# Associations between visceral adipose and renal artery calcification: Results from the multi-ethnic study of atherosclerosis

## TL;DR

The study finds that the amount of visceral fat is linked to the severity of kidney artery calcification, but not its presence, suggesting new ways to study fat's role in disease.

## Contribution

This is the first study to describe the relationship between visceral adipose tissue and renal artery calcification.

## Key findings

- VAT area is significantly associated with RAC severity among those with RAC > 0.
- VAT area is not associated with RAC presence.
- VAT density is not significantly associated with RAC presence or severity.

## Abstract

What is already known about this subject?.•Visceral adipose tissue has been associated with higher levels of atherosclerosis.•Renal artery calcification secondary to atherosclerosis has been found to be associated with an increase in all-cause mortality.What are the new findings in your manuscript?.•Presence of renal artery calcification may be associated with low density visceral adipose.•Severity of renal artery calcification is associated with high visceral adipose area.How might your results change the direction of research or the focus of clinical practice?.•Research on visceral adiposity should include measures of adipose density in addition to adipose area as the two may have inverse associations with outcomes.

What is already known about this subject?.

Visceral adipose tissue has been associated with higher levels of atherosclerosis.

Renal artery calcification secondary to atherosclerosis has been found to be associated with an increase in all-cause mortality.

What are the new findings in your manuscript?.

Presence of renal artery calcification may be associated with low density visceral adipose.

Severity of renal artery calcification is associated with high visceral adipose area.

How might your results change the direction of research or the focus of clinical practice?.

Research on visceral adiposity should include measures of adipose density in addition to adipose area as the two may have inverse associations with outcomes.

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 an increase in all-cause mortality.

1 978 participants underwent CT imaging to measure VAT and RAC. 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.

1 196 participants had complete VAT and RAC measurements. In adjusted models, 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 inversely, but not significantly, associated with RAC presence (PR 0.89, 95 % CI 0.78, 1.02, p = 0.10). Among 354 participants with RAC > 0, 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 (slope 9.78, 95 % CI -40.87, 60.44, p = 0.71).

VAT area and density are not significantly associated with RAC presence, while greater VAT area is significantly associated with RAC severity among those with RAC > 0. Our results are the first describing the relationship between VAT and RAC, and are in contrast to previous literature demonstrating a significant association between VAT and coronary artery calcification.

Image, graphical abstract