title: Epicardial adipose tissue volume and cardiovascular disease in hemodialysis patients.
abstract: OBJECTIVE
  Epicardial adipose tissue (EAT) is proposed as a cardiovascular risk marker in non-uremic subjects. However, little is known about its role in patients with higher cardiovascular risk profile such as chronic kidney disease. The aim of this study was to investigate the relationship between EAT and several cardiovascular surrogate markers (coronary artery calcification (CAC), arterial stiffness and atherosclerosis) in patients on maintenance hemodialysis.
  
  
  METHODS
  A total of 191 prevalent hemodialysis patients were enrolled in this cross-sectional study. EAT and CAC scores (CACs) were determined by multi-slice computerized tomography, arterial stiffness by carotid-femoral pulse wave velocity (PWV), and carotid artery intima-media thickness (CA-IMT) by B-mode doppler ultrasonography.
  
  
  RESULTS
  Mean age was 59 ± 13 years and time on hemodialysis 75 ± 44 months. Twenty percent of the patients had diabetes. Mean EAT volume was 62.6 ± 26.8 cm(3)/m(2). Mean CA-IMT and PWV values increased across the EAT tertiles. EAT was correlated with age, female gender, body mass index, albumin and lipid parameters. Additionally, CA-IMT and PWV values were positively correlated with EAT. EAT volume was significantly higher in patients with CACs >10 compared to the patients with CACs ≤10. Despite the univariate associations between EAT and cardiovascular surrogate markers, only age, body mass index and total cholesterol levels were associated with EAT in adjusted models.
  
  
  CONCLUSIONS
  In prevalent hemodialysis patients, EAT is correlated with atherosclerosis, arterial stiffness and the presence of CAC. However, this correlation is not independent of other risk factors.
authors.affiliation: Ege University, School of Medicine, Division of Nephrology, 35100 Bornova, Izmir, Turkey. mnturan@mail.com
authors.forename: Mehmet Nuri
authors.initials: MN
authors.lastname: Turan
authors.forename: Ozkan
authors.initials: O
authors.lastname: Gungor
authors.forename: Gulay
authors.initials: G
authors.lastname: Asci
authors.forename: Fatih
authors.initials: F
authors.lastname: Kircelli
authors.forename: Turker
authors.initials: T
authors.lastname: Acar
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yaprak
authors.forename: Naim
authors.initials: N
authors.lastname: Ceylan
authors.forename: Meltem Sezis
authors.initials: MS
authors.lastname: Demirci
authors.forename: Selen
authors.initials: S
authors.lastname: Bayraktaroglu
authors.forename: Huseyin
authors.initials: H
authors.lastname: Toz
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ozkahya
authors.forename: Ercan
authors.initials: E
authors.lastname: Ok
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000473:pathology*; D006435:Renal Dialysis