Key result
Extensive abdominal aortic calcification is linked to ~59% higher odds of rapid weight loss.
Why the study?
Abdominal aortic calcification is linked to vascular disease in other beds including gastrointestinal arteries, but whether it relates to rapid weight loss and subsequent mortality was unclear.
Is the extent of abdominal aortic calcification associated with a greater risk of incident rapid weight loss over 5 years and subsequent all-cause mortality in community-dwelling older women?
Cohort (n=929)
Blinded DXA image scoring
No
Is the extent of abdominal aortic calcification associated with a greater risk of incident rapid weight loss over 5 years and subsequent all-cause mortality in community-dwelling older women?
Moderate and extensive abdominal aortic calcification detected on routine bone density lateral spine images independently identifies older women at increased risk for rapid weight loss over 5 years, which in turn predicts higher 9.5-year all-cause and cardiovascular mortality.
May prompt weight monitoring in older women with extensive AAC; leaves open causal links and need for prospective trials.
BACKGROUND: Abdominal aortic calcification (AAC), a marker of vascular disease, is associated with disease in other vascular beds including gastrointestinal arteries. We investigated whether AAC is related to rapid weight loss over 5 years and whether rapid weight loss is associated with 9.5-year all-cause mortality in community-dwelling older women. METHODS: Lateral spine images from dual-energy x-ray absorptiometry (1998/1999) were used to assess AAC (24-point AAC scoring method) in 929 older women. Over 5 years, body weight was assessed at 12-month intervals. Rapid weight loss was defined as >5% decrease in body weight within any 12-month interval. Multivariable-adjusted logistic regression was used to assess AAC and rapid weight loss and Cox regression to assess the relationship between rapid weight loss and 9.5-year all-cause mortality. RESULTS: Mean±SD age of women was 75.0±2.6 years. During the initial 5 years, 366 (39%) women presented with rapid weight loss. Compared with women with low AAC (24-point AAC score 0–1), those with moderate (24-point AAC score 2–5: odds ratio, 1.36 [95% CI, 1.00–1.85]) and extensive (24-point AAC score 6+: odds ratio, 1.59 [95% CI, 1.10–2.31]) AAC had higher odds for presenting with rapid weight loss. Results remained similar after further adjustment for dietary factors (alcohol, protein, fat, and carbohydrates), diet quality, blood pressure, and cholesterol measures. The estimates were similar in subgroups of women who met protein intake (n=599) and physical activity (n=735) recommendations (extensive AAC: odds ratios, 1.81 [95% CI, 1.12–2.92] and 1.58 [95% CI, 1.02–2.44], respectively). Rapid weight loss was associated with all-cause mortality over the next 9.5 years (hazard ratio, 1.49 [95% CI, 1.17–1.89]; P =0.001). CONCLUSIONS: AAC extent was associated with greater risk for rapid weight loss over 5 years in older women, a risk for all-cause mortality. Since the association was unchanged after taking nutritional intakes into account, these data support the possibility that vascular disease may play a role in the maintenance of body weight.
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Smith et al. (2023) conducted a cohort in Abdominal aortic calcification and incident rapid weight loss (n=929). Extensive abdominal aortic calcification (24-point AAC score ≥6) and moderate AAC (score 2-5) vs. Low abdominal aortic calcification (24-point AAC score 0-1) was evaluated on Incident rapid weight loss (>5% decrease in body weight within any 12-month interval over 5 years) (OR 1.59, 95% CI 1.10-2.31). Extensive abdominal aortic calcification (AAC-24 score ≥6) was associated with higher odds of incident rapid weight loss over 5 years compared to low AAC (OR 1.59, 95% CI 1.10-2.31) in older women.
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