title: Waist-to-Hip Ratio, Cardiovascular Outcomes, and Death in Peritoneal Dialysis Patients.
abstract: Objectives. The primary objective of this study was to determine the relationship between waist-to-hip ratio (WHR), cardiovascular (CV) events, and mortality in peritoneal dialysis (PD) patients. A secondary objective was to investigate the association between abdominal obesity and systemic inflammatory markers. Methods. This is a prospective study of 22 prevalent PD patients. WHR was measured at baseline. C-reactive protein (CRP), tumour necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were measured. Main outcomes were first CV event and death from all causes. Survival analysis was used to examine the relationship between anthropomorphic measures and clinical outcomes. Results. Mean follow-up period was 3.1 years. In Kaplan-Meier analysis, survival was lower in those with higher WHR (P = .002). In Cox regression, WHR independently predicted mortality and first CV event after adjustment for known ischemic heart disease (hazard ratio [HR] 1.17, confidence interval [CI] 1.05-1.30 for death; HR 1.13, CI 1.01-1.26 for CV event). WHR correlated with serum TNF-α (r = 0.45; P = .05). Conclusion. The results of this study suggest WHR may be a risk factor for increased CV events and mortality in PD patients. Abdominal obesity is also associated with inflammatory markers. Larger studies are warranted to confirm these findings.
authors.affiliation: Division of Nephrology, McMaster University, St. Joseph's Healthcare, Hamilton, ON, Canada L8N 4A6.
authors.forename: Winnie S
authors.initials: WS
authors.lastname: Su
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Clase
authors.forename: K Scott
authors.initials: KS
authors.lastname: Brimble
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Margetts
authors.forename: Trevor J
authors.initials: TJ
authors.lastname: Wilkieson
authors.forename: Azim S
authors.initials: AS
authors.lastname: Gangji