title: Body Mass Index, Left Ventricular Mass Index and Cardiovascular Events in Chronic Kidney Disease.
abstract: BACKGROUND
  Obesity and left ventricular hypertrophy are prevalent in chronic kidney disease (CKD), but the association of body mass index (BMI) and left ventricular mass index (LVMI) with cardiovascular outcomes in patients with CKD is unclear. This study was designed to assess whether the combination of BMI and LVMI is independently associated with cardiovascular events in patients with CKD stages 3-5.
  
  
  METHODS
  From the outpatient department, 523 patients with CKD who received echocardiographic examination were enrolled. The patients under study were classified into 4 groups according to sex-specific median BMIs and LVMIs. Cardiovascular events were defined as cardiovascular death, hospitalization for unstable angina, nonfatal myocardial infarction, sustained ventricular arrhythmia, hospitalization for congestive heart failure, transient ischemia attack and stroke. The relative cardiovascular event risk was analyzed using Cox-regression methods.
  
  
  RESULTS
  The patients were stratified into 4 groups according to sex-specific median BMIs (men: 25.2 kg/m(2); women: 24.9 kg/m(2)) and LVMIs (men: 140.1g/m(2); women: 131.6g/m(2)). A combination of low BMI and high LVMI (versus the combination of high BMI and low LVMI) was significantly associated with cardiovascular events in an unadjusted model (hazard ratio [HR] = 3.178; 95% confidence interval [CI]: 1.645-6.140; P < 0.001) and in a multivariable model after adjustment for demographic, clinical and biochemical characteristics and medications (HR = 3.553; 95% CI: 1.494-8.450; P = 0.004).
  
  
  CONCLUSIONS
  The findings showed that the combination of low BMI and high LVMI was associated with adverse cardiovascular events in patients with CKD stages 3-5.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
authors.forename: Szu-Chia
authors.initials: SC
authors.lastname: Chen
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
authors.forename: Jiun-Chi
authors.initials: JC
authors.lastname: Huang
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Tsai
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
authors.forename: Ling-I
authors.initials: LI
authors.lastname: Chen
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC. Electronic address: cobeshm@seed.net.tw.
authors.forename: Ho-Ming
authors.initials: HM
authors.lastname: Su
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Faculty of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
authors.forename: Jer-Ming
authors.initials: JM
authors.lastname: Chang
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Faculty of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
authors.forename: Hung-Chun
authors.initials: HC
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000033:anatomy & histology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D015995:Prevalence; D016016:Proportional Hazards Models; D012044:Regression Analysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000453:epidemiology*; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
keywords: Body mass index; Cardiovascular events; Chronic kidney disease; Left ventricular mass index