title: Annual variation in body fat is associated with systemic inflammation in chronic kidney disease patients Stages 3 and 4: a longitudinal study.
abstract: BACKGROUND
  In dialysis patients, cross-sectional studies show that total and abdominal body fat associate with inflammatory markers. Whether this is true in earlier disease stages is unknown. We evaluated the cross-sectional and longitudinal (12-month interval) association between body fat markers and C-reactive protein (CRP) in pre-dialysis chronic kidney disease (CKD) patients.
  
  
  METHODS
  We studied, over a period of 1 year, clinically stable CKD patients at Stages 3-4 who were under treatment in a single outpatient clinic. Fifty-seven patients were included and 44 concluded the observational period [males: 66%; age: 62.9±13.9 years; body mass index (BMI): 25.5±5.1 kg/m2; estimated glomerular filtration rate (eGFR): 34±12.3 mL/min/1.73 m2]. Total body fat (skinfold thicknesses), waist circumference (WC), laboratory measurements (serum creatinine, total cholesterol, albumin, high-sensitivity CRP and leptin) and food intake (24-h food recall) were assessed at baseline and after 12±2 months.
  
  
  RESULTS
  Most patients had anthropometric parameters in the range of overweight/obesity and none had signs of protein-energy wasting. In univariate analysis, changes (delta: end-baseline) in CRP were associated (P<0.05) with changes in BMI (r=0.39) and WC (r=0.33). In multiple regression analysis, these associations remained significant (P<0.05) even after adjusted by potential confounders (sex, diabetes, baseline age and eGFR).
  
  
  CONCLUSIONS
  During a follow-up of 12 months, changes in BMI and WC were directly associated with changes in CRP. Our results support the concept that interventions aimed at reducing weight and/or abdominal adiposity in pre-dialysis CKD patients may also translate into reduced systemic inflammation.
authors.affiliation: Clinical and Experimental Physiopathology Program, Department of Applied Nutrition, Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil.
authors.forename: Laura Kawakami
authors.initials: LK
authors.lastname: Carvalho
authors.forename: Maria Ines
authors.initials: MI
authors.lastname: Barreto Silva
authors.forename: Barbara
authors.initials: B
authors.lastname: da Silva Vale
authors.forename: Rachel
authors.initials: R
authors.lastname: Bregman
authors.forename: Renata Brum
authors.initials: RB
authors.lastname: Martucci
authors.forename: Juan Jesus
authors.initials: JJ
authors.lastname: Carrero
authors.forename: Carla Maria
authors.initials: CM
authors.lastname: Avesani
mesh_terms: D000273:Adipose Tissue / Q000503:physiopathology*; D001823:Body Composition; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007249:Inflammation / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000473:pathology; D007677:Kidney Function Tests; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D055105:Waist Circumference
chemical_list: D002097:C-Reactive Protein