Impact on calcification of aortic arch by lifestyle-related, physiologic and biochemical factors

Abstract

OBJECTIVE: To explore the impact of lifestyle-related, physiological and biochemical factors on aortic arch calcification (AAC). METHODS: 20 430 subjects aged 50 to 85 years were included in this study from the first and second recruitment phase of the Guangzhou Biobank Cohort Study. All the subjects received face-to-face interviews to collect detailed information on their socio-demographic background, occupational exposures, living environment, lifestyle, family and personal disease histories, and received a physical examination and tests including 12-lead ECG, chest radiograph, and pulmonary function testing. Each subject was screened for a range of fasting biochemical parameters. Radiographs were reviewed by two senior radiologists. 300 radiographs were independently read by the two radiologists to assess agreement using Kappa coefficient. Logistic regression was used to assess the association between life style, physiological and biochemical factors and AAC. RESULTS: (1) The rate of agreement on diagnosis for the two radiologists was 85% and Kappa coefficient was 0.68 (P < 0.01) which showed a moderate agreement between the two radiologists. (2) Except hypertension, the subjects were significantly different on their lifestyle, physiological and biochemical factors in both men and women (P < 0.05). (3) AAC was significantly associated with older age, smoking status, LDL-C, and hypertension (P < 0.01) in both genders. ORs (95%CI) indicated the following results: age was 1.11 (1.10 - 1.12) in men and 1.12 (1.12 - 1.13) in women;smoking as 1.31 (1.17 - 1.47) in men and 1.31 (1.09 - 1.57) in women; LDL-C as 1.16 (1.06 - 1.27) in men and 1.38 (1.22 - 1.56) in women, hypertension as 1.33 (1.18 - 1.50) in men and 1.27 (1.18 - 1.38) in women. However, diabetes was found to be associated with an increased risk of AAC in women [OR(95%CI)] 1.38 (1.22 - 1.56). CONCLUSION: Age, smoking, hypertension and Low-density lipoprotein level were risk factors to both genders, on AAC, while diabetes increased the risk of AAC, in women.

目的探討生活習慣及生理生化因素對主動脈弓鈣化(AAC)的影響.方法收集'廣州生物庫隊列研究'第一、二期的研究對象20430名,年齡50～85歲的基線資料,體格檢查、實驗室檢查和胸部X線的AAC診斷結果及詳細的問卷調查數據;用logistic回歸分析某些生活習慣及生理生化因素與AAC患病率之間的關係.結果(1)2名高級放射診斷醫師獨立閱片對AAC診斷符合率為85%,Kappa值為0.68(P<0.01),顯示AAC診斷是可靠的;(2)除血壓外,男女性在某些生理生化特徵上有明顯差別(P< 0.05);(3)年齡、吸煙、LDL-C及高血壓是男女性患AAC的危險因素(P<0.01),其OR值(95%CI):年齡男性為1.11(1.10～1.12),女性1.12(1.12～1.13);吸煙男性為1.31(1.17～1.47),女性1.31(1.09～1.57);LDL-C男性為1.16(1.06～1.27),女性為1.38(1.22～1.56);高血壓男性為1.33(1.18～1.50),女性為1.27(1.18～1.38);女性患糖尿病增加患AAC的風險(P<0.001),其OR值(95%CI)為1.38(1.22～1.56).結論年齡、吸煙、高血壓、LDL-C是患AAC的危險因素,糖尿病增加女性患AAC的風險.