title: Visceral fat area is associated with HbA1c but not dialysate-related glucose load in nondiabetic PD patients.
abstract: Factors associated with increased visceral fat area (VFA) have been well documented in the general population but rarely explored in nondiabetic individuals on peritoneal dialysis (PD). As glycosylated hemoglobin (HbA1c) is positively correlated with VFA in diabetic patients, we hypothesized that the same correlation would exist in nondiabetic PD patients. We enrolled 105 nondiabetic patients who had undergone chronic PD for more than 3 months. Each subject underwent an abdominal computed tomography (CT) scan, and the umbilicus cut was analyzed for VFA. VFA values, corrected for body mass index and subjected to natural logarithm transformations, were examined to determine whether they were correlated with HbA1c and other parameters. PD dialysates prescribed at the time of enrollment were recorded to calculate glucose load. We found that when 105 nondiabetic PD patients were classified according to tertiles of HbA1c, higher HbA1c was associated with larger VFA. Multiple linear regression analysis revealed that HbA1c was an independent determinant of VFA, while glucose load and other PD-specific factors were not. In summary, HbA1c, but not PD-related glucose load, was positively correlated with VFA in nondiabetic PD patients, suggesting clinical utility of HbA1c in the PD population.
authors.affiliation: 1] Division of Nephrology, Department of Internal Medicine, I-Shou University, E-DA Road, Kaohsiung, Taiwan [2] Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei.
authors.forename: Li-chun
authors.initials: LC
authors.lastname: Ho
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei.
authors.forename: Chung-Jen
authors.initials: CJ
authors.lastname: Yen
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei.
authors.forename: Chia-Ter
authors.initials: CT
authors.lastname: Chao
authors.affiliation: 1] Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei [2] Department of Internal Medicine, Jin-Shan branch, National Taiwan University Hospital and College of Medicine, New Taipei City, Taiwan.
authors.forename: Chih-Kang
authors.initials: CK
authors.lastname: Chiang
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei.
authors.forename: Jenq-Wen
authors.initials: JW
authors.lastname: Huang
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei.
authors.forename: Kuan-Yu
authors.initials: KY
authors.lastname: Hung
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D015314:Dialysis Solutions / Q000737:chemistry; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006031:Glycosylation; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D010530:Peritoneal Dialysis; D051436:Renal Insufficiency, Chronic / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers; D015314:Dialysis Solutions; D005947:Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human