Background:Using magnetic resonance diffusion tensor imaging, we previously showed a cross-sectional association between carotid-femoral pulse wave velocity, a measure of aortic stiffness, and subtle white matter injury in clinically asymptomatic middle-age adults. While coronary artery calcium (CAC) is a robust measure of atherosclerosis, and a predictor of stroke and dementia, whether it predicts diffusion tensor imaging-based subtle white matter injury in the brain remains unknown.Methods:In FHS (Framingham Heart Study), an observational study, third-generation participants were assessed for CAC (2002–2005) and brain magnetic resonance imaging (2009–2014). Outcomes were diffusion tensor imaging-based measures; free water, fractional anisotropy, and peak width of mean diffusivity. After excluding the participants with neurological conditions and missing covariates, we categorized participants into 3 groups according to CAC score (0, 0 < to 100, and >100) and calculated a linear trend across the CAC groups. In secondary analyses treating CAC score as continuous, we computed slope of the outcomes per 20 to 80th percentiles higher log-transformed CAC score using linear regression.Results:In a total of 1052 individuals analyzed (mean age 45.4 years, 45.4% women), 71.6%, 22.4%, and 6.0% had CAC score of 0, 0 < to 100, and >100, respectively. We observed a significant linear trend of fractional anisotropy, but not other measures, across the CAC groups after multivariable adjustment. In the secondary analyses, CAC was associated with lower fractional anisotropy in men but not in women.Conclusions:CAC may be a promising tool to predict prevalent subtle white matter injury of the brain in asymptomatic middle-aged men.

中文翻译：

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多年前评估的冠状动脉钙与无症状中年男性大脑轻微白质损伤呈正相关：弗雷明汉心脏研究

背景：利用磁共振扩散张量成像，我们之前显示了颈动脉-股动脉脉搏波速度（主动脉僵硬度的测量方法）与临床无症状中年成人的细微白质损伤之间的横截面关联。虽然冠状动脉钙 (CAC) 是动脉粥样硬化的有力测量方法，也是中风和痴呆的预测因子，但它是否可以预测基于扩散张量成像的大脑中细微的白质损伤仍然未知。方法：在 FHS（弗雷明汉心脏研究）中，在一项观察性研究中，第三代参与者接受了 CAC（2002-2005 年）和脑磁共振成像（2009-2014 年）评估。结果是基于扩散张量成像的测量；自由水、分数各向异性和平均扩散率峰宽。在排除患有神经系统疾病和缺失协变量的参与者后，我们根据 CAC 评分（0、0 < 至 100 和 > 100）将参与者分为 3 组，并计算 CAC 组之间的线性趋势。在将 CAC 评分视为连续的二次分析中，我们使用线性回归计算了对数转换 CAC 评分每高 20 至 80 个百分点的结果斜率。 结果：在总共分析的 1052 名个体中（平均年龄 45.4 岁，45.4% 为女性）， 71.6%、22.4% 和 6.0% 的 CAC 评分分别为 0、0 < 至 100 和 >100。经过多变量调整后，我们在 CAC 组中观察到分数各向异性的显着线性趋势，但没有观察到其他测量值。在二次分析中，CAC 与男性较低的分数各向异性相关，但与女性无关。结论：CAC 可能是预测无症状中年男性中普遍存在的轻微脑白质损伤的有前途的工具。