title: Neutrophil-to-lymphocyte ratio as a possible indicator of epicardial adipose tissue in patients undergoing hemodialysis.
abstract: BACKGROUND
  Chronic inflammation is a major risk factor in the pathogenesis of cardiovascular disease in end-stage renal disease (ESRD) patients. Epicardial adipose tissue (EAT) is the true visceral fat depot of the heart. The relationship between coronary artery disease and EAT was shown in healthy subjects and ESRD patients. In the present study we aimed to investigate the relationship between EAT and inflammation parameters including neutrophil-to-lymphocyte ratio (NLR) in hemodialysis (HD) patients.
  
  
  METHODS
  Forty-three HD patients (25 females, 18 males; mean age: 64.1 ±11.9 years) receiving HD and 30 healthy subjects (15 females, 15 males; mean age: 59.1 ±10.8 years) were enrolled in the study. Epicardial adipose tissue measurements were performed by echocardiography.
  
  
  RESULTS
  Neutrophil-to-lymphocyte ratio levels were significantly higher in HD patients than in the healthy control group. Hemodialysis patients were separated into two groups according to their median value of NLR (group 1, NLR < 3.07 (n= 21) and group 2, NLR ≥ 3.07 (n= 22)). Group 2 patients had significantly higher EAT, C-reactive protein and ferritin levels, while albumin levels were significantly lower in this group. In the bivariate correlation analysis, EAT was positively correlated with NLR (r= 0.600,p< 0.001) and ferritin (r= 0.485,p= 0.001) levels.
  
  
  CONCLUSIONS
  Neutrophil-to-lymphocyte ratio was found to be an independent predictor of EAT in HD patients (odds ratio = 3.178;p= 0.008). We concluded that this relationship might be attributed to increased inflammation in uremic patients.
authors.affiliation: Department of Internal Medicine, School of Medicine, Erzincan University, Erzincan, Turkey.
authors.forename: Adalet
authors.initials: A
authors.lastname: Ozcicek
authors.affiliation: Department of Internal Medicine, School of Medicine, Erzincan University, Erzincan, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Ozcicek
authors.affiliation: Department of Nephrology, Atatürk State Hospital, Zonguldak, Turkey.
authors.forename: Gursel
authors.initials: G
authors.lastname: Yildiz
authors.affiliation: Department of Internal Medicine, School of Medicine, Erzincan University, Erzincan, Turkey.
authors.forename: Aysu
authors.initials: A
authors.lastname: Timuroglu
authors.affiliation: Department of Internal Medicine, School of Medicine, Erzincan University, Erzincan, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Demirtas
authors.affiliation: Department Cardiology, School of Medicine, Erzincan University, Erzincan, Turkey.
authors.forename: Mutlu
authors.initials: M
authors.lastname: Buyuklu
authors.affiliation: Department of Anesthesiology and Reanimation, School of Medicine, Erzincan University, Erzincan, Turkey.
authors.forename: Ufuk
authors.initials: U
authors.lastname: Kuyrukluyildiz
authors.affiliation: Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, Erzincan University, Erzincan, Turkey.
authors.forename: Emin Murat
authors.initials: EM
authors.lastname: Akbas
authors.affiliation: Department Cardiology, School of Medicine, Erzincan University, Erzincan, Turkey.
authors.forename: Ergun
authors.initials: E
authors.lastname: Topal
authors.affiliation: Department of Internal Medicine, Division of Nephrology, School of Medicine, Erzincan University, Erzincan, Turkey.
authors.forename: Kultigin
authors.initials: K
authors.lastname: Turkmen
keywords: end-stage renal disease; epicardial adipose tissue; inflammation; neutrophil-to-lymphocyte ratio