title: Peri-aortic fat tissue and malnutrition-inflammation-atherosclerosis/calcification syndrome in end-stage renal disease patients.
abstract: OBJECTIVE
  Thoracic peri-aortic fat tissue (PFT) is considered as a metabolically active organ in atherosclerosis. Malnutrition, inflammation and atherosclerosis/calcification (MIAC) are the most commonly encountered risk factors of cardiovascular disease in end-stage renal disease (ESRD) patients. Calcification of the aorta was found to be an important cardiovascular risk marker predicting future events, morbidity and mortality in this population. We aimed to investigate the relationship between PFT, MIAC syndrome and thoracic aortic calcification (TAC) in ESRD patients.
  
  
  METHODS
  Seventy-nine ESRD patients receiving hemodialysis (HD) or peritoneal dialysis (PD) and 20 control subjects were enrolled in this cross-sectional study. PFT and TAC were assessed using a 64-MDCT scanner. Patients with serum albumin <3.5 g/dL were defined as patients with malnutrition; those with serum C-reactive protein level >10 mg/L had inflammation, and those with coronary artery calcification score (CACS) >10 had atherosclerosis/calcification.
  
  
  RESULTS
  TAC and PFT were significantly higher in ESRD patients compared with control subjects. There was a statistically significant relationship between PFT and TAC in ESRD patients (r = 0.458, p < 0.0001). PFT was found to be significantly increased when the MIAC components increased. PFT was positively associated with age, BMI, uric acid, hemoglobin and CAC. The multivariate analysis revealed that age and uric acid were independent predictors of increased PFT. Twenty-four (30.4 %) patients had none, 30 (37.9 %) had one component, 17 (21.5 %) had two components, and 8 (10.2 %) had all MIAC components. PFT was highest among patients having all three components (28.6 cm(3)) and lowest among those who do not have the MIAC syndrome (8.54 cm(3)). TAC was highest among patients having all three components (179.2 HU) and lowest among those who do not have the MIAC syndrome (0 HU).
  
  
  CONCLUSIONS
  We found a relationship between PFT and MIAC syndrome in ESRD patients.
authors.affiliation: Division of Nephrology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey. mdkt2010@yahoo.com
authors.forename: K
authors.initials: K
authors.lastname: Turkmen
authors.forename: H Z
authors.initials: HZ
authors.lastname: Tonbul
authors.forename: F M
authors.initials: FM
authors.lastname: Erdur
authors.forename: I
authors.initials: I
authors.lastname: Guney
authors.forename: H
authors.initials: H
authors.lastname: Kayikcioglu
authors.forename: L
authors.initials: L
authors.lastname: Altintepe
authors.forename: O
authors.initials: O
authors.lastname: Ozbek
authors.forename: M I
authors.initials: MI
authors.lastname: Yilmaz
authors.forename: A
authors.initials: A
authors.lastname: Gaipov
authors.forename: S
authors.initials: S
authors.lastname: Turk
authors.forename: A
authors.initials: A
authors.lastname: Covic
authors.forename: M
authors.initials: M
authors.lastname: Kanbay
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D001018:Aortic Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D050197:Atherosclerosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D002097:C-Reactive Protein / Q000378:metabolism; D002114:Calcinosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology
chemical_list: D002097:C-Reactive Protein