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Reduced Coronary Artery and Abdominal Aortic Calcification in Hispanics With Type 2 Diabetes

¹ Division of Endocrinology and Metabolism, Carl T. Hayden Veterans Affairs Medical Center, Phoenix, Arizona
² Cooperative Studies Program, Hines Veterans Affairs Hospital, Hines, Illinois

Address correspondence and reprint requests to Peter Reaven, MD, Division of Endocrinology and Metabolism (CS-111E), Carl T. Hayden Veterans Affairs Medical Center, 650 East Indian School Rd., Phoenix, AZ 85012. E-mail: peter.reaven{at}med.va.gov

OBJECTIVE—To compare lifestyle factors, cardiovascular risk factors, and coronary artery calcium (CAC) and abdominal aortic calcium (AAC) levels in Hispanic and non-Hispanic white (NHW) individuals with type 2 diabetes.

RESEARCH DESIGN AND METHODS—We recently demonstrated in a small group of nonreferred, healthy, nondiabetic subjects that CAC was reduced in Hispanics compared with NHWs, despite a worse cardiovascular risk factor profile. In this study, we evaluated whether this ethnic disparity in vascular calcification was present in individuals with type 2 diabetes and in several different arterial beds. Hispanic and NHW subjects (n = 245) with type 2 diabetes were evaluated for cardiovascular risk factors using questionnaires and assays of plasma biomarkers. CAC and AAC were measured by electron-beam computer-assisted tomography.

RESULTS—Although Hispanics were slightly younger than NHWs, other standard risk factors and novel cardiovascular risk factors, including plasminogen activator-1 and fibrinogen levels, were similar between the groups. Despite the similar risk factor profile, the prevalence of cardiovascular disease (CVD) and mean and median levels of CAC and AAC were lower in Hispanics. Furthermore, the distribution of these calcium scores differed from that of NHWs (P < 0.05), with significantly fewer Hispanic subjects having high CAC or AAC scores. These differences were not explained by differences in CVD prevalence or any measured lifestyle or risk factor.

CONCLUSIONS—Hispanics with type 2 diabetes have reduced CAC and AAC levels compared with NHW subjects, suggesting a reduction in the overall burden of vascular calcification and atherosclerosis. These data are consistent with the notion that Hispanics are protected against the development of CVD.

Abbreviations: AAC, abdominal aortic calcium • CAC, coronary artery calcium • CVD, cardiovascular disease • EBCT, electron-beam computed tomography • MI, myocardial infarction • NHW, non-Hispanic white • PAI-1, plasminogen-activating factor 1 • PVD, peripheral vascular disease • VA, Veterans Affairs

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