title: Increased visceral adiposity is associated with coronary artery calcification in male patients with chronic kidney disease.
abstract: OBJECTIVE
  Recent epidemiological data have shown that abdominal fat accumulation is associated with increased risk of cardiovascular events in patients with chronic kidney disease (CKD). This study aimed to investigate the association between visceral adiposity and coronary artery calcification (CAC) in CKD patients.
  
  
  METHODS
  Cross-sectional study with 65 nondialyzed CKD male patients (59 ± 9 years, CKD stages 3 and 4). Abdominal fat compartments were assessed by computed tomography (CT) at L4-L5 level. Visceral to subcutaneous (V/S) fat ratio was calculated. Visceral obesity was defined as a V/S fat ratio greater than the median value of the sample study (>0.55). CAC was detected by multi-slice CT. CAC scores were calculated with the Agatston method.
  
  
  RESULTS
  CAC was present (calcium score >10 AU) in 66% of patients. In the group with visceral obesity, the CAC score was significantly higher. This group had lower adiponectin and higher leptin levels compared to patients without visceral obesity. In the whole sample, higher V/S fat ratio was associated with CAC score, independently of age, body mass index, diabetes, ionized calcium, smoking or renal function.
  
  
  CONCLUSIONS
  Our results show an association between visceral obesity and CAC in CKD patients, suggesting a deleterious effect of visceral fat in these patients. Increased visceral adiposity might enhance cardiovascular risk in this particular population.
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: C
authors.initials: C
authors.lastname: Aoqui
authors.forename: L
authors.initials: L
authors.lastname: Cuppari
authors.forename: M A
authors.initials: MA
authors.lastname: Kamimura
authors.forename: M E F
authors.initials: ME
authors.lastname: Canziani
mesh_terms: D050154:Adiposity; D000368:Aged; D015415:Biomarkers; D001837:Body Weights and Measures; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D006785:Hospitals, University; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications* / Q000000981:diagnostic imaging; D010044:Outpatient Clinics, Hospital; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology
chemical_list: D015415:Biomarkers