Prevalence and risk factors for the development of abdominal aortic calcification among the US population: NHANES study
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Department of Internal Medicine, St Mary’s Medical Center, Huntington, USA
Department of Internal Medicine, Interfaith Medical Center, Brooklyn NY, USA
Department of Medicine, Deccan College of Medical Sciences, Hyderabad, India
Allegheny Health Network, Pittsburgh, USA
Henry Ford Health System, Detroit, MI, USA
Department of Cardiology, Marshall University, Huntington, WV, USA
Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA
Submission date: 2020-12-15
Acceptance date: 2021-01-07
Publication date: 2021-04-20
Arch Med Sci Atheroscler Dis 2021;6(1):95–101
Abdominal aortic calcification (AAC) is an important marker of subclinical cardiovascular disease and its prognosis. Advanced age, hypertension, smoking, dyslipidemia, diabetes mellitus, and higher truncal fat are known markers of AAC in studies conducted around the world. However, literature for these risk factors and their co-occurrence is limited in the US.

Material and methods:
We used data from dual energy X-ray absorptiometry (Hologic, v4.0) to detect the occurrence of AAC in a sample population (n = 3140) of the NHANES survey using a computer-assisted interviewing system to assess the risk factors for AAC.

We found the national prevalence of AAC in the US to be 28.8%. After adjusting for confounders, persons with hypertension: OR = 1.66 (95% CI: 1.30–2.13) and smokers: OR = 1.63 (95% CI: 1.24–2.14) were more likely to have AAC compared to their respective counterparts. Increasing age was positively associated with AAC: OR = 1.06 (95% CI: 1.04–1.08). There was a statistically significant negative association between body mass index (BMI) and AAC, more so in smokers than in non-smokers: OR = 0.97 (95% CI: 0.94–0.97). We did not observe any statistically significant association between diabetes and AAC.

Advanced age, smoking, and hypertension was associated with increased occurrence of AAC. Paradoxically, increasing BMI was inversely associated with AAC and there was no statistically significant association between total body and trunk fat percentages and AAC. To the best of our knowledge, this is the first study to establish the nationwide prevalence and associated factors in the US.