2
|
Nishizawa A, Suemoto CK, Farias-Itao DS, Campos FM, Silva KCS, Bittencourt MS, Grinberg LT, Leite REP, Ferretti-Rebustini REL, Farfel JM, Jacob-Filho W, Pasqualucci CA. Morphometric measurements of systemic atherosclerosis and visceral fat: Evidence from an autopsy study. PLoS One 2017; 12:e0186630. [PMID: 29036197 PMCID: PMC5643130 DOI: 10.1371/journal.pone.0186630] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 10/04/2017] [Indexed: 01/21/2023] Open
Abstract
Background Morphometric measurements of systemic atherosclerosis and direct quantification of visceral fat are only possible using materials from autopsy studies. However, the few autopsy studies that have investigated the association of visceral fat with atherosclerosis had small sample sizes and focused on coronary arteries of young or middle-aged White subjects. We aimed to investigate the association of pericardial fat (PF) and abdominal visceral fat (AVF) with atherosclerosis in the aorta, coronary, carotid, and cerebral arteries in a large autopsy study. Materials and methods We evaluated deceased subjects aged 30 years or above. We dissected and weighted the PF and the AVF and evaluated the atherosclerotic burden in the aorta, as well as the carotid, coronary, and cerebral arteries using morphometric measurements. We also investigated the interaction of PF and AVF with age regarding the atherosclerotic burden. Results The mean age of the 240 included subjects was 64.8±15.3 years, and 63% was male. Greater PF was associated with a higher degree of aortic atherosclerosis after adjusting for confounding variables (coefficient = 4.39, 95% CI = 0.83; 7.94, p = 0.02). Greater AVF was associated with a higher coronary stenosis index (coefficient = 1.49, 95% CI = 0.15; 2.83, p = 0.03) and a greater number of coronary plaques (coefficient = 0.71, 95% CI = 0.24; 1.19, p = 0.003). We did not find an association of PF or AVF with carotid or cerebral atherosclerotic burden. We found a significant interaction of AVF (coefficient = -0.08; 95% CI = -0.14; -0.02, p = 0.009) and PF (coefficient = -0.87, 95% CI = -1.70; -0.04, p = 0.04) with age regarding carotid artery atherosclerotic burden. Conclusions Greater AVF was associated with greater atherosclerotic burden and extent in coronary arteries, while greater PF correlated with a higher degree of atherosclerosis in the aorta.
Collapse
Affiliation(s)
- Aline Nishizawa
- Laboratory of Cardiovascular Pathology (LIM-22), Department of Pathology, University of Sao Paulo Medical School, Sao Paulo, Brazil
- Pathophysiology in Aging Lab/Brazilian Aging Brain Study Group (LIM-22), University of Sao Paulo Medical School, Sao Paulo, Brazil
- * E-mail:
| | - Claudia K. Suemoto
- Laboratory of Cardiovascular Pathology (LIM-22), Department of Pathology, University of Sao Paulo Medical School, Sao Paulo, Brazil
- Pathophysiology in Aging Lab/Brazilian Aging Brain Study Group (LIM-22), University of Sao Paulo Medical School, Sao Paulo, Brazil
- Discipline of Geriatrics, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Daniela S. Farias-Itao
- Laboratory of Cardiovascular Pathology (LIM-22), Department of Pathology, University of Sao Paulo Medical School, Sao Paulo, Brazil
- Pathophysiology in Aging Lab/Brazilian Aging Brain Study Group (LIM-22), University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Fernanda M. Campos
- Laboratory of Cardiovascular Pathology (LIM-22), Department of Pathology, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Karen C. S. Silva
- Laboratory of Cardiovascular Pathology (LIM-22), Department of Pathology, University of Sao Paulo Medical School, Sao Paulo, Brazil
- Pathophysiology in Aging Lab/Brazilian Aging Brain Study Group (LIM-22), University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Marcio S. Bittencourt
- Division of Internal Medicine, University Hospital and State of São Paulo Cancer Institute (ICESP), University of São Paulo, Sao Paulo, Brazil
- Preventive Medicine Center, Hospital Israelita Albert Einstein and School of Medicine, Faculdade Israelita de Ciência da Saúde Albert Einstein, São Paulo, Brazil
| | - Lea T. Grinberg
- Pathophysiology in Aging Lab/Brazilian Aging Brain Study Group (LIM-22), University of Sao Paulo Medical School, Sao Paulo, Brazil
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, United States of America
- Department of Pathology, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Renata E. P. Leite
- Pathophysiology in Aging Lab/Brazilian Aging Brain Study Group (LIM-22), University of Sao Paulo Medical School, Sao Paulo, Brazil
- Discipline of Geriatrics, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Renata E. L. Ferretti-Rebustini
- Pathophysiology in Aging Lab/Brazilian Aging Brain Study Group (LIM-22), University of Sao Paulo Medical School, Sao Paulo, Brazil
- Department of Medical Surgical Nursing, University of São Paulo Nursing School, Sao Paulo, Brazil
| | - Jose M. Farfel
- Pathophysiology in Aging Lab/Brazilian Aging Brain Study Group (LIM-22), University of Sao Paulo Medical School, Sao Paulo, Brazil
- Discipline of Geriatrics, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Wilson Jacob-Filho
- Pathophysiology in Aging Lab/Brazilian Aging Brain Study Group (LIM-22), University of Sao Paulo Medical School, Sao Paulo, Brazil
- Discipline of Geriatrics, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Carlos A. Pasqualucci
- Laboratory of Cardiovascular Pathology (LIM-22), Department of Pathology, University of Sao Paulo Medical School, Sao Paulo, Brazil
- Pathophysiology in Aging Lab/Brazilian Aging Brain Study Group (LIM-22), University of Sao Paulo Medical School, Sao Paulo, Brazil
- Department of Pathology, University of Sao Paulo Medical School, Sao Paulo, Brazil
| |
Collapse
|
3
|
Patel ND, Ward RD, Calle J, Remer EM, Monga M. Vascular Disease and Kidney Stones: Abdominal Aortic Calcifications Are Associated with Low Urine pH and Hypocitraturia. J Endourol 2017; 31:956-961. [PMID: 28605936 DOI: 10.1089/end.2017.0350] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE Vascular calcifications are associated with nephrolithiasis. Although studies have demonstrated correlations with vascular disease and calcium stones in kidney stone formers (KSF), an etiologic link has remained elusive. As a noncontrast CT (NCCT) scan is typically part of a stone evaluation, our objective was to evaluate the association of NCCT-based assessment of abdominal aortic calcifications (AACs) with 24-hour urine parameters and stone composition. MATERIALS AND METHODS Ninety-seven KSF were included with CT imaging and 24-hour urine studies. For each patient, semi-automated CT software was utilized to provide an AAC Agatston score from the celiac axis to the aortic bifurcation. Univariate analysis was performed to compare patients with or without AAC. Multivariate logistic regression was performed to assess for variables associated with 24-hour urine parameters and stone composition. RESULTS The presence of AAC was associated with hypertension, diabetes, peripheral vascular disease, and coronary artery disease. Patients with any AAC showed lower 24-hour urine citrate (399 vs 593 mg/day, p < 0.001) and lower 24-hour urine pH (5.862 vs 6.328, p = 0.003). When controlling for age, system comorbidities, the presence of AAC was associated with low urine pH <6 (odds ratio [OR] 2.86, p = 0.032) and hypocitraturia <320 mg/day (OR 4.37, p = 0.005). The receiver operating characteristic curve showed that increasing AAC was associated with low urine pH (area under the curve [AUC] 0.683, p = 0.002) and uric acid stone formation (AUC 0.698, p = 0.045). CONCLUSIONS NCCT-based diagnosis of AAC is associated with low urine pH, hypocitraturia, and uric acid stone formation. The presence of AAC could be considered an additional prognosticator for the utility of alkalinization therapy.
Collapse
Affiliation(s)
- Nishant D Patel
- 1 Department of Urology, Glickman Urology and Kidney Institute , Cleveland Clinic Foundation, Cleveland, Ohio
| | - Ryan D Ward
- 2 Imaging Institute , Cleveland Clinic Foundation, Cleveland, Ohio
| | - Juan Calle
- 1 Department of Urology, Glickman Urology and Kidney Institute , Cleveland Clinic Foundation, Cleveland, Ohio
| | - Erick M Remer
- 2 Imaging Institute , Cleveland Clinic Foundation, Cleveland, Ohio
| | - Manoj Monga
- 1 Department of Urology, Glickman Urology and Kidney Institute , Cleveland Clinic Foundation, Cleveland, Ohio
| |
Collapse
|