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Abstract
Background
Atherosclerosis, the most common cause of death in type 2 diabetic patients, is closely associated with coronary artery calcium deposition. The coronary calcifications can be easily measured using coronary calcium scoring computed tomography (CT). And microalbuminuria is known as an independent risk factor of cardiovascular disease. So, we examined the association of urinary albumin to creatinine ratio (UACR) and coronary calcification score (CCS) in type 2 diabetic patients.
Methods
Among type 2 diabetic patients who underwent the multidetector CT scanning for the evaluation of CCS at Kyungpook National University Hospital between December 2007 and May 2008, 155 subjects were included. CCS, demographic and laboratory data were assessed.
Results
Coronary artery calcifications were identified in 90 patients (51%) and mean, median CCS was 205.8 ± 476.9, 8.74 (0, 132.0). 60 subjects revealed UACR greater than 30 ug/mg. With the UACR increment, CCS revealed a significant increase (P < 0.001). Age, duration of diabetes, serum Apo A1 level, serum high sensitivity C-reactive protein (hs-CRP) level were also associated with CCS. However, after adjusting for age, UACR and CCS exhibited a significant positive relationship (P = 0.002).
Figures and Tables
Fig. 1
Scatterplot of the log UACR and log (CCS + 1) in the study subjects. There was a significant positive correlation between the Log UACR and Log (CCS + 1) (P < 0.001). CCS, coronary calcification score; UACR, urinary albumin to creatinine ratio.
Table 1
Baseline characteristics of all subjects
Data was presented as mean ± SD or number of case (%). ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin II receptor blocker; BMI, body mass index; Ca, calcium; CCS, coronary calcification score; Cr, creatinine; hs-CRP, high sensitivity C-reactive protein; IQR, interquartile range; P, phosphate; SBP, systolic blood pressure; T-Chol, total cholesterol; UACR, urinary albumin to creatinine ratio.
Table 2
Clinical characteristics according to the grade of urinary albumin to creatinine ratio (UACR)
Data was presented as mean ± SD or number of case (%). *(P < 0.05). Statistics were analyzed by one-way ANOVA method. BUN, blood urea nitrogen; Ca, calcium; Cal, calcification; CCS, coronary calcification score; C-pep, C-peptide; Cr, creatinine; GGT, gamma-glutamyl trasnpeptidase; HDL-C, high density lipoprotein cholesterol; hs-CRP, high sensitivity C-reactive protein; IQR, interquartile range; LDL-C, low density lipoprotein cholesterol; Lp (a), lipoprotein (a); P, phosphate; SBP, systolic blood pressure; T-chol, total cholesterol; TG, triglyceride.
Table 3
Association of coronary calcification score and different risk variables
*P < 0.05. Apo A1, apolipoprotein A1; Apo B, apolipoprotein B; BMI, body mass index; C-pep, C-peptide; FFA, free fatty acid; GGT, gamma-glutamyl transpeptidase; HDL-C, high density lipoprotein cholesterol; hs-CRP, high sensitivity C-reactive protein; LDL-C, low density lipoprotein cholesterol; Lp (a), lipoprotein (a); SBP, systolic blood pressure; T-chol, total cholesterol; TG, triglyceride; UACR, urinary albumin to creatinine ratio.
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