title: Visceral fat thickness is associated with carotid atherosclerosis in peritoneal dialysis patients.
abstract: Visceral fat has been known to associate with atherosclerosis, inflammation, and insulin resistance. However, the influence of visceral fat on cardiovascular disease (CVD) in peritoneal dialysis (PD) patients has never been elucidated. We investigated whether visceral fat thickness (VFT) has a predictive role in carotid atherosclerosis determined by carotid intima-media thickness (cIMT) in PD patients. A cross-sectional study was undertaken in 88 prevalent PD patients. BMI and waist circumference (WC) were measured as anthropometric indexes of obesity. VFT and subcutaneous fat thickness (SFT) were determined by sonographic measurement of abdominal fat. Carotid atherosclerosis was defined as increased cIMT (>1.0 mm) or presence of plaque. Thirty-two (36.3%) patients had carotid atherosclerosis. Patients with carotid atherosclerosis showed significantly higher VFT, BMI, and WC. In univariate logistic analysis, BMI, WC, and VFT except SFT were significant risk factors of carotid atherosclerosis. However, multivariate analysis revealed VFT was an independent factor associated with carotid atherosclerosis after adjusting for demographic, biochemical parameters, and anthropometric indexes (per 1 mm increase, odds ratio (OR) = 2.294, 95% confidence interval: 1.048-5.021, P = 0.038). When the patients were divided into three groups according to VFT, log high sensitivity C-reactive protein (hs-CRP), and homeostasis model assessment-insulin resistance (HOMA(IR)) were both higher in the third tertile compared to other tertiles. In conclusion, VFT, not SFT, is independently associated with carotid atherosclerosis in PD patients. Therefore sonographic measurement of VFT could be useful to stratify the risk of cardiovascular disease in PD patients.
authors.affiliation: Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea.
authors.forename: Mi Jung
authors.initials: MJ
authors.lastname: Lee
authors.forename: Dong Ho
authors.initials: DH
authors.lastname: Shin
authors.forename: Seung Jun
authors.initials: SJ
authors.lastname: Kim
authors.forename: Hyung Jung
authors.initials: HJ
authors.lastname: Oh
authors.forename: Dong Eun
authors.initials: DE
authors.lastname: Yoo
authors.forename: Jwa-Kyung
authors.initials: JK
authors.lastname: Kim
authors.forename: Jung Tak
authors.initials: JT
authors.lastname: Park
authors.forename: Seung Hyeok
authors.initials: SH
authors.lastname: Han
authors.forename: Shin-Wook
authors.initials: SW
authors.lastname: Kang
authors.forename: Kyu Hun
authors.initials: KH
authors.lastname: Choi
authors.forename: Tae-Hyun
authors.initials: TH
authors.lastname: Yoo
mesh_terms: D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055105:Waist Circumference
chemical_list: D002097:C-Reactive Protein