title: Abdominal obesity is associated with peripheral artery disease in hemodialysis patients.
abstract: BACKGROUND
  Peripheral arterial disease (PAD) is a leading cause of morbidity in hemodialysis (HD) patients. Recent evidence suggests that abdominal obesity (AO) may play a role in PAD. However, the association between AO and PAD has not been thoroughly studied in HD patients.
  
  
  METHODS
  The present cross-sectional study aimed to examine the relationship between AO and PAD in a cohort of 204 chronic HD patients. The ankle brachial index (ABI) was used as an estimate of the presence of PAD. Plasma adiponectin levels, interleukin-6 (IL-6) levels, high sensitivity C-reactive protein (hs-CRP) levels, asymmetric dimethylarginine (ADMA) levels, and lipid profiles were measured. Logistic regression was used to estimate the association between the presence of PAD and AO as well as other potential risk factors.
  
  
  RESULTS
  The metabolic risk factors and all individual traits, including elevated ln-transformed hs-CRP, were found to be significant (P<0.05) more frequently in HD patients with AO than that in control subjects. Patients with AO had a higher prevalence of PAD than the control individuals, with a mean ABI of 0.96 ± 0.23 and 1.08 ± 0.16 (P<0.0001) and PAD prevalence of 26.9% and 10.8% (P = 0.003), respectively. By multivariate analysis, AO (odds ratio [OR], 4.532; 95% CI, 1.765-11.639; P = 0.002), elevated serum ln-transformed ADMA (OR, 5.535; 95% CI, 1.323-23.155; P = 0.019), and ln-transformed IL-6 (OR, 1.567; 95% CI, 1.033-2.378; P = 0.035) were independent predictors of the presence of PAD.
  
  
  CONCLUSIONS
  HD patients with AO exhibited a cluster of metabolic risk factors and lower ABI. AO, elevated serum ln-transformed ADMA, and ln-transformed IL-6 were independent predictors of the presence of PAD.
authors.affiliation: Department of Internal Medicine, Ditmanson Medical Foundation Chia-yi Christian Hospital, Chia-yi, Taiwan.
authors.forename: Peir-Haur
authors.initials: PH
authors.lastname: Hung
authors.forename: Hung-Bin
authors.initials: HB
authors.lastname: Tsai
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Lin
authors.forename: Kuan-Yu
authors.initials: KY
authors.lastname: Hung
mesh_terms: D052242:Adiponectin / Q000097:blood; D055109:Ankle Brachial Index / Q000379:methods; D001120:Arginine / Q000031:analogs & derivatives / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D050356:Lipid Metabolism; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000097:blood / Q000150:complications* / Q000378:metabolism; D058729:Peripheral Arterial Disease / Q000097:blood / Q000209:etiology* / Q000378:metabolism; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors
chemical_list: D052242:Adiponectin; D015850:Interleukin-6; C018524:N,N-dimethylarginine; D002097:C-Reactive Protein; D001120:Arginine