Abstract
BackgroundPeripheral arterial disease (PAD) is a leading cause of morbidity in hemodialysis (HD) patients. Recent evidence suggests that abdominal obesity (AO) may play a role in PAD. However, the association between AO and PAD has not been thoroughly studied in HD patients.MethodsThe present cross-sectional study aimed to examine the relationship between AO and PAD in a cohort of 204 chronic HD patients. The ankle brachial index (ABI) was used as an estimate of the presence of PAD. Plasma adiponectin levels, interleukin-6 (IL-6) levels, high sensitivity C-reactive protein (hs-CRP) levels, asymmetric dimethylarginine (ADMA) levels, and lipid profiles were measured. Logistic regression was used to estimate the association between the presence of PAD and AO as well as other potential risk factors.ResultsThe metabolic risk factors and all individual traits, including elevated ln-transformed hs-CRP, were found to be significant (P<0.05) more frequently in HD patients with AO than that in control subjects. Patients with AO had a higher prevalence of PAD than the control individuals, with a mean ABI of 0.96±0.23 and 1.08±0.16 (P<0.0001) and PAD prevalence of 26.9% and 10.8% (P = 0.003), respectively. By multivariate analysis, AO (odds ratio [OR], 4.532; 95% CI, 1.765–11.639; P = 0.002), elevated serum ln-transformed ADMA (OR, 5.535; 95% CI, 1.323–23.155; P = 0.019), and ln-transformed IL-6 (OR, 1.567; 95% CI, 1.033–2.378; P = 0.035) were independent predictors of the presence of PAD.ConclusionsHD patients with AO exhibited a cluster of metabolic risk factors and lower ABI. AO, elevated serum ln-transformed ADMA, and ln-transformed IL-6 were independent predictors of the presence of PAD.
Highlights
Abdominal obesity (AO), known as an over-accumulation of visceral adiposity that can be estimated by waist circumference (WC), is prevalent in hemodialysis (HD) patients [1]
Because prior findings demonstrated an association of abdominal obesity (AO) with Peripheral arterial disease (PAD) in the general population, we hypothesized that HD patients with AO will have a higher prevalence of low ankle brachial index (ABI) values and clinical PAD
Our results show that higher plasma levels of ln-transformed asymmetric dimethylarginine (ADMA) and ln-transformed IL-6 and lower plasma levels of high-density lipoprotein (HDL) are associated with PAD, as well as with AO, older age, and longer HD duration
Summary
Abdominal obesity (AO), known as an over-accumulation of visceral adiposity that can be estimated by waist circumference (WC), is prevalent in hemodialysis (HD) patients [1]. AO is characterized by chronic low grade inflammation with increased serum inflammatory cytokine levels; it is considered to be a risk factor for atherosclerosis, cardiovascular disease, and increased mortality [2]. Postorino et al have shown that high WC is associated with a high risk of cardiovascular mortality in patients with chronic kidney disease (CKD) as well as dialysis patients [3]. Recent available data suggest that peripheral artery disease (PAD) is prevalent in HD patients and is a strong predictor for subsequent cardiovascular and overall mortality [5,6]. Traditional cardiovascular disease risk factors such as smoking and diabetes are strong risk factors for PAD [7], only AO, but not generalized obesity, has been shown to be associated with PAD in the general population [8,9]. The association between AO and PAD has not been thoroughly studied in HD patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
