Endocrine Abstracts

Introduction Diabetes is a strong risk factor for coronary heart disease (CHD). Coronary artery calcium measurement (CAC) provides a non-invasive accurate assessment of the presence and severity of CHD, and thus the need for further cardiological investigations and risk-factor modifications.

Methods We analysed data from CACS assessment on 3337 male subjects who had no cardiovascular symptoms, of whom 188 had diabetes. CACS was measured by an Electron Beam CT scanner and categorised as Group 1=0; 2=1–10; 3=11–100; 4=101–400; 5=>400

Results Overall 40.4% patients were aged <55 yrs and 53.7% between 55–70 yrs. In both age groups the prevalence of elevated CACS was significantly greater in diabetes subjects than non-diabetes subjects (Groups 4+5 aged <55 −32.9% vs 9.4%, p<0.001; aged 55–70−84.2% vs 20.5%, p<0.001). However, 51.3% of diabetes subjects <55 yrs and 18.8% diabetes subjects 55–70 yrs were in Group 1 or 2, indicative of none or mild cardiovascular disease.

Looking at added CHD risk factors in Group 1 and Groups 4+5 subjects, there was no significant difference between diabetes and non-diabetes subjects with regards to a history of smoking, cholesterol >5.2 mmol/l or positive family history. Hypertension was more prevalent in Groups 4+5 diabetes compared to non-diabetes patients (aged <55 −68.0% vs 30.7%, p<0.001; aged 55–70−65.6% vs 37.1%, p<0.001). This was also similar in Group 1 subjects (aged<55 yrs −46.8% vs 16.3%, p<0.001; aged 55–70 −70.0% vs 21.5%, p<0.001).

Conclusion

1. Asymptomatic male diabetes patients have a higher prevalence of significant coronary atherosclerosis and CACS can provide a non-invasive method to assess an individuals CVD risk.

2. A significant proportion of asymptomatic male diabetes patients have objective evidence of no CHD.

3. CACS may be used in future to target preventive therapy in male diabetes patients.

Asymptomatic male diabetes patients have a higher prevalence of significant coronary atherosclerosis and CACS can provide a non-invasive method to assess an individuals CVD risk.

A significant proportion of asymptomatic male diabetes patients have objective evidence of no CHD.

CACS may be used in future to target preventive therapy in male diabetes patients.