U-shaped association of body mass index with inflammation and atherosclerosis in hemodialysis patients.
OBJECTIVE
High body mass index (BMI) is associated with mortality in the general population, whereas obesity is suggested to confer a survival advantage in hemodialysis (HD) patients. However, underlying mechanisms are yet to be elucidated. We examined the cross-sectional association of BMI with inflammatory and nutritional markers and atherosclerosis in HD patients.


METHODS
Cross-sectional study.


METHODS
One hundred and nine maintenance HD patients in the Hacettepe University Hospital Haemodialysis Unit were studied.


METHODS
Data on demographics, comorbidity, and anthropometry were obtained by patient interviews. Atherosclerosis was assessed by B-mode Doppler ultrasonography on common carotid artery. Serum markers of inflammation, nutrition, and lipid metabolism, including C-reactive protein (CRP), albumin, prealbumin, homocysteine and lipoproteins, were measured by standard methods.


METHODS
Distribution of inflammatory and nutritional markers and prevalence of atherosclerosis in underweight, normal, overweight, and obese HD patients.


RESULTS
CRP levels were significantly higher in obese and underweight HD patients compared with normal and overweight patients (P < .05). The prevalence of atherosclerosis was significantly higher in underweight and obese patients (54.5% and 50%) compared with normal and overweight patients (25.7% and 33%) (P < .05).


CONCLUSIONS
In the present study, obesity is associated with inflammation and atherosclerosis. An obesity-related survival advantage should be modified by other factors such as race, comorbid conditions, body composition, and nutritional status.
Kahraman
Serkan
S
Department of Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey. drserkan@hacettepe.edu.tr
Yilmaz
Rahmi
R
Akinci
Devrim
D
Arici
Mustafa
M
Altun
Bulent
B
Erdem
Yunus
Y
Yasavul
Unal
U
Turgan
Cetin
C
D000328:Adult; D000886:Anthropometry; D050197:Atherosclerosis / Q000150:complications* / Q000453:epidemiology; D001823:Body Composition; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007249:Inflammation / Q000150:complications*; D016014:Linear Models; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D009765:Obesity / Q000097:blood / Q000150:complications; D016017:Odds Ratio; D006435:Renal Dialysis / Q000401:mortality; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013851:Thinness / Q000150:complications / Q000503:physiopathology
D008055:Lipids; D002097:C-Reactive Protein; D002784:Cholesterol