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CLINICAL RESEARCH
Serum total bile acids are associated with coronary artery calcification as assessed by non gated chest computed tomography: a multicenter study
1
Department of Cardiovascular Medicine, Hospital affiliated with Nanjing University of Chinese Medicine, Nanjing, China
2
Department of Radiology, Hospital affiliated with Nanjing University of Chinese Medicine, Nanjing, China
3
Emergency and Critical Care Medicine Department, Nanjing Medical University’s Affiliated Suzhou Hospital, Suzhou, China
4
Changhai Hospital, Naval Medical University, Shanghai, China
These authors had equal contribution to this work
Submission date: 2025-07-14
Final revision date: 2025-10-28
Acceptance date: 2025-12-23
Online publication date: 2026-01-20
Corresponding author
Xiao Chen
Department of Radiology Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing 210029, China
Department of Radiology Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing 210029, China
Ddongling Lv
Department of Cardiovascular Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing 210029 China
Department of Cardiovascular Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing 210029 China
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Coronary artery calcification (CAC) is a risk factor for cardiovascular disease (CVD). The association between serum total bile acid (TBA) concentration and CAC has not been investigated, even though bile acid may act as a mediator between gut microbiota and CVD. We examined this relationship in a general Chinese population.
Material and methods:
This cross-sectional study included 2133 people who underwent computed tomography (CT) scans for lung cancer screening between 2018 and 2020. Information on medical history, laboratory test results, and demographics was collected from medical records. CAC was assessed on non-gated chest CT images. Multivariable logistic regression analysis and restricted triple spline analysis were applied to examine the correlation between TBA and CAC risk.
Results:
CACs were detected in 426 of 2133 participants. Participants with higher TBA concentrations had a considerably higher prevalence of CAC (33.4% in the fourth quartile and 11.5% in the first quartile, p < 0.001). TBA was closely associated with CAC, as determined by multivariable logistic regression analysis (OR = 1.05, 95% CI: 1.00–1.10). The fourth TBA quartile was significantly associated with a high incidence of CAC in the general population (OR = 1.76, 95% CI: 1.02–3.06), in older adults (OR = 1.66, 95% CI: 1.03–2.68), and in subjects without diabetes (OR = 1.62, 95% CI: 1.07–2.45) or hypertension (OR = 1.74, 95% CI: 1.16–2.63) when compared to the first TBA quartile.
Conclusions:
A substantial and positive correlation was found between elevated TBA and CAC. The causal relationship between TBA and CAC risk should be investigated in longitudinal studies.
Coronary artery calcification (CAC) is a risk factor for cardiovascular disease (CVD). The association between serum total bile acid (TBA) concentration and CAC has not been investigated, even though bile acid may act as a mediator between gut microbiota and CVD. We examined this relationship in a general Chinese population.
Material and methods:
This cross-sectional study included 2133 people who underwent computed tomography (CT) scans for lung cancer screening between 2018 and 2020. Information on medical history, laboratory test results, and demographics was collected from medical records. CAC was assessed on non-gated chest CT images. Multivariable logistic regression analysis and restricted triple spline analysis were applied to examine the correlation between TBA and CAC risk.
Results:
CACs were detected in 426 of 2133 participants. Participants with higher TBA concentrations had a considerably higher prevalence of CAC (33.4% in the fourth quartile and 11.5% in the first quartile, p < 0.001). TBA was closely associated with CAC, as determined by multivariable logistic regression analysis (OR = 1.05, 95% CI: 1.00–1.10). The fourth TBA quartile was significantly associated with a high incidence of CAC in the general population (OR = 1.76, 95% CI: 1.02–3.06), in older adults (OR = 1.66, 95% CI: 1.03–2.68), and in subjects without diabetes (OR = 1.62, 95% CI: 1.07–2.45) or hypertension (OR = 1.74, 95% CI: 1.16–2.63) when compared to the first TBA quartile.
Conclusions:
A substantial and positive correlation was found between elevated TBA and CAC. The causal relationship between TBA and CAC risk should be investigated in longitudinal studies.
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| eISSN: | 1896-9151 |
| ISSN: | 1734-1922 |
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