Visceral adiposity indicators and cardiovascular risk in hemodialytic patients.

Dejane De Almeida Melo,Alcione Miranda Dos Santos,Maria Da Conceição Chaves De Lemos,Ana Karina Teixeira França,Elisângela Milhomem Dos Santos,Ilma Kruze Grande De Arruda,Alcides Da Silva Diniz,Tuane Rodrigues De Carvalho,Elane Viana Hortegal Furtado,Claudia Porto Sabino Pinho

doi:10.20945/2359-3997000000421

Dejane De Almeida Melo, Alcione Miranda Dos Santos + Show 8 more

Open Access

https://doi.org/10.20945/2359-3997000000421

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Abstract

Cardiovascular diseases represent the main cause of death in chronic kidney disease (CKD). We aimed to evaluate the prevalence and association of the hypertriglyceridemia-waist phenotype (HWP) and visceral adiposity index (VAI) with cardiometabolic risk factors (CR) in patients with CKD on hemodialysis (HD). The study is based on a cross-sectional design with 265 HD patients in two cities in northeastern Brazil. The VAI was calculated considering the variables body mass index (BMI), waist circumference (WC), triglycerides (TG) and high density lipoprotein cholesterol (HDL-c). HWP was defined as the concomitant elevation of WC and TG. The Poisson Regression Model with robust variance estimation was adjusted considering a hierarchical approach for explanatory variables. Prevalence ratios (PR) were also estimated. The level of significance adopted was 5%. In our study HWP and VAI prevalence's were 29.82% and 58.49%, respectively. In the final model, there was an association between VAI and female gender (PR = 1.46; p < 0.0001) and high body fat (% BF) (PR = 1.33; p < 0.0019). HWP was associated with females (PR = 1.80; p = 0.002), alcohol consumption (PR = 1.58; p = 0.033), obesity (PR = 1.89; p = 0.0001), high %BF (PR = 1.76; p = 0.012) and reduced HDL-c (PR = 1.48; p = 0.035). The HWP stood out as the association with more CR factors, representing a promising method for tracking cardiometabolic risk in HD patients, mainly female.

Highlights

Chronic kidney disease (CKD) is a public health problem defined as an abnormality of kidney structure or function present for more than three months, with health implications [1]
Taking into account the impacts of visceral adiposity on cardiovascular events frequently found in the HD scenario, in addition to the scarcity of studies assessing such indexes in the Brazilian HD population and, above all, in the northeastern region of Brazil, where resources are scarce, the present study aims to assess hypertriglyceridemia-waist phenotype (HWP) prevalence and visceral adipose dysfunction according to visceral adiposity index (VAI) and to analyze its association with traditional cardiovascular risk factors (CR) factors in patients with CKD on HD
We observed a high prevalence of increased VAI levels, which is higher than the HWP prevalence

Summary

Introduction

Chronic kidney disease (CKD) is a public health problem defined as an abnormality of kidney structure or function present for more than three months, with health implications [1]. Among patients with CKD, cardiovascular disease (CVD) is the main cause of death at any stage of the disease [2]. Traditional cardiovascular risk factors (CR) cannot alone explain the high risk of CVD presented by patients on hemodialysis (HD), they seem to be highly predictive of this nosological entity [3]. In this context, the investigation of the role of visceral adiposity has gained prominence since it has been associated with metabolic abnormalities in patients under dialysis treatment [4]. HWP manifests as worse carotid atherosclerosis in patients with CKD [9]

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