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Abstract: SA-PO570

Association Between Muscle Quality Measured by Computed Tomography and Valvular and Thoracic Aortic Calcification in Maintenance Hemodialysis Patients

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Wang, Xiaoxu, Southeast University Zhongda Hospital, Nanjing, Jiangsu, China
  • Wang, Bin, Southeast University Zhongda Hospital, Nanjing, Jiangsu, China
  • Zhang, Xiaoliang, Southeast University Zhongda Hospital, Nanjing, Jiangsu, China
Background

Extra-coronary calcification (ECC) is independently associated with Cardiovascular disease (CVD). Low muscle mass is known to be related to vascular calcification. We evaluated whether muscle quality measured by computed tomography was associated with the risk of ECC in maintenance hemodialysis (MHD) patients.

Methods

The patients who underwent MHD in our Blood Purification Center from January 1, 2020 to December 31, 2022 were enrolled. Chest computed tomography images were collected and an open-source software 3D Slicer (version 5.0.3) was used to assess muscle quality (by skeletal muscle density, SMD, HU) at L1 level. The whole thoracic aorta calcification scores (TACS) and calcification scores of the 3 segments of thoracic aorta, including ascending thoracic aorta (ATACS), aortic arch (AoACS), and descending thoracic aorta (DTACS) were measured by 3D Slicer. 2-dimensional ultrasonic echocardiography was used to assess the number of calcified valves and patients were divided into 3 groups. We used multivariable linear regression analysis and cumulative logit model respectively to explore relationships between SMD and ECC.

Results

The age of 1076 patients was (57.98±14.49) years old, 59.3% of patients were male and the median dialysis age was 52 (17, 96) months. SMD was significantly negatively associated with TACS (model 1 [adjusted for age and sex]: standardized coefficient [β], -0.38 [95%CI, -0.51 — -0.24, P<0.001]; model 2 [adjusted for all factors in model 1 plus body mass index, smoking status, history of drug usage and past history]: β, -0.39 [95%CI, -0.52 — -0.25, P<0.001]; model 3 [adjusted for all factors in model 2 plus primary disease, dialysis vintage and laboratory results (albumin, interleukin-6, uric acid, et al)]: β, -0.44 [95%CI, -0.60 — -0.29, P<0.001]). Similarly, SMD was negatively correlated with ATACS, AoACS and DTACS. Additionally, increased SMD reduced the risk of cardiac valve calcification (model 1: odds ratio [OR], 0.92 [95%CI, 0.89 — 0.95, P<0.001]; model 2: OR, 0.91 [95%CI, 0.88 — 0.95, P<0.001]; model 3: OR, 0.90 [95%CI, 0.86 — 0.95, P<0.001]).

Conclusion

This is the first study evaluating the association between skeletal muscle quality and ECC in MHD patients. We identified significant negative associations between muscle quality and specific markers of ECC.

Funding

  • Government Support – Non-U.S.