Document Detail


Survival predictability of lean and fat mass in men and women undergoing maintenance hemodialysis.
MedLine Citation:
PMID:  20844076     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Larger body size is associated with greater survival in maintenance hemodialysis (MHD) patients. It is not clear how lean body mass (LBM) and fat mass (FM) compare in their associations with survival across sex in these patients.
OBJECTIVE: We examined the hypothesis that higher FM and LBM are associated with greater survival in MHD patents irrespective of sex.
DESIGN: In 742 MHD patients, including 31% African Americans with a mean (± SD) age of 54 ± 15 y, we categorized men (n = 391) and women (n = 351) separately into 4 quartiles of near-infrared interactance-measured LBM and FM. Cox proportional hazards models estimated death hazard ratios (HRs) (and 95% CIs), and cubic spline models were used to examine associations with mortality over 5 y (2001-2006).
RESULTS: After adjustment for case-mix and inflammatory markers, the highest quartiles of FM and LBM were associated with greater survival in women: HRs of 0.38 (95% CI: 0.20, 0.71) and 0.34 (95% CI: 0.17, 0.67), respectively (reference: first quartile). In men, the highest quartiles of FM and percentage FM (FM%) but not of LBM were associated with greater survival: HRs of 0.51 (95% CI: 0.27, 0.96), 0.45 (95% CI: 0.23, 0.88), and 1.17 (95% CI: 0.60, 2.27), respectively. Cubic spline analyses showed greater survival with higher FM% and higher "FM minus LBM percentiles" in both sexes, whereas a higher LBM was protective in women.
CONCLUSIONS: In MHD patients, higher FM in both sexes and higher LBM in women appear to be protective. The survival advantage of FM appears to be superior to that of LBM. Clinical trials to examine the outcomes of interventions that modify body composition in MHD patients are indicated.
Authors:
Nazanin Noori; Csaba P Kovesdy; Ramanath Dukkipati; Youngmee Kim; Uyen Duong; Rachelle Bross; Antigone Oreopoulos; Amanda Luna; Debbie Benner; Joel D Kopple; Kamyar Kalantar-Zadeh
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-09-15
Journal Detail:
Title:  The American journal of clinical nutrition     Volume:  92     ISSN:  1938-3207     ISO Abbreviation:  Am. J. Clin. Nutr.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-21     Completed Date:  2010-11-09     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  0376027     Medline TA:  Am J Clin Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1060-70     Citation Subset:  AIM; IM    
Affiliation:
Harold Simmons Center for Kidney Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90502, USA.
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MeSH Terms
Descriptor/Qualifier:
Adipose Tissue*
Adult
Aged
Body Composition*
Female
Humans
Male
Middle Aged
Proportional Hazards Models
Renal Dialysis / mortality*
Renal Insufficiency / mortality*,  therapy
Sex Factors
Survival Analysis
Grant Support
ID/Acronym/Agency:
K23-DK61162/DK/NIDDK NIH HHS; M01-RR00425/RR/NCRR NIH HHS; R21-DK078012/DK/NIDDK NIH HHS
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