THE RELATIONSHIP BETWEEN VISCERAL ADIPOSE TISSUE AND INTIMA-MEDIA THICKNESS IN PATIENTS WITH KIDNEY DISEASE

AYDIN GÜÇLÜ*, BELDA DURSUN**, SIMIN ROTA***, NURAN SABIR****, CIHAN KAYA****, FATIH YAMAN***

*Department of Nephrology, Ahi EvranUniversity, Medical School, Kirşehir Turkey - **Department of Nephrology, PamukkaleUniversity, Medical School, Denizli Turkey - ***Department of Biochemistry, PamukkaleUniversity, Medical School, Denizli Turkey - ***Department of Radiology, PamukkaleUniversity, Medical School, Denizli Turkey

Introduction: Increase in visceral adipose tissue (VAT) is associated with cardiovascular risk. However, the relationship between atherosclerosis and VAT has not yet been adequately studied in chronic kidney disease (CKD). The aim of this study was to assess the relationship among VAT, adipokines, and atherosclerosis in patients with CKD.

Materials and methods: 45 healthy control, 53 predialysis patients, and 52 hemodialysis patients have been enrolled in the study. Intima media thickness (IMT) of the carotid artery, and VAT measurements were evaluated via ultrasonography.

Results: IMT (p:0.002), VAT (p:0.021), adiponectin (p<0.001) and pentraxin-3 (p:0.003) were higher in predialysis patients than healthy controls. The values of IMT (p<0.001), VAT (p:0.0014), adiponectin (p:0.005), pentraxin-3 (p: <0.001), C reactive protein (CRP) (p:0.009), triglyceride (p: <0.001) and parathyroid hormone (PTH) (p<0.001), were higher in hemodialysis patients than healthy controls. VAT was positively correlated with CRP(r: 0, 23 p: 0.005), IMT (r: 0.347 p<0.001), body mass index (BMI) (r: 0.33 p<0.001), and negatively correlated with creatinine clearance (R: -0.245 p: 0.003). VAT is independently related with adiponectin (β:-0.213 p: 0.008), BMI (β: 0.369, P<0.001), and CRP (β:0.164, P:0.032) in multiple regression analysis. IMT was positively correlated with VAT (r: 0.347 p<0.001), CRP (r: 0.186 p: 0.022), age (r: 0.333 p<0.001), BMI (r: 0.444 p<0.001) in all participants.

Conclusion: These findings show that VAT is a strong risk factor for atherosclerosis in patients with CKD. However IMT was not correlated with adiponectin, pentraxin-3, and leptin in patients with CKD. Also sonographic measurement of VAT could be useful to stratify the risk of cardiovascular disease in patients with CKD.