Dataset Information

Famine in childhood and postmenopausal coronary artery calcification: a cohort study.

ABSTRACT:

Objective

To assess the effects of famine exposure during childhood on coronary calcium deposition and, secondarily, on cardiac valve and aortic calcifications.

Design

Retrospective cohort.

Setting

Community.

Patients

286 postmenopausal women with individual measurements of famine exposure during childhood in the Netherlands during World War II.

Intervention/exposure

Famine exposure during childhood.

Main outcome measures

Coronary artery calcifications measured by CT scan and scored using the Agatston method; calcifications of the aorta and cardiac valves (mitral and/or aortic) measured semiquantitatively. Logistic regression was used for coronary Agatston score of >100 or ?100, valve or aortic calcifications as the dependent variable and an indicator for famine exposure as the independent variable. These models were also used for confounder adjustment and stratification based on age groups of 0-9 and 10-17 years.

Results

In the overall analysis, no statistically significant association was found between severe famine exposure in childhood and a high coronary calcium score (OR 1.80, 95% CI 0.87 to 3.78). However, when looking at specific risk periods, severe famine exposure during adolescence was related to a higher risk for a high coronary calcium score than non-exposure to famine, both in crude (OR 3.47, 95% CI 1.00 to 12.07) and adjusted analyses (OR 4.62, 95% CI 1.16 to 18.43). No statistically significant association was found between childhood famine exposure and valve or aortic calcification (OR 1.66, 95% CI 0.69 to 4.10).

Conclusions

Famine exposure in childhood, especially during adolescence, seems to be associated with a higher risk of coronary artery calcification in late adulthood. However, the association between childhood famine exposure and cardiac valve/aortic calcification is less clear.

SUBMITTER: Idris NS

PROVIDER: S-EPMC3845053 | biostudies-literature | 2013 Nov

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Famine in childhood and postmenopausal coronary artery calcification: a cohort study.

Idris Nikmah S NS Uiterwaal Cuno S P M CS van der Schouw Yvonne T YT van Abeelen Annet F M AF Roseboom Tessa J TJ de Jong Pim A PA Rutten Annemarieke A Grobbee Diederick E DE Elias Sjoerd G SG

BMJ open 20131129 11

<h4>Objective</h4>To assess the effects of famine exposure during childhood on coronary calcium deposition and, secondarily, on cardiac valve and aortic calcifications.<h4>Design</h4>Retrospective cohort.<h4>Setting</h4>Community.<h4>Patients</h4>286 postmenopausal women with individual measurements of famine exposure during childhood in the Netherlands during World War II.<h4>Intervention/exposure</h4>Famine exposure during childhood.<h4>Main outcome measures</h4>Coronary artery calcifications ...[more]

PMID: 24293207

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Project description:RATIONALE & OBJECTIVE:Coronary artery calcification (CAC) is prevalent among patients with chronic kidney disease (CKD) and increases risks for cardiovascular disease events and mortality. We hypothesized that a novel serum measure of calcification propensity is associated with CAC among patients with CKD stages 2 to 4. STUDY DESIGN:Prospective cohort study. SETTING & PARTICIPANTS:Participants from the Chronic Renal Insufficiency Cohort (CRIC) Study with baseline (n=1,274) and follow-up (n=780) CAC measurements. PREDICTORS:Calcification propensity, quantified as transformation time (T50) from primary to secondary calciprotein particles, with lower T50 corresponding to higher calcification propensity. Covariates included age, sex, race/ethnicity, clinical site, estimated glomerular filtration rate, proteinuria, diabetes, systolic blood pressure, number of antihypertensive medications, current smoking, history of cardiovascular disease, total cholesterol level, and use of statin medications. OUTCOMES:CAC prevalence, severity, incidence, and progression. ANALYTICAL APPROACH:Multivariable-adjusted generalized linear models. RESULTS:At baseline, 824 (65%) participants had prevalent CAC. After multivariable adjustment, T50 was not associated with CAC prevalence but was significantly associated with greater CAC severity among participants with prevalent CAC: 1-SD lower T50 was associated with 21% (95% CI, 6%-38%) greater CAC severity. Among 780 participants followed up an average of 3 years later, 65 (20%) without baseline CAC developed incident CAC, while 89 (19%) with baseline CAC had progression, defined as annual increase≥100 Agatston units. After multivariable adjustment, T50 was not associated with incident CAC but was significantly associated with CAC progression: 1-SD lower T50 was associated with 28% (95% CI, 7%-53%) higher risk for CAC progression. LIMITATIONS:Potential selection bias in follow-up analyses; inability to distinguish intimal from medial calcification. CONCLUSIONS:Among patients with CKD stages 2 to 4, higher serum calcification propensity is associated with more severe CAC and CAC progression.

Dataset Information

Famine in childhood and postmenopausal coronary artery calcification: a cohort study.

Objective

Design

Setting

Patients

Intervention/exposure

Main outcome measures

Results

Conclusions

Publications

Famine in childhood and postmenopausal coronary artery calcification: a cohort study.

Similar Datasets

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