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Kidney Week

Abstract: SA-PO575

Body Composition and Coronary Artery Calcification in a Prospective Hemodialysis (HD) Cohort: A Substudy of the NIH THYROID-HD Trial

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Narasaki, Yoko, University of California Irvine School of Medicine, Irvine, California, United States
  • Budoff, Matthew Jay, Harbor-UCLA Medical Center, Torrance, California, United States
  • Bross, Rachelle, Harbor-UCLA Medical Center, Torrance, California, United States
  • Cervantes, Mackenzie Kerr, Harbor-UCLA Medical Center, Torrance, California, United States
  • Kopple, Joel D., Harbor-UCLA Medical Center, Torrance, California, United States
  • Brent, Gregory, University of California Los Angeles, Los Angeles, California, United States
  • Casaburi, Richard, Harbor-UCLA Medical Center, Torrance, California, United States
  • Rossiter, Harry B., Harbor-UCLA Medical Center, Torrance, California, United States
  • Radom-Aizik, Shlomit, Harbor-UCLA Medical Center, Torrance, California, United States
  • Kovesdy, Csaba P., The University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Daza Aguilar, Andrea C., University of California Irvine School of Medicine, Irvine, California, United States
  • You, Seungsook, University of California Irvine School of Medicine, Irvine, California, United States
  • Kalantar-Zadeh, Kamyar, Harbor-UCLA Medical Center, Torrance, California, United States
  • Nguyen, Danh V., University of California Irvine School of Medicine, Irvine, California, United States
  • Rhee, Connie, University of California Irvine School of Medicine, Irvine, California, United States
Background

HD patients have a high burden of coronary artery calcification (CAC), which is associated with CV mortality. We examined the relationship of body composition assessed by dual-energy x-ray absorptiometry (DXA) with CAC measured by cardiac CT in a prospective HD cohort.

Methods

In a substudy of the multi-center NIH THYROID-HD Trial, we examined associations of specific DXA body composition metrics (ratios of total body mineral content (BMC)/total mass, total fat mass/total mass, total lean mass/total mass) with elevated CAC Agatston scores (>400 Hounsfield units) in HD patients with upper reference and subclinical hypothyroid range TSH levels (>3.0-10.0mIU/L) using logistic regression. In secondary analyses, we examined the relationship between novel DXA visceral adiposity metrics (trunk/limb fat mass ratio, visceral adipose tissues (VAT) mass, VAT volume, VAT area) and elevated CAC scores.

Results

In 189 HD patients with baseline DXA and CAC measurements, the median (IQR) of CAC scores was 388 (29, 1978). Each +Δ0.02 increase in total BMC/total mass ratio was associated with lower risk of elevated CAC in adjusted analyses: OR (95%CI): 0.14 (0.03, 0.69) (Fig A). In unadjusted analyses, higher trunk/limb fat mass ratio (+Δ0.2), VAT mass (+Δ100 g), VAT volume (+Δ100 cm2), and VAT area (+Δ100 cm2) were each associated with higher risk of elevated CAC: ORs (95%CIs): 1.26 (1.02, 1.55), 1.12 (1.02, 1.23), 1.11 (1.02, 1.21), and 1.06 (1.01, 1.10), respectively (Fig B). While adjusted analyses narrowly missed statistical significance, point estimates showed higher CAC risk with higher VAT values.

Conclusion

In a subcohort of patients from the NIH THYROID-HD Trial, higher BMC/total mass was associated with lower risk of CAC, whereas higher visceral adiposity value was associated with higher CAC risk. Further research is needed to determine if VAT reduction lowers CAC risk in HD patients.

Funding

  • NIDDK Support