Background There are now several preliminary reports of reduced levels of coronary calcium in certain ethnic groups. However, it is unclear if this represents a difference in the overall extent of atherosclerosis or a specific reduction in the degree of arterial calcification. Importantly, few studies have compared between ethnic groups the relative degree of coronary calcium with the burden of atherosclerosis within the same individuals.
Methods A total of 77 Hispanics and non-Hispanic white subjects, non-smokers, with no known diabetes mellitus or coronary artery disease were divided in two age-matched groups based on their ethnicity. Body mass index, lipid profile, inflammation markers, coronary artery calcium score by electron beam computerized tomography and carotid intimal-medial thickness (IMT) were measured and compared between the two groups.
Results Medication use, alcohol intake and measures of socioeconomic status were similar in both groups. Hispanic individuals had higher levels of CRP (4.5 versus 1.6 mg/L), fasting insulin and 2-hour glucose (all p < .05) when compared to the non-Hispanic group, yet the distribution of calcium scores differed between the groups, with Hispanics having significantly fewer scores greater than 400 (chi-square < .03). In contrast, IMT did not differ between the two groups. Correlation between calcium scores and IMT was relatively poor in the whole population and in the two subgroups. In regression analysis, ethnicity was a strong and independent predictor of calcium score, but not of IMT.
Conclusions Results of this study show that Hispanic subjects have lower coronary artery calcium scores, despite a higher prevalence of traditional and non-traditional cardiovascular risk factors. The amount of atherosclerotic burden as measured by IMT was the same in both groups and not strongly related to the extent of coronary artery calcium. These findings suggest the presence of as yet unidentified genetic or environmental factors that may inhibit calcium formation in the atheromatous lesions of Hispanic men.
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