Extent of Abdominal Aortic Calcification Is Associated With Incident Rapid Weight Loss Over 5 Years: The Perth Longitudinal Study of Ageing Women

Cassandra Smith; Marc Sim; Jack Dalla Via; Abadi K Gebre; Kun Zhu; Wai H Lim; Ryan Teh; Douglas P Kiel; John T Schousboe; Itamar Levinger; Stephan von Haehling; Richard Woodman; Andrew J S Coats; Richard L Prince; Joshua R Lewis

doi:10.1161/ATVBAHA.123.320118

Extent of Abdominal Aortic Calcification Is Associated With Incident Rapid Weight Loss Over 5 Years: The Perth Longitudinal Study of Ageing Women

Arterioscler Thromb Vasc Biol. 2024 Feb;44(2):e54-e64. doi: 10.1161/ATVBAHA.123.320118. Epub 2023 Dec 14.

Authors

Cassandra Smith^{1

2}, Marc Sim^{1

2

3}, Jack Dalla Via¹, Abadi K Gebre¹, Kun Zhu^{2

4}, Wai H Lim^{2

5}, Ryan Teh^{2

6}, Douglas P Kiel⁷, John T Schousboe^{8

9}, Itamar Levinger^{10

11}, Stephan von Haehling^{12

13}, Richard Woodman¹⁴, Andrew J S Coats¹⁵, Richard L Prince^{2

4}, Joshua R Lewis^{1

2

16}

Affiliations

¹ Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia (C.S., M.S., J.D.V., A.K.G., J.R.L.).
² Medical School, The University of Western Australia, Perth (C.S., M.S., K.Z., W.H.L., R.T., R.L.P., J.R.L.).
³ Royal Perth Hospital Research Foundation, Western Australia (M.S.).
⁴ Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia (K.Z., R.L.P.).
⁵ Renal Department, Sir Charles Gairdner Hospital, Nedlands, Western Australia (W.H.L.).
⁶ Fiona Stanley Hospital, Murdoch, Western Australia (R.T.).
⁷ Marcus Institute for Aging Research, Hebrew SeniorLife, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.P.K.).
⁸ Park Nicollet Clinic and HealthPartners Institute, Minneapolis, MN (J.T.S.).
⁹ Division of Health Policy and Management, University of Minnesota, Minneapolis (J.T.S.).
¹⁰ Institute for Health and Sport, Victoria University, Melbourne, Australia (I.L.).
¹¹ Australian Institute for Musculoskeletal Science, University of Melbourne and Western Health, St Albans (I.L.).
¹² Department of Cardiology and Pneumology, University of Göttingen Medical Center, Germany (S.v.H.).
¹³ German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Germany (S.v.H.).
¹⁴ Flinders Health and Medical Research Institute-Cancer Program, Flinders University, Bedford Park, South Australia (R.W.).
¹⁵ Heart Research Institute, Sydney, Australia (A.J.S.C.).
¹⁶ Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Australia (J.R.L.).

PMID: 38095109
PMCID: PMC10832333 (available on 2025-02-01)
DOI: 10.1161/ATVBAHA.123.320118

Abstract

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.

Keywords: body composition; vascular calcification; vascular diseases; weight loss.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aging
Aorta, Abdominal / diagnostic imaging
Aortic Diseases* / etiology
Body Weight
Female
Humans
Longitudinal Studies
Risk Factors
Vascular Calcification* / etiology
Vascular Diseases*
Weight Loss

Grants and funding

R01 AR041398/AR/NIAMS NIH HHS/United States