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Abstract: FR-PO823

Association of Weight-Adjusted Waist Index with Abdominal Aorta Calcification and Mortality in Hemodialysis Patients

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1500 Health Maintenance, Nutrition, and Metabolism

Authors

  • Huang, Jiun-Chi, Brigham and Women's Hospital, Boston, United States
  • Wu, Pei-Yu, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
  • Chen, Szu-Chia, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
  • Chang, Jer-Ming, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Taiwan
Background

Weight-adjusted-waist index (WWI) is a novel indicator of central obesity, and is associated with abdominal aortic calcification (AAC) and mortality in the general population. However, obesity paradox has been described in patients with kidney disease. The association of WWI with AAC and mortality remains uncertain in hemodialysis (HD) patients.

Methods

This study included 161 patients on maintenance HD >3 months. WWI was determined as waist circumference divided by the square root of weight. Severity of AAC was quantified by the AAC score measured from lateral lumber radiography. The association between WWI and moderate or severe AAC was examined using logistic regression analysis. Cox regression analysis was performed to investigate the association of WWI with all-cause mortality. The area under the receiver operating characteristic curve (AUC) was used to compare the ability of WWI and other obesity indices to predict AAC and mortality.

Results

We found 103 HD patients had moderate or severe AAC. During a median follow-up of 5.0 years, 50 deaths occurred. In multiple logistic regression, the highest WWI category (3rd tertile >11.40 cm/√kg) (OR=4.38, 95% CI: 1.39−13.78, p=0.012) was associated with moderate or severe AAC. Compared to the lowest WWI category, 2nd tertile WWI (10.76−11.39 cm/√kg) (HR=3.25, 95% CI: 1.18−8.93, p=0.022) was significantly associated with increased risk of all-cause mortality in multivariate-adjusted Cox analysis. Furthermore, WWI had the greatest AUC for predicting moderate or severe AAC (AUC=0.713) and all-cause mortality (AUC=0.667) when compared with body mass index, waist circumference, hip circumference, and waist-to-hip ratio.

Conclusion

These findings indicated that WWI may serve a valuable indicator for identifying moderate or severe AAC and predicting mortality among maintenance HD patients.

Area under ROC curves of different obesity indices for predicting (A) moderate or severe AAC and (B) all-cause mortality