Use of neck circumference as a predictor of cardiovascular risk in chronic kidney patients undergoing haemodialysis who are candidates for transplantation

Abstract

Introduction Patients undergoing haemodialysis are at great cardiovascular risk. Neck circumference (NC) is a simple and low‐cost measure for estimating this risk precociously. The present study aimed to evaluate whether the cardiovascular risk obtained by NC is associated with the main cardiometabolic risk factors in patients on haemodialysis treatment who are on a waiting list for transplantation. Methods A cross‐sectional study was conducted including 96 patients in a single transplantation centre. Socio‐demographic, clinical‐laboratory and anthropometric data were collected. NC was considered as a dependent variable and the independent variables were body mass index (BMI), fasting glycaemia and lipid profile, triglyceride and high‐density lipoprotein‐cholesterol (TGL/HDL‐C) ratio, and triglyceride and glycaemia (TyG) index. For the comparison of averages, we used Mann–Whitney and Student’s t tests, as well as one‐way analysis of variance and Kruskal–Wallis tests. Bivariate and multivariate logistic regression was performed for the association between NC and cardiometabolic risk factors. p < 0.05 was considered statistically significant. Results There were higher BMI averages, blood glucose, triglycerides (TGL), TGL/HDL‐C ratio and TyG index in the tertile 3 of the NC, whereas the HDL‐C decreased as the tertile increased. There was a statistically significant risk of cardiovascular disease that was asscoiated, according to NC, with being overweight, high levels of TGL, TGL/HDL‐C, TyG index and low HDL‐C. Conclusions NC is shown to be associated with cardiometabolic risk factors in kidney patients undergoing haemodialysis who are on a transplant waiting list.

Neck circumference and its association with anthropometric, clinical, and biochemical parameters in patients with chronic kidney disease on hemodialysis

“…Regarding NC, this has been recognized as a parameter indicating cardiometabolic diseases [23], which has been promising in evaluating the risk of kidney failure [10]. Medeiros et al [24] showed that NC is associated with cardiometabolic risk factors in kidney failure patients on hemodialysis on a transplant waiting list, and Liu et al [25] found an association between NC and CKD indicators for patients at high cardiometabolic risk. In addition, the study of Hsiao et al [17] showed evidence that NC and albuminuria are determining factors for a precise and successful estimate of the glomerular filtration rate in patients at high cardiovascular risk, suggesting that NC should potentially be investigated in more studies.…”

“…Neck circumference has been considered an important marker of subcutaneous fat deposits in the upper body and a simple screening tool for identifying individuals with obesity [27,28]. In this sense, increased values suggest a greater risk for cardiovascular diseases in the population in general and in kidney failure patients [9,24]. The fatty acids released from subcutaneous fat in the upper body can result in oxidative stress and vascular lesions, causing an increased risk for cardiovascular diseases in individuals with higher NC [9,29].…”

Utility of the Global Leadership Initiative on Malnutrition criteria for the nutritional assessment of patients with end‐stage renal disease receiving chronic hemodialysis

“…Although malnutrition appears to play a role in the development of cardiovascular disease, which is proposed as the malnutritioninflammation-atherosclerosis syndrome, 4 the association between malnutrition and MACE has not been consistently demonstrated. [32][33][34][35] Other complex mechanisms can result in MACE, especially in patients receiving chronic haemodialysis; thus, various parameters have been proposed to evaluate the risk of MACE for this disease populations. [36][37][38] On the other hand, the distinction may result from the technique used for assessing malnutrition.…”

Associations between sleep problems and cardiometabolic risk in maintenance hemodialysis patients: A multicenter study

“…Therefore, early prediction of cardiometabolic risk is extremely important. Cardiometabolic risk factors contain high body mass index (BMI), raised low-density lipoprotein cholesterol (LDL), reduced high-density lipoprotein cholesterol (HDL), ascended total cholesterol (TC), raised triglyceride (TG), increased systolic blood pressure (SBP) and diastolic blood pressure (DBP), and elevated fasting glucose [ 7 ], all of which are associated with an increased risk of cardiovascular disease. One study showed that cardiometabolic risk was associated with abnormal glomerular filtration rate in the general population [ 8 ], and there was a significant association between cardiovascular disease risk and the severity of CKD [ 9 , 10 ].…”