title: Waist circumference is associated with carotid intima media thickness in peritoneal dialysis patients.
abstract: OBJECTIVE
  Atherosclerosis is responsible for the high mortality rate in end-stage renal disease patients. Defining risk factors for atherosclerosis may lead to reduction in cardiovascular disease through modification of these factors. Peritoneal dialysis (PD) patients are subjected to high glucose loads on a daily basis, which results in considerable weight gain and an increase in waist circumference (WC). WC as an indicator of abdominal obesity is a risk factor for atherosclerosis in the general population. Carotid artery intima media thickness (CIMT) measurement is a reliable method for the detection of early atherosclerosis. The aim of this study was to investigate the relationship between WC and CIMT and to define risk factors associated with CIMT in PD patients.
  
  
  METHODS
  Fifty-five PD patients and 40 healthy controls were included. Atherosclerosis was assessed using measurement of CIMT. Fasting blood was collected for analysis. Anthropometric parameters (age, weight, BMI, and WC) were measured.
  
  
  RESULTS
  Peritoneal dialysis patients had higher WC (93.9 ± 1.7 vs. 87.3 ± 1.2 cm, p < 0.05) and CIMT (0.70 ± 0.02 vs. 0.57 ± 0.01 mm, p < 0.01) than the control group. On univariate analysis, age, WC, plaque formation, and D/P creatinine were positively correlated with CIMT, whereas residual renal function, albumin, ultrafiltration volume, and D/D0 glucose were negatively correlated. On multivariate analysis, only age, WC, and plaque formation showed correlation (p < 0.001).
  
  
  CONCLUSIONS
  Carotid artery intima media thickness is associated with age, plaque formation, and WC in PD patients. WC measurement is a simple, inexpensive, reproducible, and reliable method of evaluating atherosclerosis risk in PD patients and should be assessed at every visit. Appropriate counsel should be provided to patients with greater WC who are deemed to be at risk for atherosclerosis.
authors.affiliation: Department of Nephrology, Marmara University School of Medicine, Pendik, Istanbul, Turkey, easicioglu@yahoo.com.
authors.forename: Ebru
authors.initials: E
authors.lastname: Asicioglu
authors.forename: Arzu
authors.initials: A
authors.lastname: Kahveci
authors.forename: Hakkı
authors.initials: H
authors.lastname: Arikan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Koc
authors.forename: Serhan
authors.initials: S
authors.lastname: Tuglular
authors.forename: Cetin Ishak
authors.initials: CI
authors.lastname: Ozener
mesh_terms: D000328:Adult; D000367:Age Factors; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000209:etiology; D001786:Blood Glucose / Q000378:metabolism; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications; D010530:Peritoneal Dialysis; D012307:Risk Factors; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D003404:Creatinine
references.citation: Nephrol Dial Transplant. 2005 Feb;20(2):404-12
references.pmid: 15618238
references.citation: Kidney Int Suppl. 2005 Jan;(93):S39-43
references.pmid: 15613067
references.citation: Am J Nephrol. 2008;28(1):91-6
references.pmid: 17914250
references.citation: Atherosclerosis. 2012 Apr;221(2):438-44
references.pmid: 22321873
references.citation: Am J Kidney Dis. 2008 Jul;52(1):66-73
references.pmid: 18440683
references.citation: Nephrol Dial Transplant. 1998 Aug;13(8):2004-12
references.pmid: 9719155
references.citation: Atherosclerosis. 2012 Jan;220(1):128-33
references.pmid: 21764060
references.citation: Am J Kidney Dis. 2009 Jan;53(1 Suppl):S1-374
references.pmid: 19111206
references.citation: Circulation. 2002 Oct 22;106(17):2212-7
references.pmid: 12390950
references.citation: Circulation. 1997 Sep 2;96(5):1432-7
references.pmid: 9315528
references.citation: Nephrol Dial Transplant. 2003 Jan;18(1):106-12
references.pmid: 12480967
references.citation: Am J Kidney Dis. 2005 May;45(5):859-65
references.pmid: 15861351
references.citation: Circulation. 2002 Jul 2;106(1):100-5
references.pmid: 12093777
references.citation: J Ren Nutr. 2008 Nov;18(6):495-502
references.pmid: 18940652
references.citation: Perit Dial Int. 2011 Jan-Feb;31(1):67-73
references.pmid: 20448238
references.citation: Kidney Int Suppl. 2005 Jan;(93):S35-8
references.pmid: 15613066
references.citation: Nephrol Dial Transplant. 2007 Feb;22(2):515-21
references.pmid: 17050638
references.citation: Am J Kidney Dis. 2003 Aug;42(2):355-61
references.pmid: 12900819
references.citation: Nephrol Dial Transplant. 2012 Feb;27(2):790-5
references.pmid: 21948862
references.citation: Am J Epidemiol. 1997 Sep 15;146(6):483-94
references.pmid: 9290509
references.citation: J Am Soc Nephrol. 2002 Jul;13(7):1918-27
references.pmid: 12089389
references.citation: N Engl J Med. 2011 Jul 21;365(3):213-21
references.pmid: 21774709
references.citation: J Am Coll Cardiol. 2009 Apr 14;53(15):1265-72
references.pmid: 19358939
references.citation: Arterioscler Thromb Vasc Biol. 2010 Feb;30(2):182-5
references.pmid: 19948842
references.citation: Perit Dial Int. 2009 Feb;29 Suppl 2:S96-S101
references.pmid: 19270241