AI-based CT finds intermuscular fat independently tied to vascular calcification in COPD

In a multicenter cohort of 539 COPD patients, intermuscular adipose tissue (IMAT) on chest CT was independently associated with vascular calcification (β=0.15, 95%CI 0.015-0.28, p=0.029), while the interaction between bone density and IMAT appeared age-dependent.

• Vertebral bone density was inversely associated with thoracic vascular calcification across all body composition phenotypes (normal, sarcopenic, non-sarcopenic obesity), with β ranging from -0.24 to -0.38 (p<0.01).
• IMAT's significant interaction with bone density on the bone-vascular axis lost significance after adjusting for age, suggesting a shared age-driven mechanism.

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