Impact on calcification of aortic arch by lifestyle-related, physiologic and biochemical factors

OBJECTIVE: To explore the impact of lifestyle-related, physiological and biochemical factors on aortic arch calcification (AAC).

METHODS: 20 430 subjects aged 50 to 85 years were included in this study from the first and second recruitment phase of the Guangzhou Biobank Cohort Study. All the subjects received face-to-face interviews to collect detailed information on their socio-demographic background, occupational exposures, living environment, lifestyle, family and personal disease histories, and received a physical examination and tests including 12-lead ECG, chest radiograph, and pulmonary function testing. Each subject was screened for a range of fasting biochemical parameters. Radiographs were reviewed by two senior radiologists. 300 radiographs were independently read by the two radiologists to assess agreement using Kappa coefficient. Logistic regression was used to assess the association between life style, physiological and biochemical factors and AAC.

RESULTS: (1) The rate of agreement on diagnosis for the two radiologists was 85% and Kappa coefficient was 0.68 (P < 0.01) which showed a moderate agreement between the two radiologists. (2) Except hypertension, the subjects were significantly different on their lifestyle, physiological and biochemical factors in both men and women (P < 0.05). (3) AAC was significantly associated with older age, smoking status, LDL-C, and hypertension (P < 0.01) in both genders. ORs (95%CI) indicated the following results: age was 1.11 (1.10 - 1.12) in men and 1.12 (1.12 - 1.13) in women;smoking as 1.31 (1.17 - 1.47) in men and 1.31 (1.09 - 1.57) in women; LDL-C as 1.16 (1.06 - 1.27) in men and 1.38 (1.22 - 1.56) in women, hypertension as 1.33 (1.18 - 1.50) in men and 1.27 (1.18 - 1.38) in women. However, diabetes was found to be associated with an increased risk of AAC in women [OR(95%CI)] 1.38 (1.22 - 1.56).

CONCLUSION: Age, smoking, hypertension and Low-density lipoprotein level were risk factors to both genders, on AAC, while diabetes increased the risk of AAC, in women.