title: Pericardial fat is associated with coronary artery calcification in non-dialysis dependent chronic kidney disease patients.
abstract: Pericardial fat (PF) a component of visceral adipose tissue has been consistently related to coronary atherosclerosis in the general population. This study evaluated the association between PF and coronary artery calcification (CAC) in non-dialysis dependent chronic kidney disease (CKD) patients. This is a post-hoc cross sectional analysis of the baseline of a prospective cohort of 117 outward CKD patients without manifest coronary artery disease (age, 56.9 ± 11.0 years, 64.1% males, 95.1% hypertensives, 25.2% diabetics, 15.5% ever smokers, CKD stage 2 to 5 with estimated glomerular filtration rate 36.8 ± 18.1 ml/min). CAC scores, PF volume and abdominal visceral fat (AVF) areas were measured by computed tomography. The association of PF as a continuous variable with the presence of CAC was analyzed by multivariate logistic regression. CAC (calcium score > 0) was present in 59.2% patients. Those presenting CAC were on average 10 years older, had a higher proportion of male gender (78.7% vs. 42.9%, p < 0.001), and had higher values of waist circumference (95.9 ± 10.7 vs. 90.2 ± 13.2 cm, p = 0.02), PF volumes (224.8 ± 107.6 vs. 139.1 ± 85.0 cm3, p<0.01) and AVF areas (109.2 ± 81.5 vs. 70.2 ± 62.9 cm2, p = 0.01). In the multivariate analysis, adjusting for age, gender, diabetes, smoking and, left ventricular concentric hypertrophy, PF was significantly associated with the presence of CAC (OR: 1.88 95% CI: 1.03-3.43 per standard deviation). PF remained associated with CAC even with additional adjustments for estimated glomerular filtration rate or serum phosphorus (OR: 1.85 95% CI: 1.00-3.42, p = 0.05). PF is independently associated with CAC in non-dialysis dependent CKD patients.
authors.affiliation: Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Paulo H N
authors.initials: PH
authors.lastname: Harada
authors.affiliation: Nephrology Division, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Maria E
authors.initials: ME
authors.lastname: Canziani
authors.affiliation: Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Leonardo M
authors.initials: LM
authors.lastname: Lima
authors.affiliation: Nephrology Division, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Maria
authors.initials: M
authors.lastname: Kamimura
authors.affiliation: Cardiovascular Magnetic Resonance and Computed Tomography Sector, Heart Institute (InCor) University of São Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Rochitte
authors.affiliation: Nephrology Division, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Marcelo M
authors.initials: MM
authors.lastname: Lemos
authors.affiliation: Nephrology Division, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Lilian
authors.initials: L
authors.lastname: Cuppari
authors.affiliation: Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Roberto
authors.initials: R
authors.lastname: Kalil Filho
authors.affiliation: Nephrology Division, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Sergio A
authors.initials: SA
authors.lastname: Draibe
authors.affiliation: Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Raul D
authors.initials: RD
authors.lastname: Santos
mesh_terms: D000273:Adipose Tissue; D000328:Adult; D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging / Q000503:physiopathology; D011446:Prospective Studies; D011859:Radiography; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D012727:Sex Characteristics; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology