Metabolic syndrome and abdominal fat are associated with inflammation, but not with clinical outcomes, in peritoneal dialysis patients

Cardiovascular Diabetology

Original Investigation

Jen-Kuang Lee¹  Yu-Chung Lien²  Cho-Kai Wu³  Jenq-Wen Huang³  Kuan-Yu Hung³  Hon-Yen Wu⁴  Chih-Kang Chiang⁵  Chung-Yi Yang⁶  Kao-Lang Liu⁶  Hui-Teng Cheng⁷  Chi-Ting Su⁸ 

[1] Cardiovascular Center & Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan;Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Taipei Branch, New Taipei City, Taiwan;Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, No. 7, Chung-Shan South Road, 100, Taipei, Taiwan;Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, No. 7, Chung-Shan South Road, 100, Taipei, Taiwan;Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan;Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, No. 7, Chung-Shan South Road, 100, Taipei, Taiwan;Integrated Diagnostics and Therapeutics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan;Medical Imaging, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan;National Taiwan University College of Medicine and Hospital, Hsin-Chu Branch, Hsin Chu City, Taiwan;National Taiwan University College of Medicine and Hospital, Yun-Lin Branch, Yun-Lin County, Taiwan;

关键词: Abdominal fat;    Atherogenic indices;    Beta blocker;    Renin-angiotensin system blocker;    Computed tomography;    Metabolic syndrome;    Peritoneal dialysis;   

DOI  :  10.1186/1475-2840-12-86

 received in 2013-04-13, accepted in 2013-06-05,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundIn the general population, metabolic syndrome (MetS) is correlated with visceral fat and a risk factor for cardiovascular disease (CVD); however, little is known about the significance of abdominal fat and its association with inflammation and medication use in peritoneal dialysis (PD) patients. We investigated the relationship of visceral fat area (VFA) with C-reactive protein (CRP) levels and medication use in PD patients and followed their clinical outcomes.MethodsIn a prospective study from February 2009 to February 2012, we assessed diabetes mellitus (DM) status, clinical and PD-associated characteristics, medication use, CRP levels, components of MetS, and VFA in 183 PD patients. These patients were categorized into 3 groups based on MetS and DM status: non-MetS (group 1, n = 73), MetS (group 2, n = 65), and DM (group 3, n = 45). VFA was evaluated by computed tomography (CT) and corrected for body mass index (BMI).ResultsPatients in group 1 had smaller VFAs than patients in groups 2 and 3 (3.2 ± 1.8, 4.6 ± 1.9, and 4.9 ± 2.0 cm2/[kg/m2], respectively, P < 0.05) and lower CRP levels (0.97 ± 2.31, 1.27 ± 2.57, and 1.11 ± 1.35 mg/dL, respectively, P < 0.05). VFA increased with the number of criteria met for MetS. After adjusting for age, body weight, and sex, CRP and albumin levels functioned as independent positive predictors of VFA; on other hand, the use of renin-angiotensin system blockers was inversely correlated with VFA in PD patients without DM. In the survival analysis, DM patients (group 3) had the poorest survival among the 3 groups, but no significant differences were found between groups 1 and 2.ConclusionThis study showed that VFA and MetS are associated with CRP levels but cannot predict survival in PD patients without DM. The complex relationship of nutritional parameters to VFA and MetS may explain these results. The type of antihypertensive medication used was also associated with the VFA. The mechanisms behind these findings warrant further investigation.

【 授权许可】

Unknown   
© Huang et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.