Bone · 2026
Sagittal abdominal diameter and abdominal aortic calcification are associated with incident major adverse cardiovascular events: The Manitoba Bone Density Registry.
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Abraha Haftom N, Gebre Abadi K, Sim Marc, Smith Cassandra, Gilani Syed Zulqarnain, Ilyas Zaid, Zarzour Fatima, Schousboe John T, Lix Lisa M, Binkley Neil, Reid Siobhan, Monchka Barret A, Kimelman Douglas, Lewis Joshua R, Leslie William D
Аннотация
BACKGROUND: Sagittal abdominal diameter (SAD), a measure of visceral adiposity, has been linked to major adverse cardiovascular events (MACE). However, the relationship between SAD and abdominal aortic calcification (AAC), a marker of subclinical vascular disease, and whether they independently and jointly predict MACE remains unclear.
OBJECTIVE: To investigate whether weight-normalized SAD and AAC scored using a validated machine learning algorithm (ML-AAC24) are independently and jointly associated with incident MACE.
METHODS: SAD and ML-AAC24 were measured from dual-energy X-ray absorptiometry (DXA) posteroanterior and lateral spine images, respectively, from the Manitoba Bone Density registry.
RESULTS: Among 8806 individuals (mean age 75.1 ± 6.6 years, 93.9% women), 11.3% experienced MACE during a mean follow-up of 3.8 years. SAD/weight and ML-AAC24 were positively correlated (Spearman r = 0.11, P < 0.001). Individuals with moderate and high ML-AAC24 had 1.1% and 3.0% higher mean SAD/weight, respectively, than those with low ML-AAC24. Both ML-AAC24 and SAD/weight were independently associated with higher risk of MACE. Adjusted hazard ratios [HRs] for MACE were 1.45, 95%CI 1.24-1.71 and 1.99, 95%CI 1.67-2.35 for moderate and high ML-AAC24, respectively, vs. low. The HR for the highest vs. lowest tertile of SAD/weight was 1.37, 95%CI 1.16-1.61. Individuals who had both high ML-AAC24 and were in the highest SAD/weight tertile had the highest MACE risk (HR 2.63, 95% CI 2.02-3.44).
CONCLUSION: Higher baseline SAD/weight was associated with higher ML-AAC24 scores. Both measures independently and jointly associated with MACE. Their combined use may potentially help identify individuals at high risk for cardiovascular disease during routine bone density testing.
OBJECTIVE: To investigate whether weight-normalized SAD and AAC scored using a validated machine learning algorithm (ML-AAC24) are independently and jointly associated with incident MACE.
METHODS: SAD and ML-AAC24 were measured from dual-energy X-ray absorptiometry (DXA) posteroanterior and lateral spine images, respectively, from the Manitoba Bone Density registry.
RESULTS: Among 8806 individuals (mean age 75.1 ± 6.6 years, 93.9% women), 11.3% experienced MACE during a mean follow-up of 3.8 years. SAD/weight and ML-AAC24 were positively correlated (Spearman r = 0.11, P < 0.001). Individuals with moderate and high ML-AAC24 had 1.1% and 3.0% higher mean SAD/weight, respectively, than those with low ML-AAC24. Both ML-AAC24 and SAD/weight were independently associated with higher risk of MACE. Adjusted hazard ratios [HRs] for MACE were 1.45, 95%CI 1.24-1.71 and 1.99, 95%CI 1.67-2.35 for moderate and high ML-AAC24, respectively, vs. low. The HR for the highest vs. lowest tertile of SAD/weight was 1.37, 95%CI 1.16-1.61. Individuals who had both high ML-AAC24 and were in the highest SAD/weight tertile had the highest MACE risk (HR 2.63, 95% CI 2.02-3.44).
CONCLUSION: Higher baseline SAD/weight was associated with higher ML-AAC24 scores. Both measures independently and jointly associated with MACE. Their combined use may potentially help identify individuals at high risk for cardiovascular disease during routine bone density testing.