The relationship between atherogenic index of plasma and epicardial adipose tissue in hemodialysis and peritoneal dialysis patients

Erdur, Mehmet Fatih; Tonbul, Halil Zeki; Özbiner, Hüseyin; Özçiçek, Adalet; Akbas, Emin Murat; Özbek, Orhan; Hamur, Hikmet; Türkmen, Kültiğin

doi:10.3109/0886022x.2013.823826

Cited by 25 publications

(19 citation statements)

References 37 publications

(43 reference statements)

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“…Similarly, in a recent report, Erdur et al. depicted a relationship between EAT deposition and TG/HDL‐C ratio in dialysis patients . Our findings strictly fortified these studies.…”

Section: Discussionsupporting

confidence: 90%

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Echocardiographic epicardial adipose tissue measurements provide information about cardiovascular risk in hemodialysis patients

Okyay

Solak

et al. 2015

Hemodialysis International

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Epicardial adipose tissue (EAT) is a cardiovascular risk predictor in general population. However, its value has not been well validated in maintainance hemodialysis (MHD) patients. We aimed to assess associations of EAT with cardiovascular risk predictors in nondiabetic MHD patients. In this cross-sectional study, we measured EAT thickness by transthoracic echocardiography in 50 MHD patients (45.8 ± 14.6 years of age, 37 male). Antropometric measurements, bioimpedance analysis, left ventricular (LV) mass, carotis intima media thickness, blood tests, homeostasis model assessment for insulin resistance (HOMA-IR) and hemodialysis dose by single-pool urea clearence index (spKt/V) were determined. The mean EAT thickness was 3.28 ± 1.04 mm. There were significant associations of EAT with body mass index (β = 0.590, P < 0.001), waist circumference (β = 0.572, P < 0.001), body fat mass (β = 0.562, P < 0.001), percentage of body fat mass (β = 0.408, P = 0.003), percentage of lean tissue mass (β = -0.421, P = 0.002), LV mass (β = 0.426, P = 0.002), carotis intima media thickness (β = 0.289, P = 0.042), triglyceride/high-density lipoprotein cholesterol ratio (β = 0.529, P < 0.001), 1/HOMA-IR (β = -0.386, P = 0.006), and spKt/V (β = -0.311, P = 0.028). No association was exhibited with visfatin C, high-sensitivity C-reactive protein, interleukin-6, and tumor necrosis factor-alpha (for all, P > 0.05). Body mass index, waist circumference, body fat mass, percentage of lean tissue mass, LV mass, triglyceride/high-density lipoprotein cholesterol ratio, HOMA-IR, and spKt/V appeared as independent predictors of EAT. EAT was significantly associated with body fat measures, cardiovascular risk predictors, and dialysis dose in MHD patients.

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“…Similarly, in a recent report, Erdur et al. depicted a relationship between EAT deposition and TG/HDL‐C ratio in dialysis patients . Our findings strictly fortified these studies.…”

Section: Discussionsupporting

confidence: 90%

“…31 Similarly, in a recent report, Erdur et al depicted a relationship between EAT deposition and TG/HDL-C ratio in dialysis patients. 32 Our findings strictly fortified these studies. The possible mechanisms linking EAT deposition and dyslipidemia should be the subject of further studies.…”

Section: Discussionsupporting

confidence: 83%

Echocardiographic epicardial adipose tissue measurements provide information about cardiovascular risk in hemodialysis patients

Okyay

Solak

et al. 2015

Hemodialysis International

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“…Unfortunately, LDL-C particle size and insulin resistance were not measured in our study, making it difficult to clarify the underlying mechanism for increased cardiovascular risk of a high AIP in ESRD patients on dialysis. However, a cross-sectional evaluation of the AIP and surrogates of cardiovascular disease in dialysis patients supported our findings [19, 20]. In a study of 31 HD patients and 31 healthy volunteers, the AIP and carotid intima medial thickness were higher in HD patients compared with controls [19].…”

Section: Discussionsupporting

confidence: 78%

“…There was a significant positive correlation between the AIP and carotid intima medial thickness in HD patients. Another study also showed that the AIP was significantly associated with increased epicardial adipose tissue, the true visceral fat deposit of the heart in ESRD patients [20]. We did not perform carotid artery ultrasonography or cardiac computed tomography in the current study, but a further study with these cardiovascular surrogates may be helpful to verify a significant association between the AIP and cardiovascular disease in ESRD patients.…”

Section: Discussionmentioning

confidence: 87%

The atherogenic index of plasma and the risk of mortality in incident dialysis patients: Results from a nationwide prospective cohort in Korea

et al. 2017

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BackgroundThe atherogenic index of plasma (AIP), which is the logarithmic ratio of triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C), had a linear relationship with clinical outcomes in the general population. However, the association of each lipid profile, TG and HDL-C, with survival was not straightforward in dialysis patients. This non-linear association led us to further investigate the prognostic impact of the AIP in these patients.MethodsFrom a nationwide prospective cohort, 1,174 incident dialysis patients were included. Patients were categorized into quintiles according to the AIP. An independent association of the AIP with all-cause and cardiovascular mortality was determined.ResultsDuring a mean follow-up duration of 33.2 months, 170 patients (14.5%) died, and cardiovascular death was observed in 55 patients (4.7%). Multivariate Cox analyses revealed that the lowest (quintile 1, hazard ratio [HR] = 1.76, 95% confidence interval [CI] = 1.02–3.03) and the highest (quintile 5, HR = 2.15, 95% CI = 1.26–3.65) AIP groups were significantly associated with higher all-cause mortality compared to patients in quintile 3 (reference group). In terms of cardiovascular mortality, only the highest AIP group (quintile 5, HR = 2.59, 95% CI = 1.06–6.34) was significantly associated with increased risk of mortality. Sensitivity analyses showed that a U-shaped association between the AIP and all-cause mortality remained significant in non-diabetic and underweight to normal body mass index patients.ConclusionsBoth the highest and the lowest AIP groups were independently associated with all-cause mortality, showing a U-shaped association. It suggested further studies are needed to identify targets and subgroups that can benefit from intervention of the AIP in incident dialysis patients.

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“…Given the exceedingly high risk of coronary heart disease events in patients with CKD and the complex relationship between metrics of body adiposity and cardiovascular disease risk in these patients , studies focusing on epicardial fat in CKD appear to be highly relevant. So far, five studies have been conducted in patients with this disease: four studies in patients with kidney failure and one in predialysis stage G3–5 patients . However, all these studies were cross‐sectional and relatively small (ranging from 16 to 93 patients).…”

Section: Epicardial Fat In Ckdmentioning

confidence: 99%

The location of adipose tissue is important: epicardial fat in patients with chronic kidney disease

Zoccali

Mallamaci

2015

J Intern Med

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The relationship between atherogenic index of plasma and epicardial adipose tissue in hemodialysis and peritoneal dialysis patients

Cited by 25 publications

References 37 publications

Echocardiographic epicardial adipose tissue measurements provide information about cardiovascular risk in hemodialysis patients

Echocardiographic epicardial adipose tissue measurements provide information about cardiovascular risk in hemodialysis patients

The atherogenic index of plasma and the risk of mortality in incident dialysis patients: Results from a nationwide prospective cohort in Korea

The location of adipose tissue is important: epicardial fat in patients with chronic kidney disease

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