Severe Abdominal Aortic Calcification Research Articles

Association between Ward's triangle bone mineral density levels and abdominal aortic calcification: Data from the national health and nutrition examination survey 2013–2014

BACKGROUND & AIMSDespite extensive research into the cardiovascular implications of abdominal aortic calcification (AAC), there is a scarcity of robust studies exploring its association with Ward's triangle bone mineral density (BMD). This study aimed to evaluate this relationship in a nationally representative sample and compare the predictive value with femoral neck BMD and total femur BMD. METHODSWe conducted a cross-sectional analysis of 2013-2014 National Health and Nutrition Examination Survey (NHANES) data, utilizing a complex, stratified, multistage, cluster sampling design. BMD measurements at Ward's triangle, femoral neck, and total femur were assessed using DXA scans. AAC severity was defined by a Kauppila score of ≥5. Predictors of AAC-24 scores were identified through correlation and linear regression models. Stratified regression and restricted cubic splines were applied to explore subgroup and dose-response relationships. RESULTSOf the 2,965 participants representing 116,562,500 individuals in the U.S., 11% had severe AAC. Ward's triangle BMD showed a significant negative association with AAC-24 scores (β = -1.90, 95% CI: -2.80 to -1.00, P < 0.002) and a reduced risk of severe AAC (OR = 0.85, 95% CI: 0.76 to 0.95, P = 0.010). Non-linear associations were observed between Ward's triangle BMD and AAC outcomes. Ward's triangle BMD outperformed femoral neck and total femur BMD in predicting AAC. CONCLUSIONSHigher Ward's triangle BMD is linked to lower odds of severe AAC, highlighting its potential for improved early detection of AAC over femoral neck and total femur BMD. Healthcare providers should consider the implications of reduced Ward's triangle BMD for systemic atherosclerosis and recommend early AAC screening for enhanced cardiovascular risk management.

Composite dietary antioxidant index and abdominal aortic calcification: a national cross-sectional study

PurposeThe Composite Dietary Antioxidant Index (CDAI) is a novel, inclusive measure for evaluating the antioxidant potential of diets. We aim to explore the link between the CDAI and abdominal aortic calcification (AAC) in U.S. adults aged ≥ 40 years.MethodsThis cross-sectional study collected dietary and AAC data for individuals aged ≥ 40 years from the 2013–2014 National Health and Nutrition Examination Survey (NHANES) database. The CDAI was calculated using six dietary antioxidants. AAC was evaluated using a semi-quantitative scoring system known as AAC-24, with an AAC score greater than 6 as severe AAC (SAAC). To examine the association between CDAI and AAC, including SAAC, liner/logistic regression analyses and smooth curve fitting were applied.ResultsA total of 2,640 participants were included in this study, and significant decreases in AAC score and SAAC prevalence were observed with ascending CDAI levels (P < 0.01). After adjusting for confounding factors, a clear link was established between the CDAI and both AAC score (β = -0.083, 95% CI -0.144–0.022, P = 0.008) and SAAC (OR = 0.883, 95% CI 0.806–0.968, P = 0.008), respectively. Further smooth curve fitting indicated a negative correlation between CDAI and both AAC score and SAAC.ConclusionsDietary antioxidant consumption, as quantified by the CDAI, shows an inverse relationship with AAC risk. Additional longitudinal and intervention studies are essential.

Long sleep duration is associated with abdominal aortic calcification among male adults with chronic kidney disease: NHANES 2013-2014.

There are no studies exploring the correlation between sleep duration and abdominal aortic calcification (AAC). This study aims to investigate this relationship and its significance. Additionally, given the higher prevalence of sleep disorders and AAC in patients with chronic kidney disease (CKD), we conducted further studies in this population. We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2013-2014. Sleep duration was assessed by a sleep questionnaire and categorized into 2-5, 6-8, and ≥ 9h. The AAC-24 score is determined using the Kauppila scoring system and used for AAC assessment. Multivariable linear and logistic regression analysis were used to explore the relationship between sleep duration and AAC. Among the 2,996 participants, 14.29% reported nightly short sleep (2-5h), 77.64% reported intermediate sleep (6-8h), and 8.08% reported long sleep (≥ 9h). After adjusting for potential confounding factors, among male participants with CKD, long sleep (≥ 9h) significantly increased AAC-24 scores compared with intermediate sleep (6-8h) (β: 2.12; 95% CI: 0.75, 3.50), and the risk of severe AAC (SAAC) was increased by 1.55 times (OR: 2.55; 95% CI: 1.02, 6.36). And among female CKD and non-CKD participants, sleep duration was not associated with AAC. Long sleep duration increases the risk of AAC among male adults with CKD. Prospective studies are needed to confirm this finding.

Gender-specific correlations between remnant cholesterol and severe abdominal aortic calcification in American adults.

Remnant cholesterol (RC) predicts cardiovascular risk and is associated with a range of diseases, including asthma, hypertension, depression, periodontitis, and alcoholic fatty liver disease. However, its correlation with abdominal aortic calcification (AAC) has not been reported. Using a cross-sectional approach, this study examined data from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) cycle. Multiple logistic regression, generalized summation models, and subgroup analyses were used in examining the correlation between RC and the prevalence of severe AAC. The mean age of participants in this study was 57.70 ± 11.73 years, with 142 individuals (9.67%) suffering from severe AAC. The median RC was 0.52 mmol/L (Q1-Q3, 0.36-0.75 mmol/L). Among female participants, a significant positive correlation was observed between RC and severe AAC (per natural log [RC] increment: 2.14; 95% CI, 1.07-4.27). Smooth curve fitting and threshold effect analysis revealed a saturation effect at an RC level of 0.57 mmol/L. Conversely, in male participants, no significant correlation was found between RC and the prevalence of severe AAC (per natural log [RC] increment: 0.88; 95% CI, 0.43-1.78). Our findings suggest a significant interaction between gender and RC in relation to severe AAC (P for interaction = 0.0042). Higher RC levels were significantly associated with an increased prevalence of severe AAC in women.

Association between oxidative balance scores and severe abdominal aortic calcification in American adults: National health and nutrition examination survey

Background and aimAbdominal aortic calcification (AAC) is a key predictor of cardiovascular diseases (CVDs). The Oxidative Balance Score (OBS) served as a tool to evaluate the systemic status of oxidative stress. However, evidence on the link between OBS and severe abdominal aortic calcification (SAAC) is currently inadequate. This study aims to establish this correlation in the US adult population, contributing valuable insights to the understanding of cardiovascular health. Methods and resultsIn our study with 2745 participants from the 2013–2014 National Health and Nutrition Examination Survey (NHANES), we analyzed both OBS and AAC score data. Logistic regression and smooth curve fitting were used to investigate the relationship between OBS and SAAC. The overall prevalence of severe abdominal aortic calcification disease was 9.1%. Multivariable logistic regression revealed that higher oxidative balance scores were associated with a lower risk of SAAC. After adjusting for potential confounders (model III), for every 1-point increase in oxidative balance scores, the odds of SAAC decreased by 3% [OR = 0.97, 95% CI= (0.95,0.99), P = 0.03]. The dose–response relationship demonstrated a negative correlation between oxidative balance scores and SAAC (p for nonlinear = 0.368). ConclusionsThis study reveals a negative association between oxidative balance scores and severe abdominal aortic calcification in US adults. The implications of these findings merit careful consideration and should be taken into account in the formulation of clinical guidelines and updates.

Associations between waist-to-height ratio and abdominal aortic calcification: A cross-sectional study.

Waist-to-height ratio (WtHR) is a validated biomarker of central obesity that appears to be preferable to other body composition measurements in the evaluation of cardiovascular disease. The goal of this research was to explore the connection between WtHR and abdominal aortic calcification (AAC) among adults. On the basis of data from the 2013 to 2014 National Health and Nutrition Examination Survey, multivariate logistic regression, sensitivity analysis, as well as smoothed curve fitting were used to evaluate the connection between WtHR and AAC. Subgroup analyses along with interaction tests were done to see if this link was consistent across populations. Among 3079 participants aged >40 years, there was a negative association between WtHR and ACC. Each 1-unit emergence of WtHR was related to a 2% reduction in the probability of severe AAC in the entirely adjusted model (odds ratio = 0.02, 95% confidence interval: [0.00-0.12]). Participants in the highest WtHR quartile were 39% less likely to acquire severe AAC compared with those in the lowest quartile. (odds ratio = 0.61, 95% confidence interval: [0.37-1.00]). This negative association was more pronounced in the diabetes subgroup. We discovered a reversed U-shaped association between WtHR as well as AAC score utilizing a 2-stage linear regression model, with an intersection point of 0.56. WtHR was negatively associated with AAC among US adults.

Association between Abdominal Aortic Calcification and Coronary Heart Disease in Essential Hypertension: A Cross-Sectional Study from the 2013-2014 National Health and Nutrition Examination Survey.

This study aimed to investigate the association between abdominal aortic calcification (AAC) and coronary heart disease (CHD) in essential hypertension (EH). This study included patients diagnosed with EH during the 2013-2014 NHANES survey cycle. The study cohort was categorized into the following four groups based on their AAC-24 score: no AAC (0); mild AAC (1-4); moderate AAC (5-15); and severe AAC (16-24). Logistic regression models were used to assess the association between AAC and CHD. Restricted cubic spline curves (RCS) were used to explore possible nonlinear relationships between AAC and CHD. The prevalence of CHD was found to be higher in the moderate AAC and severe AAC groups than in the group without AAC (40.1% versus 30.9%, 47.7% versus 30.9%). On a continuous scale, the fully adjusted model showed a 7% increase in the risk of CHD prevalence per score increase in AAC [OR (95% CI) = 1.07 (1.03-1.11)]. On a categorical scale, the fully adjusted model showed the risk of CHD prevalence in EH patients with moderate AAC and severe AAC was 2.06 (95%CI, 1.23-3.45) and 2.18 (1.09-5.25) times higher than that in patients without AAC, respectively. The RCS curve suggested a dose-response linear relationship between AAC and CHD. These findings highlight that in patients with EH, a higher severity of AAC is associated with a higher risk of CHD prevalence.

A cross-sectional study investigating the relationship between urinary albumin creatinine ratio and abdominal aortic calcification in adults.

The presence of abdominal aortic calcification (AAC) is strongly linked to the development of atherosclerosis and the incidence of morbidity and mortality related to cardiovascular diseases (CVD). Urinary albumin creatinine ratio (UACR) was found related with the increased risk of CVD. The aim of this study is to explore the relationship between the UACR and severe AAC (SAAC). This study included a total of 2,379 individuals aged over 40 years, and their information was obtained from the National Health and Nutrition Examination Survey conducted (NHANES) in 2013-2014. The measurement of AAC was conducted through dual-energy x-ray absorptiometry and assessed using the Kauppila scoring system. SAAC was characterized by a Kauppila score of 6 or higher. Multivariate regression models were used to analyze the relationship between UACR level and SAAC, with covariate adjustment. In the completely adapted model, the top third subgroup exhibits increased likelihood of SAAC (odds ratio 1.50; 95%CI: 0.98, 2.29; p = 0.030) in contrast to the bottom third subgroup. The subgroup analyses revealed a more pronounced correlation among the older participants (p-value for interaction = 0.013). In the United States, SAAC was more likely to occur in adults who had a higher probability of UACR. The use of UACR has the potential to be a valuable method for forecasting the likelihood of SAAC.

Association between dietary folate intake and severe abdominal aorta calcification in adults: A cross-sectional analysis of the national health and nutrition examination survey.

Prior studies have established a connection between folate intake and cardiovascular disease (CVD). Abdominal aortic calcification (AAC) has been introduced as a good predictor of CVD events, but no previous study has investigated the relationship between dietary folate intake and severe AAC. Therefore, the study aims to explore the association between dietary folate intake and severe AAC in the United States (US) middle-aged and elderly population. This study employed cross-sectional data from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) to examine the relationship between dietary folate intake and severe AAC. Two 24-h dietary recall interviews were conducted to assess dietary folate intake and its sources, while a DXA scan was used to determine the AAC score. To analyze the association between dietary folate intake and severe AAC, a multivariable logistic regression model was applied, and a subgroup analysis was performed. Our analysis utilized data from 2640 participants aged 40years and above, including 288 individuals diagnosed with severe AAC. After adjusting for confounding factors, we observed an inverted L-shaped association between folate intake and severe AAC. Upon further adjustment for specific confounding factors and covariates, the multivariable-adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the second, third, and fourth quartiles of folate intake, using the first quartile as the reference, were as follows: 1.24 (0.86-1.79), 0.86 (0.58-1.27), and 0.63 (0.41-0.97), respectively. Subgroup analysis results were consistent with the logistic regression models, indicating concordant findings. Moreover, no significant interaction was observed in the subgroup analyses. The study findings suggest an inverted L-shaped association between dietary folate intake and severe AAC. However, additional prospective investigations are necessary to explore the impact of dietary folate intake on severe AAC in patients.

Association between dietary carotenoid intakes and abdominal aortic calcification in adults: National Health and Nutrition Examination Survey 2013-2014.

Abdominal aortic calcification (AAC) is an important marker of subclinical atherosclerosis and a predictor of cardiovascular disease. This study aims to explore the association between carotenoid intakes and AAC. We included 2889 participants from the National Health and Nutrition Examination Survey (NHANES). Dietary carotenoid intakes were obtained through 24-h dietary recall interviews. Severe AAC was defined as a Kauppila score > 5. The main analysis utilizes logistic and restricted cubic spline models. Severe AAC was detected in 378 (13.08%) participants. In fully adjusted models, the odds ratios (OR) with 95% confidence intervals (CI) of α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein with zeaxanthin and total carotenoid intakes for individuals with severe AAC were 0.53 (0.23-0.77), 0.39 (0.19-0.80), 0.18 (0.05-0.62), 0.40 (0.20-0.78), 0.53 (0.32-0.88) and 0.38 (0.18-0.77) in the highest versus lowest quartile intake, respectively. Dose-response analyses revealed that all of the carotenoids were associated with decreased risk of severe AAC in a nonlinear trend. Total carotenoid intakes of at least 100ug/kg/day were associated with decreased odds for severe AAC. α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein with zeaxanthin and total carotenoids were inversely associated with the risk of severe AAC in adults.

Association between hemoglobin A1c and abdominal aortic calcification: results from the National Health and Nutrition Examination Survey 2013–2014

BackgroundHemoglobin A1c (HbA1c), a “gold standard” for the assessment of glycemic control, was associated with an increased risk of cardiovascular disease and coronary artery calcification. However, its effects on abdominal aortic calcification (AAC) are uncertain. The present study comprehensively investigated the association between HbA1c and AAC in the 2013–2014 National Health and Nutrition Examinations Surveys.MethodsAmong 1,799 participants ≥ 40 years, dual-energy X-ray absorptiometry-derived AAC was quantified using the Kauppila score (AAC-24). Severe AAC was defined as a total AAC-24 > 6. Weighted linear regression models and logistic regression models were used to determine the effects of HbA1c on AAC. The restricted cubic spline model was used for the dose-response analysis.ResultsThe mean AAC-24 of participants was 1.3, and 6.7% of them suffered from severe AAC. Both AAC-24 and the prevalence of severe AAC increased with the higher tertile of HbA1c (P < 0.001). Elevated HbA1c levels would increase the AAC-24 (β = 0.73, 95% CI: 0.30–1.16) and the risk of severe AAC (OR = 1.63, 95% CI: 1.29–2.06), resulting in nearly linear dose-response relationships in all participants. However, this positive correlation were not statistically significant when participants with diabetes were excluded. Furthermore, subgroup analysis showed significant interactions effect between HbA1c and hypertension on severe AAC with the OR (95% CI) of 2.35 (1.62–3.40) for normotensives and 1.39 (1.09–1.79) for hypertensives (P for interaction = 0.022).ConclusionControlling HbA1c could reduce AAC scores and the risk of severe AAC. Glycemic management might be a component of strategies for preventing AAC among all participants, especially normotensives.

Association between dietary calcium intake and severe abdominal aorta calcification among American adults: a cross-sectional analysis of the National Health and Nutrition Examination Survey.

Evidence regarding the relationship between dietary calcium intake and severe abdominal aortic calcification (AAC) is limited. Therefore, this study aimed to investigate the association between dietary calcium intake and severe AAC in American adults based on data from the National Health and Nutrition Examination Survey (NHANES). The present cross-sectional study utilized data from the NHANES 2013-2014, a population-based dataset. Dietary calcium intake was assessed using two 24-h dietary recall interviews. Quantification of the AAC scores was accomplished utilizing the Kauppila score system, whereby severe AAC was defined as having an AAC score greater than 6. We used multivariable logistic regression models, a restricted cubic spline analysis, and a two-piecewise linear regression model to show the effect of calcium intake on severe AAC. Out of the 2640 individuals examined, 10.9% had severe AAC. Following the adjustment for confounding variables, an independent association was discovered between an augmented intake of dietary calcium and the incidence of severe AAC. When comparing individuals in the second quartile (Q2) of dietary calcium intake with those in the lowest quartile (Q1), a decrease in the occurrence of severe AAC was observed (odds ratio: 0.66; 95% confidence interval: 0.44-0.99). Furthermore, the relationship between dietary calcium intake and severe AAC demonstrated an L-shaped pattern, with an inflection point observed at 907.259 mg/day. Subgroup analyses revealed no significant interaction effects. The study revealed that the relationship between dietary calcium intake and severe AAC in American adults is L-shaped, with an inflection point of 907.259 mg/day. Further research is required to confirm this association.

Association between dietary selenium intake and severe abdominal aortic calcification in the United States: a cross-sectional study.

Abdominal aortic calcification (AAC) is an important predictor of cardiovascular disease. The purpose of the current study was to detect the association between dietary selenium intake and severe AAC. We included 2651 participants from the National Health and Nutrition Examination Survey (NHANES, 2013-2014). Dietary selenium intake was measured using the 24-hour recall method. AAC was quantified using the Kauppila score system based on dual-energy X-ray absorptiometry, with a score of >6 indicating severe AAC. The association between dietary selenium intake and severe AAC was analyzed by using a weighted multivariate logistic regression model, smooth curve fitting, and stratified subgroup analysis. After adjusting for multiple covariates, we found that higher dietary selenium intake was negatively associated with severe AAC incidence. When selenium intake was converted into tertiles, the highest tertile of dietary selenium intake was significantly associated with the incidence of severe AAC (odds ratio = 0.66). Smooth curve fitting revealed that this relationship was nonlinear. Subgroup analysis revealed that this negative association was present in participants with chronic kidney disease, but was absent when participants had hypertension or diabetes mellitus. Higher dietary selenium intake was negatively associated with severe AAC incidence in a nonlinear pattern, except in participants with diabetes mellitus or hypertension. However, further cohort studies are required to validate these findings.

Relationship between Novel Anthropometric Indices and the Prevalence of Abdominal Aortic Calcification: A Large Cross-Sectional Study.

The relationship between novel anthropometric indices, specifically a body shape index (ABSI) and body roundness index (BRI), with abdominal aortic calcification (AAC) or severe AAC (SAAC) is unclear. The aim of our study was therefore to investigate possible relationships between novel anthropometric indices and prevalence of AAC and SAAC. We obtained U.S. general population data from the National Health and Nutrition Examination Survey between 2013 and 2014. The study used restricted cubic spline (RCS) analysis, multivariable logistic regression modeling, subgroup analysis, and receiver operating characteristic (ROC) curve assessment. We investigated relationships between ABSI or BRI and AAC and SAAC risk. Associations between ABSI or BRI and the degree of AAC were also evaluated using a generalized additive model. The study cohort was comprised of 1062 individuals. The RCS plots revealed a U-shaped curve associating ABSI with AAC risk. A similar trend emerged for SAAC, where the risk initially increased before subsequently decreasing with rising ABSI levels. Additionally, BRI exhibited a positive correlation with both AAC and SAAC risk. As ABSI and BRI values increased, the degree of AAC also increased. In ROC analysis, ABSI displayed a significantly larger area under the curve compared to BRI. ABSI is associated with AAC prevalence following a U-shaped curve. Additionally, BRI is positively correlated with AAC risk. ABSI demonstrates a superior discriminative ability for AAC compared to BRI. Therefore, maintaining an appropriate ABSI and BRI may reduce the prevalence of AAC.

Association between dietary total choline and abdominal aorta calcification among older US adults: A cross-sectional study of the National Health and Nutrition Examination Survey.

Numerous studies indicate a potential bidirectional association between dietary choline intake and its derivative, betaine, and subclinical atherosclerosis. However, little research has been conducted on the relationship between dietary choline and severe abdominal aortic calcification (SAAC). This cross-sectional study analyzed population-based data from the National Health and Nutrition Examination Survey (2013-2014). Choline intake and food sources were measured using two 24-h dietary-recall interviews. The abdominal aortic calcification score was measured using a dual-emission x-ray absorptiometry scan. To assess the relationship between choline intake and SAAC, the study utilized restricted cubic spline and a multivariable logistic regression model. Among the 2640 individuals included in the study, 10.9% had SAAC. After adjusting for all selected covariates, compared with the lowest quartile of dietary choline, the odds ratios of SAAC for the second-quartile, third-quartile, and fourth-quartile dietary choline intake were 0.63 (95% confidence interval [CI], 0.43-0.93), 0.63 (95% CI, 0.42-0.94), and 0.77 (95% CI, 0.5-1.16), respectively. The study found an L-shaped relationship between dietary choline and SAAC in the dose-response analysis. Subgroup analyses did not demonstrate any statistically significant interaction effects for any subgroup. The study found that a higher intake of dietary choline is associated with a lower prevalence of SAAC. The dose-response analysis revealed an L-shaped relationship between dietary choline and SAAC. However, further studies are warranted to investigate the direct role of choline in the development of SAAC.

Associations Between Life's Essential 8 and Abdominal Aortic Calcification Among Middle-Aged and Elderly Populations.

Abdominal aortic calcification (AAC) is an independent risk factor for cardiovascular disease. We aim to examine the associations between Life's Essential 8 (LE8), the recently updated measurement of cardiovascular health (CVH), and AAC among participants aged ≥40 years. This population-based cross-sectional study used data from the National Health and Nutrition Examination Survey in 2013 to 2014. AAC (AAC score>0) and severe AAC (AAC score>6) were quantified by the Kauppila score system. Multiple linear, multivariable logistic, and restricted cubic spline models were used to assess the associations. A total of 2369 participants were included with a mean AAC score of 1.41 (0.13). Participants in the high-cardiovascular-health group had lower AAC scores, lower prevalence of AAC, and lower prevalence of severe AAC. After the adjustment of potential confounders (age, sex, race and ethnicity, education levels, marital status, poverty income ratio, estimated glomerular filtration rate, serum creatinine, serum uric acid, serum phosphorus, and serum total calcium), higher cardiovascular health was significantly associated with lower risk of AAC. Meanwhile, elevated nicotine exposure score, blood glucose score, and blood pressure score within the LE8 components were significantly associated with lower risk of AAC. Also, nonlinear dose-response relationships were observed. Subgroup analyses (age strata, sex, poverty income ratio, education levels, marital status) indicated the inverse associations of LE8 and AAC were generally similar in different populations. LE8 was negatively and nonlinearly related to the risk of AAC among middle-aged and older populations. Meanwhile, LE8 components should prioritize higher scores for nicotine exposure, blood glucose, and blood pressure evaluations.

Blood urea nitrogen concentration is associated with severe abdominal aortic calcification in adults: a cross-sectional investigation

The purpose of this research is to examine the correlation between blood urea nitrogen (BUN) and severe abdominal aortic calcification (AAC) among American adults aged 40 years and older. A total of 2757 participants in the NHANES from 2013 to 2014 were included in the final analysis. BUN was measured by means of the enzymatic conductivity rate method. AAC scores were quantified by the Kauppila scoring system, and severe AAC was defined as an AAC score ≥ 6. Multivariable logistic regression and restricted cubic splines were used in the analyses. In the multivariable logistic regression model, the highest BUN level (log 2-transformed) was associated with an increased risk of severe AAC [odds ratio (OR) = 1.77, 95% CI 1.17, 2.71]. The restricted cubic spline plot displayed a reverse l-shaped association between BUN (log2-transformed) and severe AAC (p for nonlinearity < 0.001). In addition,the interactions of BUN were not discover. In general, there is a positive correlation between BUN and the risk of severe AAC.

Abstract 18786: The Association Between Aortic Abdomen Calcification, Systemic Immune Inflammation Index, Estimated Pulse Wave Velocity, Atherogenic Index of Plasma and Triglyceride-Glucose Index Among Non-Diabetic Patients: A NHANES 2013-2014 Cross Sectional Study

Background: Not enough studies showed the predictive value of systemic immune inflammation (SII) index, estimated pulse wave velocity (EPWV) index, atherogenic index of plasma (AIP) and triglyceride glucose (TyG) index for developing abdominal aortic calcification (AAC). This study assesses the relationship between the previous indexes and the risk of AAC. Methods: National Health and Nutrition Examination Survey (NHANES) data was utilized. The study included data from 2013 to 2014. We included non-diabetic participants aged 18 years or older. All studied indexes were divided into four quartiles, except AIP, into two categories. SPSS was used for the analysis. The sensitivity and specificity of the included indexes in predicting AAC were calculated by receiver operating characteristic (ROC) analysis. We performed univariate and multivariate logistic regression to analyze the associated factors with higher values of studied indexes. Results: The analysis included 1315 non-diabetic patients, of which 324 had AAC, and 74 had severe AAC. Except for SII index, all indexes showed a statistically significant association with the presence of AAC (P &lt; 0.05). AAC was more prevalent among patients in the third and fourth quartiles of all Triglyceride-Glucose Index models, p-value&lt;0.05. Participants in the second quartile of the AIP were more likely to be affected by AAC, p-value&lt;0.05. In addition, all unadjusted regression models showed that higher values of the inquired indexes were significantly associated with the risk of abdominal aortic calcification. The areas under the curve (AUC) for TyG index, AIP, and EPWV were 0.558 (95% CI 0.52-0.59), 0.551(95% CI 0.51- 0.58), 0.692 (95% CI 0.65- 0.72) (p-value ≤ 0.05), respectively. Conclusion: Among all involved indexes, the estimated pulse wave velocity index was the best indicator for abdominal aortic calcification.

Association of abdominal aortic calcification and lower back pain in patients with degenerative spondylolisthesis.

Abdominal aortic calcification (AAC) is hypothesized to lead to ischemic pain of the lower back. This retrospective study aims to identify the relationship between AAC and lower back pain (LBP) in patients with degenerative lumbar spondylolisthesis. Lower back pain was assessed preoperatively and 2 years after surgery using the numeric analogue scale. Abdominal aortic calcification was assessed according to the Kauppila classification and was grouped into no, moderate, and severe. A multivariable regression, adjusted for age, sex, body mass index, hypertension, and smoking status, was used to assess the association between AAC and preoperative/postoperative LBP as well as change in LBP after surgery. A total of 262 patients were included in the final analysis. The multivariable logistic regression demonstrated an increased odds ratio (OR) for preoperative LBP ≥ 4 numeric analogue scale (OR = 9.49, 95% confidence interval [CI]: 2.71-40.59, P < 0.001) and postoperative LBP ≥ 4 (OR = 1.72, 95% CI: 0.92-3.21, P = 0.008) in patients with severe AAC compared with patients with no AAC. Both moderate and severe AAC were associated with reduced improvement in LBP after surgery (moderate AAC: OR = 0.44, 95% CI: 0.22-0.85, P = 0.016; severe AAC: OR = 0.41, 95% CI: 0.2-0.82, P = 0.012). This study demonstrates an independent association between AAC and LBP and reduced improvement after surgery. Evaluation of AAC could play a role in patient education and might be considered part of the differential diagnosis for LBP, although further prospective studies are needed.

Accelerated Bone Loss in Older Men With Severe Abdominal Aortic Calcification-the Prospective MINOS Study.

Data on the association between the severity of abdominal aortic calcification (AAC) and bone loss are discordant. Our aim was to assess the association between baseline AAC and prospectively assessed bone loss in older men. This prospective cohort study started in 1995 (MINOS). Men aged 50 to 85 years (n = 778) had AAC assessed on the lateral radiograph of the spine using Kauppila's semiquantitative score and was followed prospectively for 7.5 years. Bone mineral density (BMD) and bone mineral content (BMC) were measured by dual-energy x-ray absorptiometry every 18 months. Statistical analysis was performed using linear mixed models. In comparison to men without AAC (AAC = 0), severe AAC (>6) was associated with more rapid bone loss at the total hip (-0.62 ± 0.06 vs -0.32 ± 0.04%/year; P < .001), trochanter, and distal forearm (-0.72 ± 0.06 vs -0.45 ± 0.03%/year; P < .001). The highest decile (AAC >10) was associated with more rapid bone loss at the femoral neck, whole body, and ultradistal radius (-0.86 ± 0.12 vs -0.34 ± 0.05%/year; P < .001). The results were similar for BMD and for BMC. The patterns were similar in sensitivity analyses (eg, after excluding men with abdominal obesity, after excluding current smokers, after excluding men with ischemic heart disease or with diabetes mellitus, after excluding men with abnormal concentrations of lipids, bioavailable 17β-estradiol or 25-hydroxycholecalciferol, after excluding men with glomerular filtration rate <60 mL/min). Severe AAC is associated with faster bone loss in older men and may contribute to the higher fracture risk observed in this population.