Abdominal obesity is the most significant metabolic syndrome component predictive of cardiovascular events in chronic hemodialysis patients

Abstract

Five components of metabolic syndrome (MetS) have been identified as predictive of cardiovascular events (CVEs) in the general population: impaired fasting glucose, abdominal obesity, hypertriglyceridemia, hypertension and low high-density lipoprotein cholesterol. Whether MetS and its components are also predictive of CVEs in chronic hemodialysis (HD) patients remains unclear. We therefore investigated the role of MetS and its components in patients on chronic HD. MetS at baseline was diagnosed in 91 HD patients based on the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI) and the International Diabetes Federation (IDF) definitions. During a 3-year period, all hospitalizations, CVEs and deaths were recorded and analyzed using Kaplan-Meier survival analysis and Cox regression. There were no differences in the number of CVEs, hospitalizations or deaths between patients with and without AHA/NHLBI-defined MetS; however, patients with IDF-defined MetS were found to be at a higher risk for CVEs (P = 0.006). Cox regression analysis showed that, of the MetS components, abdominal obesity was the single most significant predictor of CVEs (hazard ratio 6.25; 95% confidence interval: 1.65-23.6; P = 0.007). IDF-defined MetS was more predictive of CVEs than AHA/NHLBI-defined MetS. Of the MetS components, abdominal obesity was the single most significant predictor of CVEs in chronic HD patients.