<b>Objective</b>
<p>To examine the utility of repeated computed
tomography (CT) coronary artery calcium (CAC) testing, we assessed risks of
detectable CAC and its cardiovascular consequences in individuals with and
without type 2 diabetes from ages 45 to 85 years.</p>
<p><b>Research Design and Methods</b></p>
<p>We included 5836 individuals (618 with
type 2 diabetes, 2972 without baseline CAC) from the Multi-Ethnic Study of
Atherosclerosis. Logistic and Cox regression evaluated the impact of type 2
diabetes, diabetes treatment duration and other predictors on prevalent and incident
CAC. We used time-dependent Cox modeling of follow-up data (median 15.9 years) for
two repeat CT exams and cardiovascular events to assess the association of CAC at
follow-up CT with cardiovascular events.</p>
<p><b>Results</b></p>
<p>For 45-year-olds with type 2
diabetes, the likelihood of CAC at baseline was 23% versus 17% for those without.
Median age at incident CAC was 52.2 versus 62.3 years for those with and
without diabetes. Each 5 years of diabetes treatment increased the odds and hazard
rate of CAC by 19% (95% confidence interval [CI] 8-33%) and 22% (95% CI 6-41%).
Male gender, white ethnicity/race,
hypertension, hypercholesterolemia, obesity, and low serum creatinine also
increased CAC. CAC at follow-up CT independently increased coronary heart
disease rates. </p>
<p><b>Conclusions </b></p>
<p>We estimated cumulative CAC incidence
to age 85. Patients with type 2 diabetes develop CAC at a younger age than
those without diabetes. Because incident CAC is associated with increased
coronary heart disease risk, the value of periodic CAC-based risk assessment in
type 2 diabetes should be evaluated.</p>
Gender Difference in the Impact of Type 2 Diabetes on Coronary Heart Disease Risk
