U-Shaped Association of Body Mass Index With Inflammation and Atherosclerosis in Hemodialysis Patients

Kahraman, Serkan; Yilmaz, Rahmi; Akinci, Devrim; Arici, Mustafa; Altun, Bulent; Erdem, Yunus; Yasavul, Unal; Turgan, Cetin

doi:10.1053/j.jrn.2005.07.004

« Previous Next »Journal of Renal Nutrition
Volume 15, Issue 4 , Pages 377-386, October 2005

U-Shaped Association of Body Mass Index With Inflammation and Atherosclerosis in Hemodialysis Patients

Serkan Kahraman, MD
- Fellow of Nephrology, Hacettepe University Faculty of Medicine, Department of Nephrology, Ankara, Turkey.
- Address reprint requests to Serkan Kahraman, MD, Hacettepe Hastanesi, Nefroloji Bolumu, 06100 Sihhiye, Ankara, Turkey.
Rahmi Yilmaz, MD
- Fellow of Nephrology, Hacettepe University Faculty of Medicine, Department of Nephrology, Ankara, Turkey.
Devrim Akinci, MD
- Fellow of Radiology, Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, Turkey.
Mustafa Arici, MD
- Associate Professor of Nephrology, Hacettepe University Faculty of Medicine, Department of Nephrology, Ankara, Turkey.
Bulent Altun, MD
- Associate Professor of Nephrology, Hacettepe University Faculty of Medicine, Department of Nephrology, Ankara, Turkey.
Yunus Erdem, MD
- Professor of Nephrology, Hacettepe University Faculty of Medicine, Department of Nephrology, Ankara, Turkey.
Unal Yasavul, MD
- Professor of Nephrology, Hacettepe University Faculty of Medicine, Department of Nephrology, Ankara, Turkey.
Cetin Turgan, MD
- Professor of Nephrology, Hacettepe University Faculty of Medicine, Department of Nephrology, Ankara, Turkey.

Objective

High body mass index (BMI) is associated with mortality in the general population, whereas obesity is suggested to confer a survival advantage in hemodialysis (HD) patients. However, underlying mechanisms are yet to be elucidated. We examined the cross-sectional association of BMI with inflammatory and nutritional markers and atherosclerosis in HD patients.

Design

Cross-sectional study.

Setting and participants

One hundred and nine maintenance HD patients in the Hacettepe University Hospital Haemodialysis Unit were studied.

Methods

Data on demographics, comorbidity, and anthropometry were obtained by patient interviews. Atherosclerosis was assessed by B-mode Doppler ultrasonography on common carotid artery. Serum markers of inflammation, nutrition, and lipid metabolism, including C-reactive protein (CRP), albumin, prealbumin, homocysteine and lipoproteins, were measured by standard methods.

Main outcome measure

Distribution of inflammatory and nutritional markers and prevalence of atherosclerosis in underweight, normal, overweight, and obese HD patients.

Results

CRP levels were significantly higher in obese and underweight HD patients compared with normal and overweight patients (P < .05). The prevalence of atherosclerosis was significantly higher in underweight and obese patients (54.5% and 50%) compared with normal and overweight patients (25.7% and 33%) (P < .05).

Conclusions

In the present study, obesity is associated with inflammation and atherosclerosis. An obesity-related survival advantage should be modified by other factors such as race, comorbid conditions, body composition, and nutritional status.