title: Usefulness of the conicity index together with the conjoint use of adipocytokines and nutritional-inflammatory markers in hemodialysis patients.
abstract: Abdominal fat has been recognized as the most hormonally active tissue secreting a variety of adipocytokines and, therefore, potentially contributing to inflammation. The conicity index (Cindex) has been considered a valuable indicator of central obesity. This study aims to relate plasma concentrations of leptin, adiponectin, interleukin-6 (IL-6), and serum C-reactive protein (CRP) with Cindexvalues in hemodialysis (HD) patients. Cross-sectional study in 45 HD patients (55.6 % men; DM 20 %; mean age, 68.1 year). Cindexand nutritional-inflammatory markers were used for the abdominal fat depot assessment. Patients were classified as having a low or high median Cindex(MCindex): low group (men, <1.39; women, <1.33) and high group (men, ≥1.39; women, ≥1.33). A combination of plasma leptin, IL-6, adiponectin, and CRP was used to design an inflammatory index (Iindex) while a protein-energy wasting index (PEWindex) was calculated from the Iindexplus the malnutrition-inflammation score (MIS). Waist circumference (WC) and Cindexbut not BMI were significantly higher in men than in women (p < 0.01). The MCindexwas significantly associated with the adipocytokine profile (CRP, leptin, and adiponectin). Patients with a high MCindexhad a higher Iindexand PEWindex(p < 0.01). ROC curve analyses measured by area under the curve (AUC) were 0.69 and 0.68 (p < 0.05), for the Cindexand MCindex, respectively, demonstrating the usefulness of the Cindexas an abdominal fat mass biomarker able for wasting-inflamed HD patients. These findings in HD patients underscore the importance of incorporating the evaluation of one abdominal fat indicator, such as the Cindexand an inflammatory biomarker such as the IL-6 and CRP, in substitution of the BMI, in current clinical practice.
authors.affiliation: Departamento de Nutrición y Bromatología I (Nutrición), Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040, Madrid, Spain. marruperto@yahoo.com.
authors.forename: Mar
authors.identifier: http://orcid.org/0000-0002-8790-4007
authors.initials: M
authors.lastname: Ruperto
authors.affiliation: Servicio de Nefrología, Hospital Universitario La Princesa, Madrid, Spain.
authors.forename: Guillermina
authors.initials: G
authors.lastname: Barril
authors.affiliation: Departamento de Nutrición y Bromatología I (Nutrición), Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040, Madrid, Spain.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Sánchez-Muniz
mesh_terms: D050153:Abdominal Fat / Q000276:immunology / Q000378:metabolism; D054392:Adipokines / Q000097:blood* / Q000378:metabolism; D050154:Adiposity; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D056128:Obesity, Abdominal / Q000150:complications / Q000175:diagnosis* / Q000276:immunology / Q000378:metabolism; D011502:Protein-Energy Malnutrition / Q000150:complications / Q000175:diagnosis* / Q000276:immunology / Q000378:metabolism; D006435:Renal Dialysis / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000628:therapy*; D012680:Sensitivity and Specificity; D012727:Sex Characteristics; D055105:Waist Circumference
chemical_list: D054392:Adipokines; D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6; D002097:C-Reactive Protein
keywords: Adipocytokines; Conicity index; Hemodialysis; Inflammatory index; Protein-energy wasting