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Open Access Original investigation

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

Jenq-Wen Huang1, Chung-Yi Yang2, Hon-Yen Wu14, Kao-Lang Liu2, Chi-Ting Su5, Cho-Kai Wu1, Jen-Kuang Lee8, Chih-Kang Chiang13, Hui-Teng Cheng6, Yu-Chung Lien7* and Kuan-Yu Hung1*

Author Affiliations

1 Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, No. 7, Chung-Shan South Road, Taipei 100, Taiwan

2 Medical Imaging, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan

3 Integrated Diagnostics and Therapeutics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan

4 Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan

5 National Taiwan University College of Medicine and Hospital, Yun-Lin Branch, Yun-Lin County, Taiwan

6 National Taiwan University College of Medicine and Hospital, Hsin-Chu Branch, Hsin Chu City, Taiwan

7 Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Taipei Branch, New Taipei City, Taiwan

8 Cardiovascular Center & Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan

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Cardiovascular Diabetology 2013, 12:86  doi:10.1186/1475-2840-12-86

Published: 8 June 2013

Abstract

Background

In 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.

Methods

In 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).

Results

Patients 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.

Conclusion

This 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.

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