双能X线吸收法测量的内脏脂肪面积与维持性血液透析患者冠状动脉钙化严重程度的关系OA

Objective To investigate the relationship between visceral fat area(VFA)measured by dual-energy X-ray absorptiometry(DXA)and coronary artery calcification(CAC)severity in ma-intenance hemodialysis(MHD)patients.Methods A total of 283 MHD patients who underwent DXA body composition assessment and coronary artery calcium score(CACS)evaluation were enrolled.Patients were divided into low calcification group(CACS＜100,n=107)and high calcification group(CACS 100,n=176)according to CACS.General characteristics,laboratory results,and body composi-tion parameters were compared between the two groups.Univariate and multivariate Logistic regres-sion models were used to analyze influencing factors of high calcification degree(CACS ≥100).Re-ceiver operating characteristic(ROC)curves were plotted,and the area under the curve(AUC)was calculated to evaluate the predictive performance of independent influencing factors.Results The high calcification group had significantly higher male proportion,age,dialysis vintage,VFA,total body fat percentage,and trunk-to-hip fat ratio(A/G)than the low calcification group(P＜0.05).Univariate Logistic regression analysis showed that sex(OR=1.810,95％CI,1.103 to 2.971,P=0.019),age(OR=1.067,95％CI,1.044 to 1.091,P＜0.001),dialysis vintage(OR=1.011,95％CI,1.006 to 1.015,P＜0.001),VFA(OR=1.029,95％CI,1.021 to 1.036,P＜0.001),total body fat percentage(OR=1.132,95％CI,1.094 to 1.172,P＜0.001),and A/G(OR=35.575,95％CI,13.173 to 96.074,P＜0.001)were all influencing factors for high cal-cification degree.Multivariate Logistic regression analysis revealed that sex(OR=3.141,95％CI,1.231 to 8.015,P=0.017),dialysis vintage(OR=1.008,95％CI,1.003 to 1.013,P=0.003),VFA(OR=1.016,95％CI,1.002 to 1.030,P=0.028),and total body fat percentage(OR=1.089,95％CI,1.015 to 1.167,P=0.017)were independent influencing factors.ROC curve analysis showed that AUC of VFA in predicting high calcification degree was 0.827(95％CI,0.778 to 0.876,P＜0.001),with an optimal cutoff value of 125.1 cm2,a sensitivity of 71.6％,and a specificity of 80.4％.The combined model of sex,dialysis vintage,VFA,and total body fat percentage achieved an AUC of 0.861(95％CI,0.817 to 0.904),and was better than any single indicator.Conclusion VFA measured by DXA is positively correlated with CAC severity in MHD patients.Elevated VFA is an independent risk factor for high calcification degree(CACS≥100).DXA-measured VFA may serve as a novel auxiliary indicator for cardiovascular risk assessment in MHD patients.