Associations of cardiovascular disease risk factors and calcified atherosclerosis with aortoiliac bifurcation position: the MultiEthnic Study of Atherosclerosis

Angiology. 2015 Jan;66(1):90-5. doi: 10.1177/0003319713516669. Epub 2013 Dec 26.

Abstract

We investigated associations of cardiovascular disease (CVD) risk factors and calcified atherosclerosis with aortoiliac bifurcation position. The bifurcation position was determined by measuring the distance from the aortoiliac bifurcation to the L5-S1 disk space (or aortoiliac bifurcation distance [AIBD]), using computed tomography scans. The 1711 study participants (51% male) had a mean age of 62 ± 10 years and a mean AIBD of 26 ± 15 mm. In multivariable linear regression, older age, male gender, smoking, hypertension, larger aortic diameter, and smaller lumbar height were each independently associated with a smaller AIBD (more caudal bifurcation position). In contrast, diabetes, elevated triglycerides, and increased pulse pressure were independently associated with a larger AIBD (more cephalad bifurcation position). These findings suggest that age-related bifurcation descent is associated with CVD markers for aortic disease. Future studies should assess whether the bifurcation position is an independent prognosticator for CVD.

Keywords: abdominal aorta; aortoiliac bifurcation; atherosclerosis; diabetes.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aortic Diseases / blood
  • Aortic Diseases / diagnosis*
  • Aortic Diseases / ethnology
  • Aortic Diseases / physiopathology
  • Aortography / methods
  • Atherosclerosis / blood
  • Atherosclerosis / diagnosis*
  • Atherosclerosis / ethnology
  • Atherosclerosis / physiopathology
  • Biomarkers / blood
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / diagnosis*
  • Cardiovascular Diseases / ethnology
  • Cardiovascular Diseases / physiopathology
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / ethnology
  • Female
  • Hemodynamics
  • Humans
  • Hypertension / diagnosis
  • Hypertension / ethnology
  • Iliac Artery* / diagnostic imaging
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Predictive Value of Tests
  • Prospective Studies
  • Risk Factors
  • Sex Factors
  • Smoking / adverse effects
  • Smoking / ethnology
  • Tomography, X-Ray Computed
  • Triglycerides / blood
  • United States / epidemiology
  • Vascular Calcification / blood
  • Vascular Calcification / diagnosis*
  • Vascular Calcification / ethnology
  • Vascular Calcification / physiopathology

Substances

  • Biomarkers
  • Triglycerides