Influences of changes in obesity-related parameters on progression of arteriosclerosis in hemodialysis patients: a prosp
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RESEARCH
Open Access
Influences of changes in obesity-related parameters on progression of arteriosclerosis in hemodialysis patients: a prospective cohort study Takeshi Iida1,2, Satoshi Morimoto1* , Hidenobu Okuda2, Yoshifumi Amari1,2, Takatomi Yurugi2, Fumitaka Nakajima2 and Atsuhiro Ichihara1
Abstract Background: Hemodialysis patients have a greater risk of cardiovascular disease, their major cause of death. Obesity is a risk factor for arteriosclerosis, cardiovascular disease, and mortality in the general population. Conversely, an increased body mass index (BMI) is known to be associated with better survival of hemodialysis patients. However, the influences of changes in parameters associated with obesity on arteriosclerosis in these patients have not been evaluated. Here, we evaluated the relationship between changes in parameters associated with obesity and brachial-ankle pulse wave velocity (baPWV), as an index of arteriosclerosis, in hemodialysis patients. Methods: Two hundred and fifty-eight subjects were selected from patients undergoing stable hemodialysis. BMI, abdominal circumference (AC), visceral fat area (VFA) and subcutaneous fat areas (SFA), and baPWV were assessed at baseline and 4 years later. Ankle-brachial index and baPWV were measured on a non-dialysis day using volumeplethysmographic apparatus. Abdominal circumference was measured at the level of umbilicus by computed tomography (CT). Body fat distribution was determined using CT. All CT scans were performed on a non-dialysis day with the subject in a supine position. Results: Sixty-one patients died during the 4-year period. Abdominal circumference, BMI, VFA, and SFA were higher, and baPWV was lower in patients who survived than in those who died. During the study period, baPWV increased and was positively correlated with the change in visceral plus subcutaneous fat area in patients whose initial VFA was > 100 cm2. There were negative correlations between the change in baPWV and changes in AC, and SFA in individuals whose VFA was < 100 cm2. Conclusions: These data suggest that patients with a large VFA should adopt strategies aimed at reducing body weight, while patients with a small VFA should avoid undernutrition. Keywords: Visceral fat area, Subcutaneous fat area, Brachial-ankle pulse wave velocity, Cardiovascular disease, Prognosis
* Correspondence: [email protected] 1 Department of Endocrinology and Hypertension, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article'
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