Association Between Fasting Glucose Variability in Young Adulthood and the Progression of Coronary Artery Calcification in Middle Age: The CARDIA Study

OBJECTIVE <a>To investigate whether intraindividual variability of fasting glucose (FG) in young adulthood is associated with coronary artery calcification (CAC) progression in middle age.</a> RESEARCH DESIGN AND METHODS We included 2,256 CARDIA (<a></a><a>Coronary Artery Risk Development Study in Young Adults</a>) participants with CAC assessment by computed tomography scanner at baseline (2000–2001) and 10 years later (2010-2011). CAC progression was assessed for each individual as the difference of logarithmic CAC scores at follow-up and baseline (log [CAC (follow-up) + 1] - log [CAC (baseline) + 1]). FG variability was defined by the coefficient of variation about the mean FG (FG-CV), the SD of FG (FG-SD), and the average real variability of FG (FG-ARV) during 10-year follow-up. We investigated the association between FG variability and CAC progression with adjustment for demographics, clinical risk factors, mean FG level, change in FG level, diabetes incidence and medication use. RESULTS After multivariable adjustment, 1-SD increment in FG-CV was associated with worse progression of CAC as demonstrated as percent change in CAC with 5.9% (incident CAC, 95% CI 1.0%, 10.7%) and 6.7% (any CAC progression, 95% CI 2.3%, 11.1%) progression during 10 years. Similar findings were also observed in FG-SD and FG-ARV. CONCLUSIONS Higher FG variability during young adulthood was associated with greater CAC progression in middle age, suggesting its value in predicting risk for subclinical coronary artery diseases.

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Association Between Fasting Glucose Variability in Young Adulthood and the Progression of Coronary Artery Calcification in Middle Age

10.2337/figshare.12588878.v2 ◽

2020 ◽

Author(s):

Weijing Feng ◽

Zhibin Li ◽

Wenjie Guo ◽

Xianglin Fan ◽

Feiran Zhou ◽

...

Keyword(s):

Coronary Artery ◽

Young Adulthood ◽

Coronary Artery Calcification ◽

Middle Age ◽

Fasting Glucose ◽

Glucose Variability ◽

Diabetes Incidence ◽

The Difference ◽

Average Real Variability

OBJECTIVE <a>To investigate whether intraindividual variability of fasting glucose (FG) in young adulthood is associated with coronary artery calcification (CAC) progression in middle age.</a> RESEARCH DESIGN AND METHODS We included 2,256 CARDIA (<a></a><a>Coronary Artery Risk Development Study in Young Adults</a>) participants with CAC assessment by computed tomography scanner at baseline (2000–2001) and 10 years later (2010-2011). CAC progression was assessed for each individual as the difference of logarithmic CAC scores at follow-up and baseline (log [CAC (follow-up) + 1] - log [CAC (baseline) + 1]). FG variability was defined by the coefficient of variation about the mean FG (FG-CV), the SD of FG (FG-SD), and the average real variability of FG (FG-ARV) during 10-year follow-up. We investigated the association between FG variability and CAC progression with adjustment for demographics, clinical risk factors, mean FG level, change in FG level, diabetes incidence and medication use. RESULTS After multivariable adjustment, 1-SD increment in FG-CV was associated with worse progression of CAC as demonstrated as percent change in CAC with 5.9% (incident CAC, 95% CI 1.0%, 10.7%) and 6.7% (any CAC progression, 95% CI 2.3%, 11.1%) progression during 10 years. Similar findings were also observed in FG-SD and FG-ARV. CONCLUSIONS Higher FG variability during young adulthood was associated with greater CAC progression in middle age, suggesting its value in predicting risk for subclinical coronary artery diseases.

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Association Between Fasting Glucose Variability in Young Adulthood and the Progression of Coronary Artery Calcification in Middle Age

Diabetes Care ◽

10.2337/dc20-0838 ◽

2020 ◽

Vol 43 (10) ◽

pp. 2574-2580

Author(s):

Weijing Feng ◽

Zhibin Li ◽

Wenjie Guo ◽

Xianglin Fan ◽

Feiran Zhou ◽

...

Keyword(s):

Coronary Artery ◽

Young Adulthood ◽

Coronary Artery Calcification ◽

Middle Age ◽

Fasting Glucose ◽

Glucose Variability

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Fasting Glucose Variability in Young Adulthood and Cognitive Function in Middle Age: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Diabetes Care ◽

10.2337/dc18-1287 ◽

2018 ◽

Vol 41 (12) ◽

pp. 2579-2585 ◽

Cited By ~ 12

Author(s):

Michael P. Bancks ◽

Mercedes R. Carnethon ◽

David R. Jacobs ◽

Lenore J. Launer ◽

Jared P. Reis ◽

...

Keyword(s):

Young Adults ◽

Coronary Artery ◽

Cognitive Function ◽

Young Adulthood ◽

Middle Age ◽

Fasting Glucose ◽

Glucose Variability

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Abstract P037: Epigenetic Markers of Cardiovascular Health Trajectories and Coronary Artery Calcification in the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Circulation ◽

10.1161/circ.135.suppl_1.p037 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Lifang Hou ◽

Yinan Zheng ◽

Norrina B. Allen ◽

Drew Nannini ◽

Zhou Zhang ◽

...

Keyword(s):

Coronary Artery ◽

Young Adulthood ◽

Coronary Artery Calcification ◽

Cardiovascular Health ◽

Epigenetic Markers ◽

Mediation Analyses ◽

Mediating Role ◽

Relative Risks ◽

Methylome Analysis

Background: Trajectory of AHA’s cardiovascular health (CVH) through young adulthood are associated with subclinical CVD. The human epigenome is modifiable by lifestyle and environmental factors and may be an important mechanism of CVH outcomes. We sought to determine associations of epigenetic markers with CVH trajectories and with coronary artery calcification (CAC) through young adulthood. Methods: Among CARDIA ppts, we performed methylome analysis at follow up year (Y) 15 and Y20 using Illumina Methylation EPIC array (~850K CpG loci). We compared methylome between those with optimal CVH at baseline and remained stable (optimal-stable, n=645) and individuals with baseline optimal but declining CVH during follow up (n=100) to identify methylomic biomarkers of CVH trajectories. Differentially methylated CpGs were further examined in association with incident CAC risk at Y25 (n=745), and for their potential mediating role in CVH-associated CAC risk. Results: In 1,087 CARDIA ppts (mean age=25 at baseline), we identified 25 hypermethylated CpGs (18 at Y15, 13 at Y20, including 6 seen at both Y15 and Y20) significantly associated with optimal-stable CVH trajectories. The 6 common CpGs were stable (mean ICC = 0.66) whereas the remaining 19 CpGs were dynamic (mean ICC = 0.39) over a 5-year interval. Hypermethylation of 6 stable CpGs was associated with a decreased risk of having future CAC incidence ( Table 1 ). Hypermethylation of 10 (out of 19) dynamic CpGs at Y20 was associated with a decreased risk for incident CAC while the associations was less pronounced at Y15. Mediation analyses showed that hypermethylation of these 16 CpGs at Y15 and Y20 contributed 15% and 23% reduction in the CVH-associated relative risks (RRs) of CAC incidence at Y25. Conclusion: We observed distinct methylomic patterns in young adulthood with stable optimal CVH trajectories relative to those with declining CVH. CVH associated methylomic marks may predict CAC incidence and potentially mediate the associations of CVH trajectories with incident CAC risk.

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White blood cell count in young adulthood and coronary artery calcification in early middle age: coronary artery risk development in young adults (CARDIA) study

European Journal of Epidemiology ◽

10.1007/s10654-013-9842-7 ◽

2013 ◽

Vol 28 (9) ◽

pp. 735-742 ◽

Cited By ~ 17

Author(s):

Lifang Hou ◽

Donald M. Lloyd-Jones ◽

Hongyan Ning ◽

Mark D. Huffman ◽

Myriam Fornage ◽

...

Keyword(s):

Young Adults ◽

Coronary Artery ◽

Blood Cell ◽

Cell Count ◽

Young Adulthood ◽

White Blood Cell Count ◽

White Blood Cell ◽

Coronary Artery Calcification ◽

Middle Age ◽

Blood Cell Count

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Abstract P011: White Blood Cell Count in Young Adulthood and Coronary Artery Calcification in Early Middle Age: Coronary Artery Risk Development in Young Adults (CARDIA) Study

Circulation ◽

10.1161/circ.125.suppl_10.ap011 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Lifang Hou ◽

Donald Lloyd-Jones ◽

Hongyan Ning ◽

Mark . D Huffman ◽

Myriam Fornage ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Coronary Artery ◽

Blood Cell ◽

Young Adulthood ◽

White Blood Cell ◽

Coronary Artery Calcification ◽

Middle Age ◽

Hdl Cholesterol ◽

Wbc Count

Background: White blood cell (WBC) count is associated with incident coronary heart disease (CHD). Coronary artery calcification (CAC) is a measure of subclinical atherosclerosis that predicts CHD events. Since data are sparse regarding the association of WBC count with future CAC, we examined the association of WBC count in early adulthood (age 18-30 yrs.) with the presence of CAC 15 or 20 years later (age 33-50 yrs.). Methods: We included CARDIA participants who had baseline data on risk factors and WBC counts, and participated in the Year (Y) 15 or Y20 examinations with CAC score information. We performed age-, sex-, and race-adjusted linear regression analyses to examine the cross-sectional association between baseline (Y0) WBC count (total and subtypes) and known CHD risk factors, including systolic blood pressure (SBP), BMI, smoking (packs/year), total and HDL-cholesterol. We used multiple logistic regressions to assess prospective associations between Y0 WBC count and the presence of CAC at Y15 and Y20. Results: Among 3094 participants, mean (SD) age at baseline was 25± 4 years, 57% were women and 45% were black. In total, 263 and 566 subjects had CAC score>0 at Y15 and Y20 examination, respectively. Y0 SBP, BMI, and smoking (p<0.001), and HDL-cholesterol (p=0.01) were significantly associated with Y0 total WBC counts. Compared to participants without CAC at Y20, those with CAC score>0 had higher Y0 counts (10 9 /L, SD) of total WBC (6.0 ± 1.8 vs. 6.2 ± 1.9, p=0.04), lymphocyte (2.16 ± 0.75 vs. 2.23 ± 0.76 p=0.05), and eosinophil (0.16 ± 0.13 vs. 0.18 ± 0.16, p<0.001). These counts were positively associated with the presence of Y20 CAC after adjusting for potential confounders ( Table 1 ). Similar patterns were observed for Y15 CAC (data not shown). Conclusion: Total WBC and certain subtype counts in young adulthood are significantly associated with presence of CAC 15 or 20 years later in early middle age. These findings suggest the possible involvement of WBC in the initiation and/or early development of atherosclerosis. Table 1. Y0 WBC counts and CAC presence at Y20 (OR (95% CI) per 1 x 10 9 /L WBC counts Model 1 * Model 2 ** Total WBC 1.24 (1.12, 1.37) 1.11 (1.00, 1.24) Monocyte 1.02 (0.93, 1.13) 0.96 (0.87, 1.07) Neutrophils 1.13 (0.99, 1.28) 1.06 (0.93, 1.21) Lymphocyte 1.16 (1.05, 1.28) 1.03 (0.93, 1.14) Eosinophil 1.17 (1.05, 1.29) 1.14 (1.02, 1.27) * Age, sex, race adjusted; ** Model 1 plus Y0 education, SBP, BMI, TC, HDL, smoking and blood pressure lowering medication use.

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Abstract P305: Incidence of Coronary Artery Calcification and Its Association With Eicosapentaenoic Acids From The ERA JUMP Study

Circulation ◽

10.1161/circ.125.suppl_10.ap305 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Akira Sekikawa ◽

Hirotsugu Ueshima ◽

David J Curb ◽

Sunghee Lee ◽

Chol Shin ◽

...

Keyword(s):

Risk Factors ◽

Fatty Acids ◽

Coronary Artery ◽

Incidence Rate ◽

Coronary Artery Calcification ◽

Rate Ratio ◽

Incidence Rate Ratio ◽

White Men ◽

The Difference

Objectives: To compare incidence of coronary artery calcification (CAC) between men in Japan and the US and to examine whether marine n-3 fatty acids contribute to the difference in the incidence. Methods: The ERA JUMP Study is a population-based longitudinal study which has examined the progression of subclinical atherosclerosis in Japanese, Japanese American and white men aged 40-49 at baseline in 2002-2007. Incident cases of CAC were defined as those with CAC score=zero at baseline (n=278: 167 Japanese and 111 whites) and CAC score ≥10 at follow-up. Mean follow-up years were 6.2 for Japanese and 4.6 for whites. Stepwise robust logistic regression was used to determine baseline predictors of CAC incidence in each group. Generalized linear model was used to examine whether the difference in risk factors and marine n-3 fatty acids at baseline between Japanese and whites contributed to the difference in incidence rates. Results: Baseline characteristics show that levels of risk factors were similar between the two groups including LDL-C and BP. Exceptions were higher rates of smoking in Japanese (49 vs. 7%) and higher levels of HDL-C in Japanese (54 vs. 49 mg/dL). Levels of marine n-3 fatty acids were 100+% higher in Japanese. Incidence rate was significantly lower in Japanese than in whites (0.9 for Japanese vs. 2.9 for whites (per 100 person years) p<0.01). Logistic regression analyses showed that predictors of CAC incidence were HDL-C, BMI, and triglycerides for whites and BP and eicosapentaenoic acids (EPA) for Japanese. Generalized linear model showed that incidence rate ratio was 0.606 after adjusting for age, follow-up time, BMI, BP, HDL-C, LDL-C, and smoking (p<0.01), which remained significant after further adjusting for other risk factors. However, after further adjusting for EPA, the statistical significance disappeared (p=0.07). ( Table ) Conclusions: CAC incidence is significantly lower in Japanese than in white men. The data suggest that high levels of EPA contribute to the lower CAC incidence in Japanese. Table. Incidence rate ratio of coronary artery calcification between Japanese men and white men (n=278) Incidence rate ratio between two groups (95% CI) (Japanese vs. whites) p -value Model I 0.606 (0.427, 0.861) <0.01 Model II 0.571 (0.392, 0.830) <0.01 Model III 0.669 (0.431, 1.038) 0.07 Model I: Adjusted for age, follow-up time, BMI, BP sys, HDL-C pack-years of smoking and LDL-C Model II: Further adjusted for triglycerides, glucose, hypertension medication, lipid medication, CRP and alcohol Model III: Further adjusted for EPA (eicosapentaenoic acid)

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