Öz
Kaynakça
- 1. Mohan J, Shams P, Bhatti K, Zeltser R. Coronary Artery Calcification. 2024 Nov 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. 2024.
- 2. Greenland P, Blaha MJ, Budoff MJ, Erbel R, Watson KE. Coronary Calcium Score and Cardiovascular Risk. J Am Coll Cardiol. 2018;72(4):434-447. doi: 10.1016/j.jacc.2018.05.027.
- 3. Ji B, Liu XB. Coronary artery calcification: concepts and clinical applications. Ann Med Surg (Lond). 2024;86(5):2848-2855. doi: 10.1097/MS9.0000000000002016.
- 4. Shisen J, Leung DY, Juergens CP. Gender and age differences in the prevalence of coronary artery calcification in 953 Chinese subjects. Heart Lung Circ.2005;14(2):69-73. doi: 10.1016/j.hlc.2005.03.007.
- 5. Siegersma KR, Groepenhoff F, Eikendal ALM, Op den Brouw WJ, Leiner T, Appelman Y, et al. Coronary calcification measures predict mortality in symptomatic women and men. Open Heart. 2022;9(2):e002005. doi: 10.1136/openhrt-2022-002005.
- 6. Mankad R, Best PJ. Cardiovascular disease in older women: a challenge in diagnosis and treatment. Womens Health (Lond). 2008;4(5):449-464. doi: 10.2217/17455057.4.5.449.
- 7. Nakao YM, Miyamoto Y, Higashi M, Noguchi T, Ohishi M, Kubota I, et al. Sex differences in impact of coronary artery calcification to predict coronary artery disease. Heart. 2018;104(13):1118-1124. doi: 10.1136/heartjnl-2017-312151.
- 8. Wu X, Qiu W, Yang H, Chen YJ, Liu J, Zhao G. Associations of the triglyceride-glucose index and atherogenic index of plasma with the severity of new-onset coronary artery disease in different glucose metabolic states. Cardiovasc Diabetol. 2024;23(1):76. doi: 10.1186/s12933-024-02163-9.
- 9. Won KB, Choi SY, Chun EJ, et al. Different associations of atherogenic index of plasma, triglyceride glucose index, and hemoglobin A1C levels with the risk of coronary artery calcification progression according to established diabetes. Cardiovasc Diabetol. 2024;23(1):418. doi: 10.1186/s12933-024-02508-4.
- 10. Yao H, Feng G, Liu Y, Chen Y, Shao C, Wang Z. Coronary artery calcification burden, atherogenic index of plasma, and risk of adverse cardiovascular events in the general population: evidence from a mediation analysis. Lipids Health Dis. 2024;23(1):258. doi: 10.1186/s12944-024-02255-1.
- 11. McClelland RL, Chung H, Detrano R, Post W, Kronmal RA. Distribution of coronary artery calcium by race, gender, and age: results from the Multi-Ethnic Study of Atherosclerosis (MESA). Circulation. 2006;113(1):30-37. doi: 10.1161/CIRCULATIONAHA.105.580696.
- 12. Kronmal RA, McClelland RL, Detrano R, et al. Risk factors for the progression of coronary artery calcification in asymptomatic subjects: results from the Multi-Ethnic Study of Atherosclerosis (MESA). Circulation. 2007;115(21):2722-2730. doi: 10.1161/CIRCULATIONAHA.106.674143.
- 13. Jansz TT, Go MHY, Hartkamp NS, et al. Coronary Artery Calcification as a Marker for Coronary Artery Stenosis: Comparing Kidney Failure to the General Population. Kidney Med. 2021;3(3):386-394.e1. doi: 10.1016/j.xkme.2021.01.010.
- 14. Sangiorgi G, Rumberger JA, Severson A, et al. Arterial calcification and not lumen stenosis is highly correlated with atherosclerotic plaque burden in humans: a histologic study of 723 coronary artery segments using nondecalcifying methodology. J Am Coll Cardiol. 1998;31(1):126-133. doi: 10.1016/s0735-1097(97)00443-9.
- 15. Pepine CJ, Nichols WW, Pauly DF. Estrogen and different aspects of vascular disease in women and men. Circ Res. 2006;99(5):459-461. doi: 10.1161/01.RES.0000241056.84659.59.
- 16. Kim BS, Chan N, Hsu G, et al. Sex Differences in Coronary Arterial Calcification in Symptomatic Patients. Am J Cardiol. 2021;149:16-20. doi: 10.1016/j.amjcard.2021.03.025.
- 17. Kim B, Makaryus J. Gender-based Differences In The Contribution Of Traditional Cardiovascular Risk Factors To The Development Of Coronary Artery Calcification. Journal of Cardiovascular Computed Tomography. 2020;14(3):S63. doi: 10.1016/j.jcct.2020.06.118.
- 18. Lessmann N, de Jong PA, Celeng C, et al. Sex Differences in Coronary Artery and Thoracic Aorta Calcification and Their Association With Cardiovascular Mortality in Heavy Smokers. JACC Cardiovasc Imaging. 2019;12(9):1808-1817. doi: 10.1016/j.jcmg.2018.10.026.
- 19. Won KB, Han D, Lee JH, et al. Atherogenic index of plasma and coronary artery calcification progression beyond traditional risk factors according to baseline coronary artery calcium score. Sci Rep. 2020;10(1):21324. doi: 10.1038/s41598-020-78350-x.
- 20. Liu F, Ling Q, Xie S, et al. Association between triglyceride glucose index and arterial stiffness and coronary artery calcification: a systematic review and exposure-effect meta-analysis. Cardiovasc Diabetol. 2023;22(1):111. doi: 10.1186/s12933-023-01819-2.
- 21. Kim JH, Lee DY, Park SE, et al. Triglyceride glucose index predicts coronary artery calcification better than other indices of insulin resistance in Korean adults: the Kangbuk Samsung Health Study. Precis Future Med. 2017; 1(1):43-51. doi: 10.23838/pfm.2017.00059.
- 22. Lu YW, Chang CC, Chou RH, et al. Gender difference in the association between TyG index and subclinical atherosclerosis: results from the I-Lan Longitudinal Aging Study. Cardiovasc Diabetol. 2021;20(1):206. doi: 10.1186/s12933-021-01391-7.
- 23. Lu YW, Tsai CT, Chou RH, et al. Sex difference in the association of the triglyceride glucose index with obstructive coronary artery disease. Sci Rep. 2023;13(1):9652. doi: 10.1038/s41598-023-36135-y.
- 24. Lambrinoudaki I, Kazani MV, Armeni E, et al. The TyG Index as a Marker of Subclinical Atherosclerosis and Arterial Stiffness in Lean and Overweight Postmenopausal Women. Heart Lung Circ. 2018;27(6):716-724. doi: 10.1016/j.hlc.2017.05.142.
The impact of gender differences on the roles of the atherogenic index of plasma and triglyceride-glucose index in predicting moderate to severe coronary artery calcification
Öz
Objective: This study aimed to evaluate the association of the triglyceride-glucose (TyG) index and the atherogenic index of plasma (AIP) with moderate-to-severe coronary artery calcium score (CACS), with a particular focus on gender differences. Given the gender-specific variations in the development of coronary artery calcification, tailored diagnostic approaches are required.
Methods: In this retrospective, single-center study, 246 consecutive patients aged 25-77 years who underwent 128-slice coronary computed tomography angiography (CCTA) for coronary artery disease screening between June 2024 and January 2025 were analyzed. Patients were categorized into three groups according to their CACS: Group 1 (CACS=0), Group 2 (CACS=1-99), and Group 3 (CACS≥100). Demographic characteristics and medical histories were recorded. Biochemical parameters, lipid panel, and hemogram values were analyzed from venous blood samples collected after 12 hours of fasting. Multivariate logistic regression analyses were performed to identify independent predictors of moderate-to-severe CACS in both genders.
Results: In women, advanced age (odds ratio [OR]=1.126; 95% confidence interval [CI]: 1.031–1.136; P<0.001), elevated triglyceride levels (OR=0.964; 95%CI:0.937–0.992; P=0.011), and a higher TyG index (OR=35.317;95%CI:6.328–187.356; P=0.002) were independently associated with moderate-to-severe CACS. In men, advanced age (OR=1.083; 95% CI:1.007–1.165; P=0.032), severe coronary artery stenosis (OR=12.298; 95% CI: 1.451–104.208; P=0.021), and smoking (OR=8.771; 95%CI: 1.810-42.501; P=0.007) were independent predictors. AIP was not identified as an independent predictor of moderate-to-severe CACS in either gender.
Conclusions: Advanced age was independently associated with CACS in both genders. The TyG index was a significant predictor of moderate-to-severe CACS in women, while traditional risk factors, such as smoking and severe coronary artery stenosis, were more relevant in men. AIP was not an independent predictor of moderate-to-severe CACS in either gender.
Anahtar Kelimeler
Coronary artery calcium score gender differences atherosclerosis atherogenic index of plasma triglyceride-glucose index
Etik Beyan
The research adhered to the norms of the Declaration of Helsinki and was granted approval by Siirt University Noninterventional Clinical Research Ethical Committee (Date: 28.11.2024, Decision No: 2024/12/01/04).
Destekleyen Kurum
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Kaynakça
- 1. Mohan J, Shams P, Bhatti K, Zeltser R. Coronary Artery Calcification. 2024 Nov 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. 2024.
- 2. Greenland P, Blaha MJ, Budoff MJ, Erbel R, Watson KE. Coronary Calcium Score and Cardiovascular Risk. J Am Coll Cardiol. 2018;72(4):434-447. doi: 10.1016/j.jacc.2018.05.027.
- 3. Ji B, Liu XB. Coronary artery calcification: concepts and clinical applications. Ann Med Surg (Lond). 2024;86(5):2848-2855. doi: 10.1097/MS9.0000000000002016.
- 4. Shisen J, Leung DY, Juergens CP. Gender and age differences in the prevalence of coronary artery calcification in 953 Chinese subjects. Heart Lung Circ.2005;14(2):69-73. doi: 10.1016/j.hlc.2005.03.007.
- 5. Siegersma KR, Groepenhoff F, Eikendal ALM, Op den Brouw WJ, Leiner T, Appelman Y, et al. Coronary calcification measures predict mortality in symptomatic women and men. Open Heart. 2022;9(2):e002005. doi: 10.1136/openhrt-2022-002005.
- 6. Mankad R, Best PJ. Cardiovascular disease in older women: a challenge in diagnosis and treatment. Womens Health (Lond). 2008;4(5):449-464. doi: 10.2217/17455057.4.5.449.
- 7. Nakao YM, Miyamoto Y, Higashi M, Noguchi T, Ohishi M, Kubota I, et al. Sex differences in impact of coronary artery calcification to predict coronary artery disease. Heart. 2018;104(13):1118-1124. doi: 10.1136/heartjnl-2017-312151.
- 8. Wu X, Qiu W, Yang H, Chen YJ, Liu J, Zhao G. Associations of the triglyceride-glucose index and atherogenic index of plasma with the severity of new-onset coronary artery disease in different glucose metabolic states. Cardiovasc Diabetol. 2024;23(1):76. doi: 10.1186/s12933-024-02163-9.
- 9. Won KB, Choi SY, Chun EJ, et al. Different associations of atherogenic index of plasma, triglyceride glucose index, and hemoglobin A1C levels with the risk of coronary artery calcification progression according to established diabetes. Cardiovasc Diabetol. 2024;23(1):418. doi: 10.1186/s12933-024-02508-4.
- 10. Yao H, Feng G, Liu Y, Chen Y, Shao C, Wang Z. Coronary artery calcification burden, atherogenic index of plasma, and risk of adverse cardiovascular events in the general population: evidence from a mediation analysis. Lipids Health Dis. 2024;23(1):258. doi: 10.1186/s12944-024-02255-1.
- 11. McClelland RL, Chung H, Detrano R, Post W, Kronmal RA. Distribution of coronary artery calcium by race, gender, and age: results from the Multi-Ethnic Study of Atherosclerosis (MESA). Circulation. 2006;113(1):30-37. doi: 10.1161/CIRCULATIONAHA.105.580696.
- 12. Kronmal RA, McClelland RL, Detrano R, et al. Risk factors for the progression of coronary artery calcification in asymptomatic subjects: results from the Multi-Ethnic Study of Atherosclerosis (MESA). Circulation. 2007;115(21):2722-2730. doi: 10.1161/CIRCULATIONAHA.106.674143.
- 13. Jansz TT, Go MHY, Hartkamp NS, et al. Coronary Artery Calcification as a Marker for Coronary Artery Stenosis: Comparing Kidney Failure to the General Population. Kidney Med. 2021;3(3):386-394.e1. doi: 10.1016/j.xkme.2021.01.010.
- 14. Sangiorgi G, Rumberger JA, Severson A, et al. Arterial calcification and not lumen stenosis is highly correlated with atherosclerotic plaque burden in humans: a histologic study of 723 coronary artery segments using nondecalcifying methodology. J Am Coll Cardiol. 1998;31(1):126-133. doi: 10.1016/s0735-1097(97)00443-9.
- 15. Pepine CJ, Nichols WW, Pauly DF. Estrogen and different aspects of vascular disease in women and men. Circ Res. 2006;99(5):459-461. doi: 10.1161/01.RES.0000241056.84659.59.
- 16. Kim BS, Chan N, Hsu G, et al. Sex Differences in Coronary Arterial Calcification in Symptomatic Patients. Am J Cardiol. 2021;149:16-20. doi: 10.1016/j.amjcard.2021.03.025.
- 17. Kim B, Makaryus J. Gender-based Differences In The Contribution Of Traditional Cardiovascular Risk Factors To The Development Of Coronary Artery Calcification. Journal of Cardiovascular Computed Tomography. 2020;14(3):S63. doi: 10.1016/j.jcct.2020.06.118.
- 18. Lessmann N, de Jong PA, Celeng C, et al. Sex Differences in Coronary Artery and Thoracic Aorta Calcification and Their Association With Cardiovascular Mortality in Heavy Smokers. JACC Cardiovasc Imaging. 2019;12(9):1808-1817. doi: 10.1016/j.jcmg.2018.10.026.
- 19. Won KB, Han D, Lee JH, et al. Atherogenic index of plasma and coronary artery calcification progression beyond traditional risk factors according to baseline coronary artery calcium score. Sci Rep. 2020;10(1):21324. doi: 10.1038/s41598-020-78350-x.
- 20. Liu F, Ling Q, Xie S, et al. Association between triglyceride glucose index and arterial stiffness and coronary artery calcification: a systematic review and exposure-effect meta-analysis. Cardiovasc Diabetol. 2023;22(1):111. doi: 10.1186/s12933-023-01819-2.
- 21. Kim JH, Lee DY, Park SE, et al. Triglyceride glucose index predicts coronary artery calcification better than other indices of insulin resistance in Korean adults: the Kangbuk Samsung Health Study. Precis Future Med. 2017; 1(1):43-51. doi: 10.23838/pfm.2017.00059.
- 22. Lu YW, Chang CC, Chou RH, et al. Gender difference in the association between TyG index and subclinical atherosclerosis: results from the I-Lan Longitudinal Aging Study. Cardiovasc Diabetol. 2021;20(1):206. doi: 10.1186/s12933-021-01391-7.
- 23. Lu YW, Tsai CT, Chou RH, et al. Sex difference in the association of the triglyceride glucose index with obstructive coronary artery disease. Sci Rep. 2023;13(1):9652. doi: 10.1038/s41598-023-36135-y.
- 24. Lambrinoudaki I, Kazani MV, Armeni E, et al. The TyG Index as a Marker of Subclinical Atherosclerosis and Arterial Stiffness in Lean and Overweight Postmenopausal Women. Heart Lung Circ. 2018;27(6):716-724. doi: 10.1016/j.hlc.2017.05.142.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Kardiyoloji |
| Bölüm | Original Article |
| Yazarlar | |
| Erken Görünüm Tarihi | 16 Nisan 2025 |
| Yayımlanma Tarihi | 4 Mayıs 2025 |
| Gönderilme Tarihi | 24 Mart 2025 |
| Kabul Tarihi | 13 Nisan 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 11 Sayı: 3 |
