Supplemental Fig. S1
Measurement of perirenal fat thickness. Computed tomography evaluation of perirenal fat thickness was the distance from kidney to nearest viscera or muscle, and five perirenal measurements were taken: lateral (A), posterolateral (B), posterior (C), anterolateral (D), and medial (E) on a slice passing through the renal vein.
enm-35-122-s006.pdf
Fig. 1The risk of arterial calcification according to the quartiles of perirenal fat thickness. Total perirenal fat thickness was defined as the sum of perirenal fat thickness of both sides, and it was classified as Q1 (the lowest quartile) to Q4 (the highest quartile). Odds ratios (ORs) with 95% confidence interval (CIs) of the calcification in each arterial bed according to the perirenal fat thickness are shown (A) in the entire population, (B) those without renal artery calcification, and (C) in those with renal artery calcification. All statistical values were adjusted for age, sex, body mass index, hypertension, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, smoking history, and family history of heart disease in first-degree relatives. RACS, renal artery calcification score. aP<0.05 compared to Q1; bP<0.005 compared to Q1; cP for trend.
Table 1Clinical Characteristics of the Study Subjects According to Perirenal Fat Thickness
Characteristic |
Q1 (n = 979) |
Q2 (n = 981) |
Q3 (n = 980) |
Q4 (n = 979) |
P valuea
|
Age, yr |
50.4±10.3 |
54.7±10.4 |
57.4±10.7 |
60.6±10.2 |
<0.001 |
Men |
544 (55.6) |
544 (55.6) |
544 (55.6) |
544 (55.6) |
1.000 |
Body mass index, kg/m2
|
23.9 (21.9–26.0) |
26.0 (23.5–28.0) |
27.0 (25.0–29.8) |
29.0 (27.0–32.3) |
<0.001 |
SBP, mm Hg |
118 (108–128) |
122 (112–136) |
124 (116–136) |
130 (120–140) |
<0.001 |
DBP, mm Hg |
76 (68–82) |
78 (70–84) |
80 (72–84) |
80 (74–86) |
<0.001 |
Total cholesterol, mg/dL |
196 (174–221) |
202 (178–228) |
209 (182–235) |
208 (183–233) |
<0.001 |
HDL-C, mg/dL |
55 (43–69) |
51 (40–66) |
52 (41–64) |
49 (39–59) |
<0.001 |
Triglycerides, mg/dL |
112 (79–167) |
135 (93–196) |
145 (101–198) |
164 (117–234) |
<0.001 |
LDL-C, mg/dL |
115 (92–137) |
117 (94–143) |
122 (98–146) |
122 (99–144) |
<0.001 |
Hypertension |
200 (20.4) |
341 (34.8) |
374 (38.2) |
509 (52.0) |
<0.001 |
Dyslipidemia (n = 3,458) |
207 (24.0) |
318 (36.9) |
351 (39.8) |
410 (48.1) |
<0.001 |
Obesity |
61 (6.5) |
144 (15.2) |
250 (26.1) |
427 (45.1) |
<0.001 |
Smoker |
|
|
|
|
|
Ex-smoker |
265 (27.1) |
299 (30.5) |
365 (37.1) |
343 (35.0) |
0.140b
|
Current smoker |
103 (10.5) |
89 (9.1) |
85 (8.7) |
77 (7.9) |
|
Medications |
|
|
|
|
|
Anti-platelet agents |
60 (6.1) |
77 (7.8) |
93 (9.5) |
102 (10.4) |
<0.001 |
Lipid-lowering agents |
72 (7.4) |
103 (10.5) |
137 (14.0) |
160 (16.3) |
<0.001 |
Anti-hypertensive drugs |
64 (6.5) |
121 (12.3) |
151 (15.4) |
227 (23.2) |
<0.001 |
Arterial calcification |
|
|
|
|
|
Coronary artery |
396 (40.4) |
494 (50.4) |
567 (57.9) |
632 (64.6) |
<0.001 |
Carotid artery (n = 3,479) |
144 (16.4) |
225 (25.9) |
292 (34.0) |
366 (41.8) |
<0.001 |
Thoracic aorta |
206 (21.0) |
290 (29.6) |
376 (38.4) |
490 (50.1) |
<0.001 |
Abdominal aorta |
344 (35.1) |
489 (49.8) |
573 (58.5) |
648 (66.2) |
<0.001 |
Iliac artery |
323 (33.0) |
440 (44.9) |
503 (51.3) |
578 (59.0) |
<0.001 |
Renal artery |
47 (4.8) |
95 (9.7) |
144 (14.7) |
202 (20.6) |
<0.001 |
Table 2Risk of Arterial Calcification According to Perirenal Fat Thickness (per Quartile)
Variable |
Unadjusted |
Age and sex–adjusted |
Model 1 |
Model 2 |
OR (95% CI) |
P value |
OR (95% CI) |
P value |
OR (95% CI) |
P value |
OR (95% CI) |
P value |
Coronary artery |
1.386 (1.308–1.468) |
<0.001 |
1.162 (1.088–1.240) |
<0.001 |
1.083 (1.01–1.171) |
0.047 |
1.079 (0.990–1.176) |
0.082 |
Carotid artery |
1.520 (1.420–1.627) |
<0.001 |
1.162 (1.074–1.258) |
<0.001 |
1.115 (1.016–1.224) |
0.022 |
1.118 (1.006–1.241) |
0.037 |
Thoracic aorta |
1.548 (1.455–1.647) |
<0.001 |
1.096 (1.014–1.184) |
0.021 |
1.156 (1.053–1.268) |
0.002 |
1.141 (1.030–1.264) |
0.011 |
Abdominal aorta |
1.522 (1.436–1.614) |
<0.001 |
1.077 (1.001–1.159) |
0.046 |
1.136 (1.041–1.240) |
0.004 |
1.117 (1.013–1.233) |
0.027 |
Iliac artery |
1.414 (1.335–1.498) |
<0.001 |
1.056 (0.985–1.131) |
0.125 |
1.042 (0.959–1.132) |
0.327 |
1.012 (0.924–1.110) |
0.793 |
Renal artery |
1.666 (1.519–1.827) |
<0.001 |
1.227 (1.104–1.365) |
<0.001 |
1.289 (1.137–1.460) |
<0.001 |
1.251 (1.091–1.435) |
0.001 |
Table 3Prevalence of Vascular Calcification According to Perirenal Fat Thickness
Variable |
Q1 |
Q1 |
Q3 |
Q4 |
P valuea
|
P valueb
|
Renal artery calcification (–) |
932 |
886 |
836 |
777 |
|
|
Coronary artery |
357 (38.3) |
414 (46.7) |
450 (53.8) |
460 (59.2) |
<0.001 |
0.086 |
Carotid artery (n = 3,032c) |
115 (13.8) |
168 (21.4) |
195 (26.9) |
227 (33.1) |
<0.001 |
0.360 |
Thoracic aorta |
171 (18.3) |
208 (23.5) |
249 (29.8) |
307 (39.5) |
<0.001 |
0.100 |
Abdominal aorta |
300 (32.2) |
398 (44.9) |
432 (51.7) |
454 (58.4) |
<0.001 |
0.045 |
Iliac artery |
284 (30.5) |
360 (40.6) |
380 (45.5) |
396 (51.0) |
<0.001 |
0.671 |
Renal artery calcification (+) |
47 |
95 |
144 |
202 |
|
|
Coronary artery |
39 (83.0) |
80 (84.2) |
117 (81.3) |
172 (85.1) |
0.701 |
0.237 |
Carotid artery (n = 447d) |
29 (70.7) |
57 (67.9) |
97 (73.5) |
139 (73.2) |
0.475 |
0.212 |
Thoracic aorta |
35 (74.5) |
82 (86.3) |
127 (88.2) |
183 (90.6) |
0.008 |
0.254 |
Abdominal aorta |
44 (93.6) |
91 (95.8) |
141 (97.9) |
194 (96.0) |
0.551 |
0.244 |
Iliac artery |
39 (83.0) |
80 (84.2) |
123 (85.4) |
182 (90.1) |
0.089 |
0.456 |
Table 4Risk of Arterial Calcification According to Perirenal Fat Thickness (per Quartile) in Subjects without Renal Artery Calcification
Variable |
Unadjusted |
Age and sex–adjusted |
Model 1 |
Model 2 |
OR (95% CI) |
P value |
OR (95% CI) |
P value |
OR (95% CI) |
P value |
OR (95% CI) |
P value |
Coronary artery |
1.329 (1.250–1.413) |
<0.001 |
1.155 (1.079–1.237) |
<0.001 |
1.076 (0.991–1.169) |
0.080 |
1.082 (0.989–1.185) |
0.086 |
Carotid artery |
1.437 (1.330–1.554) |
<0.001 |
1.146 (1.051–1.250) |
0.002 |
1.059 (0.956–1.174) |
0.273 |
1.056 (0.940–1.186) |
0.360 |
Thoracic aorta |
1.426 (1.330–1.528) |
<0.001 |
1.050 (0.966–1.141) |
0.249 |
1.105 (1.000–1.222) |
0.050 |
1.098 (0.982–1.227) |
0.100 |
Abdominal aorta |
1.424 (1.339–1.516) |
<0.001 |
1.065 (0.988–1.147) |
0.099 |
1.122 (1.026–1.228) |
0.012 |
1.109 (1.003–1.228) |
0.045 |
Iliac artery |
1.321 (1.242–1.406) |
<0.001 |
1.028 (0.957–1.105) |
0.449 |
1.002 (0.918–1.093) |
0.972 |
0.979 (0.889–1.079) |
0.671 |