The Associations Between Abdominal Obesity and Coronary Artery Calcification in Chronic Kidney Disease Population.

IF 2.1 Q2 UROLOGY & NEPHROLOGY International Journal of Nephrology and Renovascular Disease Pub Date : 2024-02-01 eCollection Date: 2024-01-01 DOI:10.2147/IJNRD.S446445

Peng-Tzu Liu, Jong-Dar Chen

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Abstract

Background: 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.

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慢性肾脏病人群腹部肥胖与冠状动脉钙化之间的关系

背景：心血管疾病（CVD）是慢性肾脏病（CKD）患者死亡的主要原因，而代谢紊乱会加剧这一风险。与体重指数相比，腰围（WC）被认为是内脏脂肪异常的更有效指标。然而，对慢性肾脏病、异常腰围和心血管疾病之间的关联研究仍然不足：一项在台湾进行的横断面研究（2006 年 7 月至 2016 年 5 月）涉及在一家医疗中心进行自费健康检查的 10342 名参与者。研究人员进行了体格检查和血液样本采集，以评估代谢参数，并使用慢性肾脏病流行病学协作公式评估了肾功能。冠状动脉钙化（CAC）评分是通过冠状动脉256切片多载体计算机断层扫描血管造影术确定的，CAC评分大于0阿加斯顿单位（AU）和≥400 AU分别表示阳性CAC和严重CAC：对患有慢性肾脏病和未患有慢性肾脏病的人进行了基于性别的比较。在 CKD 组中，男女收缩压、血清空腹血糖 (FBG) 和血红蛋白 A1c (HbA1c) 水平均显著升高，血清高密度脂蛋白胆固醇水平降低。对异常腹围相关性的研究显示，与无腹围异常的人相比，男女腹型肥胖（AO）者的年龄明显偏大，收缩压/舒张压、血清 FBG、HbA1c 和血脂谱也更高。多元逻辑回归分析显示，与 AO 患者相比，CKD 患者与严重 CAC 评分的关系更为明显（几率比 [ORs] 分别为 2.7 和 1.4）。此外，腹部肥胖和慢性肾脏病（腹部肥胖[+]/慢性肾脏病[+]）的综合影响导致 CAC 阳性（OR：2.4，95% 置信区间[CI]：1.6-3.5）和严重 CAC（OR：4.4，95% 置信区间：1.4-14.2）的风险增加：结论：腹部肥胖明显增加了 CKD 患者罹患 CAC 的几率，并且与严重 CAC 风险增加 4.4 倍有关。

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来源期刊

International Journal of Nephrology and Renovascular Disease UROLOGY & NEPHROLOGY-

CiteScore

3.90

自引率

5.00%

发文量

审稿时长

16 weeks

期刊介绍： International Journal of Nephrology and Renovascular Disease is an international, peer-reviewed, open-access journal focusing on the pathophysiology of the kidney and vascular supply. Epidemiology, screening, diagnosis, and treatment interventions are covered as well as basic science, biochemical and immunological studies. In particular, emphasis will be given to: -Chronic kidney disease- Complications of renovascular disease- Imaging techniques- Renal hypertension- Renal cancer- Treatment including pharmacological and transplantation- Dialysis and treatment of complications of dialysis and renal disease- Quality of Life- Patient satisfaction and preference- Health economic evaluations. The journal welcomes submitted papers covering original research, basic science, clinical studies, reviews & evaluations, guidelines, expert opinion and commentary, case reports and extended reports. The main focus of the journal will be to publish research and clinical results in humans but preclinical, animal and in vitro studies will be published where they shed light on disease processes and potential new therapies and interventions.