International Journal of Nephrology and Renovascular Disease (Feb 2024)
The Associations Between Abdominal Obesity and Coronary Artery Calcification in Chronic Kidney Disease Population
Abstract
Peng-Tzu Liu,1– 4 Jong-Dar Chen1,4 1Department of Family Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei City, Taiwan; 2Graduate Institute of Chemistry, Fu Jen Catholic University, New Taipei City, Taiwan; 3Graduate Institute of Biomedical and Pharmaceutical Science, Fu Jen Catholic University, New Taipei City, Taiwan; 4School of Medicine, Fu Jen Catholic University, New Taipei City, TaiwanCorrespondence: Jong-Dar Chen, Center for Occupational and Environmental Medicine, Department of Family Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, 95 Wen Chang Road, Shih Lin, Taipei City, 110, Taiwan, Tel +886-2-28332211, ext. 2626, Fax +886-2-28389468, Email [email protected]: Cardiovascular disease (CVD) is the primary cause of mortality in chronic kidney disease (CKD) patients, with metabolic disorders exacerbating this risk. Compared with body mass index, waist circumference (WC) has been proposed as a more effective indicator of abnormal visceral fat. However, the associations among CKD, abnormal WC, and CVD remain understudied.Material and Methods: A cross-sectional study in Taiwan (July 2006 to May 2016) involved 10,342 participants undergoing self-paid health checkups at a single medical center. Physical examinations and blood samples were taken to assess metabolic parameters, and renal function was evaluated using the Chronic Kidney Disease Epidemiology Collaboration formula. Coronary artery calcification (CAC) scores were determined through coronary 256-slice multidetector computed tomography angiography, with a CAC score of > 0 Agatston unit (AU) and ≥ 400 AU denoting positive CAC and severe CAC, respectively.Results: Sex-based comparisons were conducted between individuals with CKD and those without CKD. In the CKD group, both sexes exhibited significantly elevated levels for systolic blood pressure, serum fasting blood glucose (FBG), and hemoglobin A1c (HbA1c) as well as reduced serum high-density lipoprotein cholesterol. Examination of the associations of abnormal WC revealed that for both sexes, individuals with abdominal obesity (AO) were significantly older and had higher systolic/diastolic blood pressure, serum FBG, HbA1c, and lipid profiles compared with those without AO. Multiple logistic regression analysis revealed that CKD patients exhibited a more pronounced association with severe CAC scores compared with AO patients (odds ratios [ORs]: 2.7 and 1.4, respectively). Furthermore, the combined effects of AO and CKD (AO[+]/CKD[+]) resulted in increased risks of positive CAC (OR: 2.4, 95% confidence interval [CI]: 1.6– 3.5) and severe CAC (OR: 4.4, 95% CI: 1.4– 14.2).Conclusion: Abdominal obesity significantly raised the odds of CAC and was associated to a 4.4-fold increased risk of severe CAC in CKD patients.Keywords: abdominal obesity, coronary artery calcification, coronary artery calcium score, chronic kidney disease
