Document Detail


Relationship between adiposity and cardiovascular risk factors in prevalent hemodialysis patients.
MedLine Citation:
PMID:  19596588     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Increased body mass index (BMI) is associated with reduced all-cause and cardiovascular (CV) mortality in hemodialysis (HD) patients, whereas CV risk increases with BMI in the general population. In the general population, obesity is associated with inflammation, decreased high-density lipoprotein (HDL) cholesterol, increased low-density lipoprotein (LDL) cholesterol, and triglycerides (TGs), all risk factors for CV disease. Low-density lipoprotein cholesterol does not predict CV risk in HD, whereas increased C-reactive protein and interleukin-6 (IL-6), low HDL and apolipoprotein (apo) AI, and increased fasting TGs do predict risk. Renal failure is associated with dyslipidemia and inflammation in normal-weight patients. We hypothesized that the effects of obesity may be obscured by renal failure in HD.
METHODS: We explored the relationship between adipose tissue pools and distribution, i.e., subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) (measured by magnetic resonance imaging) and measures of inflammation (C-reactive protein, IL-6, ceruloplasmin, and alpha1 acid glycoprotein), HDL and LDL cholesterol, total TGs, apo AI, apo B, apo CII (an activator of lipoprotein lipase), apo CIII (an inhibitor of lipoprotein lipase), and the adipokines, leptin and adiponectin, in 48 patients with prevalent HD.
RESULTS AND CONCLUSIONS: Total TG concentrations were positively correlated with VAT controlled for age, sex, and weight. Both apo CII and apo CIII were correlated only with VAT. Adiponectin was inversely correlated with VAT, and leptin was positively associated with SAT. C-reactive protein and alpha1 acid glycoprotein were weakly associated with SAT, whereas ceruloplasmin was strongly associated with VAT according to multiple regression analysis. In contrast, apo B, LDL, apo AI, HDL, and IL-6 were not correlated with any measure of body composition, potentially mitigating the effects of obesity in HD.
Authors:
George A Kaysen; Peter Kotanko; Fansan Zhu; Shubho R Sarkar; Steven B Heymsfield; Martin K Kuhlmann; Tjien Dwyer; Len Usvyat; Peter Havel; Nathan W Levin
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-07-10
Journal Detail:
Title:  Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation     Volume:  19     ISSN:  1532-8503     ISO Abbreviation:  J Ren Nutr     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-28     Completed Date:  2009-11-23     Revised Date:  2011-07-25    
Medline Journal Info:
Nlm Unique ID:  9112938     Medline TA:  J Ren Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  357-64     Citation Subset:  IM    
Affiliation:
Renal Research Institute, New York, New York, USA. gakaysen@ucdavis.edu
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MeSH Terms
Descriptor/Qualifier:
Adiponectin / blood
Adiposity*
Adult
Aged
Aged, 80 and over
Apolipoprotein A-I / blood
Body Mass Index
C-Reactive Protein / analysis
Cardiovascular Diseases / epidemiology*
Ceruloplasmin / analysis
Cholesterol, HDL / blood
Cholesterol, LDL / blood
Female
Humans
Inflammation / etiology
Interleukin-6 / blood
Intra-Abdominal Fat
Leptin / blood
Male
Middle Aged
Obesity / blood,  complications
Renal Dialysis / mortality*
Risk Factors
Subcutaneous Fat
Triglycerides / blood
Grant Support
ID/Acronym/Agency:
P01 DK-42618/DK/NIDDK NIH HHS; R01 DK050777-03/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Adiponectin; 0/Apolipoprotein A-I; 0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Interleukin-6; 0/Leptin; 0/Triglycerides; 9007-41-4/C-Reactive Protein; EC 1.16.3.1/Ceruloplasmin
Comments/Corrections

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