Introduction and Objective: Coronary artery calcification (CAC), a proxy of atherosclerosis, has increased incidence and prevalence in individuals with diabetes. It is also known that CAC predicts future coronary heart disease, along with mortality in this population. We aimed to evaluate whether the association between diabetes and CAC incidence holds in individuals with diabetes and BMI < 30 kg/m2.Methods: We analyzed data of 2,105 asymptomatic individuals with BMI < 30 kg/m2 and no prior cardiovascular disease from the ELSA-Brasil cohort. The association between diabetes at baseline and CAC incidence was examined by multivariable logistic regression adjusted for age, sex, race, tobacco use, hypertension, triglycerides, LDL-c, and HDL. CAC incidence was defined by initial CAC = 0 and repeated CAC > 0. The mean interscan period was 5.2 years.Results: At baseline, the mean age was 48 ± 7.5 years, 60.7% of individuals were female, and 58.9% were White, with a mean BMI of 25 ± 2.8 kg/m2, diabetes prevalence of 10.7% and hypertension prevalence of 18.3%. Diabetes was associated with CAC incidence, odds ratio (OR) 1.82 (95% CI 1.3-2.55, p<0.001) in the crude model and in the model adjusted for age, sex, race, and tobacco, OR 1.79 (95% CI 1.26 -2.52, p: 0.001). In the fully adjusted model, the OR was 1.4 (95% CI 0.97-2.02, p:0.07). The overall CAC incidence was 15.1%, 14.1% in individuals without diabetes and 23% in individuals with diabetes (chi square p< 0.001).Conclusion: Individuals with BMI < 30 kg/m2 and diabetes have increased incidence of CAC, a proxy of coronary atherosclerosis. Diabetes is associated with increased odds of incident coronary calcification even after adjustment for several confounders. In the fully adjusted model, there was a trend towards significance that did not reach the classic statistical significance as the OR was attenuated by other factors, such as hypertension and dyslipidemia.
T.B. Mendes: None. C.C. Janovsky: None. G. Generoso: None. B. Halpern: Other Relationship; Eli Lilly and Company, AstraZeneca, Novo Nordisk, Merck & Co., Inc, Boehringer-Ingelheim. Advisory Panel; Currax. R. Correa Fabiano: None. R. Santos: Research Support; Amgen Inc, Sanofi. Consultant; ESPERION Therapeutics, Inc., Daiichi Sankyo. Speaker’s Bureau; Daiichi Sankyo. Research Support; Eli Lilly and Company. Speaker’s Bureau; Eli Lilly and Company. Research Support; Kowa Company, Ltd, Novartis Pharmaceuticals Corporation. Speaker’s Bureau; Novo Nordisk. Research Support; Ionis Pharmaceuticals. Speaker’s Bureau; Novartis Pharmaceuticals Corporation. I.M. Bensenor: None. P.A. Lotufo: None. M.S. Bittencourt: Speaker’s Bureau; Cleerly. Board Member; Elucid.
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