Relationship between visceral fat area,coronary artery calcification score and prognosis of hemodialysis patients

Objective To explore the relationship between visceral fat area (VFA),coronary artery calcification score (CACs) and clinical prognosis of maintenance hemodialysis (MHD) patients.Methods From January 2018 to January 2019,a total of 120 hospitalized MHD patients were recruited as research subjects.Baseline VFA was detected by bioelectrical impedance analysis and baseline CACs were calculated by multi-slice spiral CT scanning and Agatston scoring method.They were divided according to the optical cut-off.Area under curve (AUC) values of VFA/CACs in predicting cardiovascular events (CVEs) were analyzed by receiver operating curve (ROC).CVEs,cardiovascular death (CVD),all-cause mortality rate and cumulative incidence of CVEs were compared between two groups.Finally,the risk factors of CVEs,CVD and all-cause mortality were screened by multivariate Cox regression analysis.Results ROC indicated that AUC values of VFA/CACs in predicting CVEs were 0.82 and 0.73 respectively (P<0.05) and the cut-offs 108.6 and 73.6 cm².They were divided into CACs ≥ 108.6 (n=45) and <108.6 (n=75),VFA ≥ 73.6 cm² (n=56) and <73.6 cm² (n=64).Compared with CACs<108.6 group,age of patients was older in CACs ≥ 108.6 group,dialysis time longer and diabetes rate higher.Also CVEs,CVD and all-cause mortality rate were greater too (P<0.05).Compared with VFA< 73.6 cm² group,age of patients was older,dialysis time longer and diabetes rate higher in VFA ≥ 73.6 cm² group.And CVEs,CVD and all-cause mortality rate were greater too (P<0.05).Kaplan-Meier survival analysis indicated that the cumulative survival rate of CVEs in CACs ≥ 108.6 group was lower than that in CACs<108.6 group and VFA ≥ 73.6 cm² group was lower than that in VFA< 73.6 cm² group (P<0.05).Cox regression analysis revealed that VFA ≥ 73.6 cm² was a risk factor for CVEs,CVD and all-cause death (P<0.05).Conclusion VFA is more closely correlated with the elevations of CVEs,CVD and all-cause mortality in MHD patients than CACs.It suggests that early monitoring of VFA should be strengthened.Limited by sample size and observation time,the results should be further validated.