title: Metabolic syndrome and abdominal fat are associated with inflammation, but not with clinical outcomes, in peritoneal dialysis patients.
abstract: BACKGROUND
  In the general population, metabolic syndrome (MetS) is correlated with visceral fat and a risk factor for cardiovascular disease (CVD); however, little is known about the significance of abdominal fat and its association with inflammation and medication use in peritoneal dialysis (PD) patients. We investigated the relationship of visceral fat area (VFA) with C-reactive protein (CRP) levels and medication use in PD patients and followed their clinical outcomes.
  
  
  METHODS
  In a prospective study from February 2009 to February 2012, we assessed diabetes mellitus (DM) status, clinical and PD-associated characteristics, medication use, CRP levels, components of MetS, and VFA in 183 PD patients. These patients were categorized into 3 groups based on MetS and DM status: non-MetS (group 1, n = 73), MetS (group 2, n = 65), and DM (group 3, n = 45). VFA was evaluated by computed tomography (CT) and corrected for body mass index (BMI).
  
  
  RESULTS
  Patients in group 1 had smaller VFAs than patients in groups 2 and 3 (3.2 ± 1.8, 4.6 ± 1.9, and 4.9 ± 2.0 cm2/[kg/m2], respectively, P < 0.05) and lower CRP levels (0.97 ± 2.31, 1.27 ± 2.57, and 1.11 ± 1.35 mg/dL, respectively, P < 0.05). VFA increased with the number of criteria met for MetS. After adjusting for age, body weight, and sex, CRP and albumin levels functioned as independent positive predictors of VFA; on other hand, the use of renin-angiotensin system blockers was inversely correlated with VFA in PD patients without DM. In the survival analysis, DM patients (group 3) had the poorest survival among the 3 groups, but no significant differences were found between groups 1 and 2.
  
  
  CONCLUSIONS
  This study showed that VFA and MetS are associated with CRP levels but cannot predict survival in PD patients without DM. The complex relationship of nutritional parameters to VFA and MetS may explain these results. The type of antihypertensive medication used was also associated with the VFA. The mechanisms behind these findings warrant further investigation.
authors.forename: Jenq-Wen
authors.initials: JW
authors.lastname: Huang
authors.forename: Chung-Yi
authors.initials: CY
authors.lastname: Yang
authors.forename: Hon-Yen
authors.initials: HY
authors.lastname: Wu
authors.forename: Kao-Lang
authors.initials: KL
authors.lastname: Liu
authors.forename: Chi-Ting
authors.initials: CT
authors.lastname: Su
authors.forename: Cho-Kai
authors.initials: CK
authors.lastname: Wu
authors.forename: Jen-Kuang
authors.initials: JK
authors.lastname: Lee
authors.forename: Chih-Kang
authors.initials: CK
authors.lastname: Chiang
authors.forename: Hui-Teng
authors.initials: HT
authors.lastname: Cheng
authors.forename: Yu-Chung
authors.initials: YC
authors.lastname: Lien
authors.forename: Kuan-Yu
authors.initials: KY
authors.lastname: Hung
mesh_terms: D050153:Abdominal Fat / Q000000981:diagnostic imaging / Q000503:physiopathology*; D050154:Adiposity; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D007249:Inflammation / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D018836:Inflammation Mediators / Q000097:blood; D053208:Kaplan-Meier Estimate; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis / Q000276:immunology* / Q000401:mortality / Q000503:physiopathology*; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009752:Nutritional Status; D056128:Obesity, Abdominal / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology*; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000401:mortality; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers; D018836:Inflammation Mediators; D002097:C-Reactive Protein