Abdominal obesity is the most significant metabolic syndrome component predictive of cardiovascular events in chronic hemodialysis patients

Wu, Chia-Chun; Liou, Hung-Hsiang; Su, Pei Fang; Chang, Min-Yu; Wang, Hsi Hao; Chen, Meng Jen; Hung, Shih Yuan

doi:10.1093/ndt/gfr057

Cited by 31 publications

(33 citation statements)

References 33 publications

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“…Hypertension has been described as one of the most important factors for the development of metabolic syndrome,27,29–31 together with central obesity 27,30,31. However, the criteria for central obesity also differed among the various studies, some of which measured it according to waist circumference while others used the body mass index.…”

Section: Discussionmentioning

confidence: 99%

“…In the current study, even though central obesity measured as waist circumference was the third most frequent metabolic syndrome defining risk factor in patients on hemodialysis, obesity measurement according to the body mass index only accounted for 11.8% of patients. The magnitude of influence of other metabolic syndrome defining risk factors in patients on hemodialysis has not yet been fully clarified, as variable information has been reported by the different studies carried out28,29,31 depending on the criteria used for the diagnosis of metabolic syndrome 30…”

Section: Discussionmentioning

confidence: 99%

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Metabolic syndrome in hemodialysis patients as a risk factor for new-onset diabetes mellitus after renal transplant: a prospective observational study

Bonet¹,

Martinez-Castelao²,

Bayés³

2013

DMSO

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PurposeMetabolic syndrome is a cluster of biochemical abnormalities including cardiovascular and diabetes risk factors. The development of diabetes mellitus after renal transplant represents a major posttransplant complication that may adversely affect graft/patient survival. The aim of this study was to assess the role of metabolic syndrome in patients on hemodialysis as a risk factor for the incidence of new-onset diabetes mellitus after renal transplant.Patients and methodsThis was a prospective observational epidemiologic study carried out in adult nondiabetic patients undergoing chronic hemodialysis and on the renal transplant waiting list between November 2008 and April 2009. Patients were followed up from Visit 1 (baseline) to 6 months after the renal transplant. The analysis of the role of metabolic syndrome in hemodialysis patients as a risk factor for the incidence of new-onset diabetes mellitus after renal transplant included the estimation of relative risk and its 95% confidence interval (CI).ResultsA total of 383 evaluable patients were entered into the study (mean age, 52.7 years; male, 57.7%; Caucasian, 90.1%). The prevalence of metabolic syndrome on hemodialysis was 30.4% (95% CI, 25.8%–35.4%). Hypertension was the most prevalent criterion for metabolic syndrome (65.0%), followed by low levels of high-density lipoprotein cholesterol (52.7%), abdominal obesity (36.2%), hypertriglyceridemia (32.4%), and impaired glucose (8.9%). After the renal transplant, the prevalence of metabolic syndrome was still 25.8%. During the posttransplant period, the incidence of new-onset diabetes mellitus reached 13.0% (95% CI, 7.8%–20.6%) and patients with pretransplant metabolic syndrome were 2.6 times (95% CI, 1.043–6.608) more likely to develop new-onset diabetes mellitus after the renal transplant than those without metabolic syndrome.ConclusionThe presence of metabolic syndrome in patients undergoing hemodialysis represents an independent risk factor for the incidence of new-onset diabetes mellitus after renal transplant.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Metabolic syndrome in hemodialysis patients as a risk factor for new-onset diabetes mellitus after renal transplant: a prospective observational study

Bonet¹,

Martinez-Castelao²,

Bayés³

2013

DMSO

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“…In contrast, in adults with mean GFR 87 ml/min/1.73 m 2 the prevalence of MS was 1 to 35 % across the same ranges of BMI [54]. Wu et al found MS in 50.5 % of dialyzed adults when the ATP III definition was used, and in 30.8 % when the IDF definition was used [55]. As in the general population, MS significantly increases CV risk in adults with CKD and even in dialyzed patients.…”

Section: The Prevalence Of Metabolic Abnormalities and Metabolic Syndmentioning

confidence: 99%

Metabolic syndrome in children with chronic kidney disease and after renal transplantation

Litwin

Niemirska

2013

Pediatr Nephrol

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Visceral obesity and metabolic abnormalities typical for metabolic syndrome (MS) are the new epidemic in adolescence. MS is not only the risk factor for cardiovascular disease but also for chronic kidney disease (CKD). Thus, there are some reasons to recognize MS as a new challenge for pediatric nephrologists. First, hypertensive and diabetic nephropathy, the main causes of CKD in adults, both share the same pathophysiological abnormalities associated with visceral obesity and insulin resistance and have their origins in childhood. Secondly, as the obesity epidemic also affects children with CKD, MS emerges as the risk factor for progression of CKD. Thirdly, metabolic abnormalities typical for MS may pose additional risk for cardiovascular morbidity and mortality in children with CKD. Finally, although the renal transplantation reverses uremic abnormalities it is associated with an exposure to new metabolic risk factors typical for MS and MS has been found to be the risk factor for graft loss and cardiovascular morbidity after renal transplantation. MS is the result of imbalance between dietary energy intake and expenditure inducing disproportionate fat accumulation. Thus, the best prevention and treatment of MS is physical activity and maintenance of proper relationship between lean and fat mass.

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“…The accumulation of abdominal fat increases waist size. Several studies have suggested that abdominal obesity is associated with type 2 diabetes (Heianza et al, 2014), cardiovascular disease (Shields et al, 2012), and metabolic syndrome (Wu et al, 2011). Furthermore, the Canadian Health Measures Survey found a positive association between abdominal obesity and cardiovascular disease among men and women with normal BMI (Shields et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

The effects of phthalate and nonylphenol exposure on body size and secondary sexual characteristics during puberty

Hou

Lin

Tsai³

et al. 2015

International Journal of Hygiene and Environmental Health

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Abdominal obesity is the most significant metabolic syndrome component predictive of cardiovascular events in chronic hemodialysis patients

Abstract: IDF-defined MetS was more predictive of CVEs than AHA/NHLBI-defined MetS. Of the MetS components, abdominal obesity was the single most significant predictor of CVEs in chronic HD patients.

Cited by 31 publications

References 33 publications

Metabolic syndrome in hemodialysis patients as a risk factor for new-onset diabetes mellitus after renal transplant: a prospective observational study

Metabolic syndrome in hemodialysis patients as a risk factor for new-onset diabetes mellitus after renal transplant: a prospective observational study

Metabolic syndrome in children with chronic kidney disease and after renal transplantation

The effects of phthalate and nonylphenol exposure on body size and secondary sexual characteristics during puberty

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