Abstract

Introduction: Visceral adipose tissue (VAT) has been associated with higher levels of atherosclerosis. Renal artery calcification (RAC) secondary to atherosclerosis has been found to be associated with hypertension and an increase in all-cause mortality. Hypothesis: There are significant associations between VAT area and density with the presence and extent of renal artery calcification. Methods: Within the Multi-Ethnic Study of Atherosclerosis (MESA) abdominal aortic calcification ancillary study, 1,978 participants from five of the six field centers around the US underwent abdominal CT imaging to measure VAT and RAC. Standardized questionnaires were used to obtain demographic and health history data. Blood samples were assayed for lipid, glucose, creatinine, and adipokine levels. Rate ratio regression was used to estimate prevalence ratios (PRs) for the presence of RAC, while linear regression was used to estimate linear coefficients for the severity of RAC among participants with RAC > 0. Results: Of the 1,978 participants, 1,196 participants had complete visceral adiposity and renal artery measurements. After controlling for sociodemographic variables, CVD risk factors, adipokine levels, and VAT density, VAT area was not associated with RAC presence (PR 1.02, 95% CI 0.89, 1.16, p = 0.80), while greater VAT density was borderline protective for RAC presence (PR 0.89, 95% CI 0.78, 1.02, p = 0.10) when controlling for the same factors and VAT area. 354 participants had RAC > 0 and were included in linear regression analyses assessing RAC severity. After controlling for sociodemographic variables, CVD risk factors, adipokine levels, and VAT density, VAT area was significantly associated with RAC severity (slope 63.32, 95% CI 11.84, 114.81, p = 0.02), while VAT density was not associated with RAC severity (slope 9.78, 95% CI -40.87, 60.44, p = 0.71). Conclusions: In this relatively large, multi-ethnic cohort of adults from five communities in the US, we have demonstrated that higher density VAT may be protective for RAC presence, while greater VAT area is significantly associated with RAC severity. While this is the first study examining the relationship between VAT and RAC, our results are consistent with previous studies describing associations between increased VAT area and decreased VAT density with outcomes including hypertension, hypercholesterolemia, and metabolic syndrome. Category: Subclinical Cardiovascular Disease

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