Deoxycholic Acid and Coronary Artery Calcification in the Chronic Renal Insufficiency Cohort

Anna Jovanovich, Xuan Cai, Rebecca Frazier, Josh D. Bundy, Jiang He, Panduranga Rao, Claudia Lora, Mirela Dobre, Alan Go, Tariq Shafi, Harold I. Feldman, Eugene P. Rhee, Makoto Miyazaki, Tamara Isakova, Michel Chonchol

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BACKGROUND: Deoxycholic acid (DCA) is a secondary bile acid that may promote vascular calcification in experimental settings. Higher DCA levels were associated with prevalent coronary artery calcification (CAC) in a small group of individuals with advanced chronic kidney disease. Whether DCA levels are associated with CAC prevalence, incidence, and progression in a large and diverse population of individuals with chronic kidney disease stages 2 to 4 is unknown. METHODS AND RESULTS: In the CRIC (Chronic Renal Insufficiency Cohort) study, we evaluated cross-sectional (n=1057) and longitudinal (n=672) associations between fasting serum DCA levels and computed tomographic CAC using multivariable-adjusted regression models. The mean age was 57±12 years, 47% were women, and 41% were Black. At baseline, 64% had CAC (CAC score >0 Agatston units). In cross-sectional analyses, models adjusted for demographics and clinical factors showed no association between DCA levels and CAC >0 compared with no CAC (prevalence ratio per 1-SD higher log DCA, 1.08 [95% CI, 0.91–1.26). DCA was not associated with incident CAC (incidence per 1-SD greater log DCA, 1.08 [95% CI, 0.85–1.39]) or CAC progression (risk for increase in ≥100 and ≥200 Agatston units per year per 1-SD greater log DCA, 1.05 [95% CI, 0.84–1.31] and 1.26 [95% CI, 0.77–2.06], respectively). CONCLUSIONS: Among CRIC study participants, DCA was not associated with prevalent, incident, or progression of CAC.

Original languageEnglish (US)
Article numbere022891
JournalJournal of the American Heart Association
Issue number7
StatePublished - Apr 5 2022


  • chronic kidney disease
  • coronary artery calcification
  • deoxycholic acid
  • microbiome
  • secondary bile acid

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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