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Type 2 diabetes does not attenuate racial differences in coronary calcification |
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| Authors: | Wade Alisha N Fedyna Sean Mehta Nehal N St Clair Caitlin Ginwala Naeema Krishna Rama K Qasim Atif N Braunstein Seth Iqbal Nayyar Schutta Mark H Reilly Muredach P |
| Affiliation: | a Cardiovascular Institute, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-6160, United States b Institute of Diabetes, Obesity and Metabolism, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-6160, United States c Institue of Translational Medicine and Therapeutics, Departments of Medicine and Pharmacology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-6160, United States d State University of New York Upstate Medical University, Syracuse, NY, United States e Pennsylvania Hospital, Philadelphia, PA 19104-6160, United States f Philadelphia Veterans Affairs Medical Center, Department of Medicine, Division of Endocrinology, Philadelphia, PA 19104-6160, United States g Division of Endocrinology and Metabolism, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa |
| Abstract: | AimsCoronary artery calcification (CAC) is a strong predictor of atherosclerotic cardiovascular disease (CVD). Whites appear to have a higher prevalence of CAC than African-Americans (AAs), but it is unknown if type 2 diabetes, a major cardiovascular risk factor, attenuates this difference. We investigated the relationship of race and CAC in a sample of patients with type 2 diabetes without clinical CVD.MethodsMultivariable analyses of self-reported ethnicity and CAC scores, stratified by gender, in 861 subjects [32% AA, 66.9% male] with type 2 diabetes.ResultsAA race was associated with lower CAC scores in age-adjusted models in males [Tobit ratio for AAs vs. Whites 0.14 (95% CI 0.08-0.24, p < 0.001)] and females [Tobit ratio 0.26 (95% CI 0.09-0.77, p = 0.015)]. This persisted in men after adjustment for traditional, metabolic and inflammatory risk factors, but adjustment for plasma triglycerides [0.48 (95% CI 0.15-1.49, p = 0.201)] and HOMA-IR [0.28 (95% CI 0.08-1.03, p = 0.055)] partially attenuated the association in women.ConclusionsRelative to African-Americans, White race is a strong predictor of CAC, even in the presence of type 2 diabetes. The relationship in women appears less robust possibly due to gender differences in metabolic risk factors. |
| Keywords: | Race Coronary artery calcification Atherosclerosis Type 2 diabetes |
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