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The Associations Between Abdominal Obesity and Coronary Artery Calcification in Chronic Kidney Disease Population
Peng-Tzu Liu1,2,3,4, Jong-Dar Chen1,4
1Department of Family Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei City, Taiwan.
Insights
Abdominal obesity significantly increases cardiovascular disease risk in chronic kidney disease (CKD) patients. This study found that abdominal obesity combined with CKD leads to a 4.4-fold higher risk of severe coronary artery calcification.
Area of Science:
- Nephrology
- Cardiology
- Metabolic Disorders
Background:
- Cardiovascular disease (CVD) is the leading cause of death in chronic kidney disease (CKD) patients.
- Metabolic disorders worsen CVD risk in CKD.
- Waist circumference (WC) is a better visceral fat indicator than BMI, but its link with CKD and CVD is understudied.
Purpose of the Study:
- To investigate the association between CKD, abnormal waist circumference (abdominal obesity), and cardiovascular disease (CVD).
- To assess the risk of coronary artery calcification (CAC) in individuals with CKD and abdominal obesity.
Main Methods:
- A cross-sectional study of 10,342 participants in Taiwan (2006-2016).
- Assessed metabolic parameters, renal function (CKD Epidemiology Collaboration formula), and coronary artery calcification (CAC) using computed tomography.
- Analyzed associations using multiple logistic regression.
Main Results:
- CKD patients had higher blood pressure, glucose, HbA1c, and lower HDL cholesterol.
- Abdominal obesity (AO) was linked to older age, higher blood pressure, glucose, HbA1c, and poorer lipid profiles.
- CKD patients had a higher association with severe CAC (OR: 2.7) than AO patients (OR: 1.4).
- Combined AO and CKD (AO[+]/CKD[+]) increased risks of positive CAC (OR: 2.4) and severe CAC (OR: 4.4).
Conclusions:
- Abdominal obesity significantly increases the odds of coronary artery calcification (CAC).
- Abdominal obesity is associated with a 4.4-fold increased risk of severe CAC in CKD patients.
- The combination of abdominal obesity and CKD poses a substantial risk for cardiovascular events.
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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