Association between free fatty acids and vascular calcification in CKD patients

As an independent risk factor for cardiovascular events in patients with chronic kidney disease (CKD), the mechanism of vascular calcification (VC) remains unclear, and current treatments targeting known mechanisms have still failed to reduce its occurrence. The relationship between free fatty acids (FFAs) and vascular calcification has been confirmed in general population in recent years, but not in CKD patients. Therefore, we investigated the association between free fatty acids and vascular calcification in CKD patients.

A total of 103 patients diagnosed with CKD stage 3-4 were included in this cross-sectional study. The severity of VC in this population was evaluated by abdominal aortic calcification score (AACS). Univariate binary logistic regression analysis was used for univariate analysis. Parameters with p < 0.1 in univariate analysis and established risk factors were considered potential confounders and were entered into multivariable logistic regression analysis. The discriminatory ability of FFAs on the presence of AAC was analyzed by receiver operating characteristic curves (ROC) according to the area under the curve (AUC).

The serum FFAs levels were significantly increased in the group with AAC scores ≥ 5 group [0.67 (0.65, 1.13) mmol/L vs. 0.62 (0.39, 0.65) mmol/L, P<0.001]. FFAs levels were independently associated with AAC severity (OR=1.269, P = 0.012, 95% CI:1.053-1.528). FFAs levels showed the biggest AUC of 0.868, with a sensitivity of 71.4% and a specificity of 94.1% and the optimal threshold was 0.665 mmol/L.

Elevated serum FFAs are associated with vascular calcification severity in patients with CKD stage 3-4.