AU,2.8±19.6 AU, 2.4±47.6 AU and 37.9±99.6 AU for woman, respectively(all p< 0.001). In the same age subgroup, progression rate of CAC and annualized progression of CACS in man were higher than woman (all p<0.05), with the exception of those older than 65 years (p >0.05). Multivariate Cox regression analysis showed that age (HR1.06,95%CI 1.04-1.07), male (HR1.57,95%CI 1.08-2.30), diabetes (HR1.98,95%CI 1.16-3.39), hypertension (HR1.27,95%CI 1.10-2.01) and smoking (HR1.71,95%CI 1.19-2.45) independently increase the risk of CAC progression.Conclusions Progression of CAC increased with age in Beijing community-base natural population. It was faster and severer in man than woman, but the differences were decreased in subgroup of older than 65 years. Male, age, hypertension, diabetes and smoking were independent predictors of CAC progression.Part 4Comparison of Coronary Artery Calcium in Community-base Population of Beijing and GuangzhouObjectives To compare the prevalence, amount of coronary artery calcium (CAC) in community-base population of Beijing and Guangzhou.Methods Two hundred and forty five residents from Beijing and 180 from Guangzhou were enrolled, aged from 45 to 74 years and free of clinical cardiovascular disease, underwent cardiac risk factor survey by questionnaire,anthropometric measurement and coronary calcium computed tomography (CT) scanning. We determined and compared the prevalence and amount of CAC.Results The Beijing participants had a CAC prevalence of 37.6%, and a median of coronary artery calcium score (CACS) 53.5AU in those with positive CACS, higher than 26.1% and 20AU of the Guangzhou participants (all p<0.05), further analysis showed that CAC prevalence of 48.1%, and median of CACS 77 AU higher in the Beijing men than 32.4% and 20.5AU in the Guangzhou man (all p<0.05), whereas, there was no difference between the Beijing women 25.4%,35 AU and 17.3% and 25.4AU in the Guangzhou women (all p>0.05).Conclusions The burden of atherosclerosis for the Beijing community-based population is higher than the Guangzhou community-based population, this is especially pronounced for Beijing man. The CAC increases with the increasing of age in both Beijing and Guangzhou population, age has a stronger association with CAC in the Beijing women than in the Guangzhou women. |
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