Visceral fat area independently predicts mortality in patients on hemodialysis

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October 16, 2020

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Visceral fat area predicted cardiovascular events, related mortality and mortality due to any cause better than coronary artery calcification, according to a prospective study of 97 patients treated with hemodialysis.

“The underlying mechanisms of how [visceral fat area] or [coronary artery calcifications] affect cardiovascular outcomes remain unknown,” Yuqin Xiong, MD, and colleagues wrote in a study published in the Journal of Renal Nutrition.

Xiong and colleagues’ prospective study analyzed demographic information from electronic health records and serum biochemical indexes. Investigators followed up with patients monthly. The main etiologies of 97 Chinese patients (male patients, 61.9%; comorbid diabetes, 20.6%; median dialysis vintage, 10 months) were glomerulonephritis (35%), hypertensive nephropathy (26.8%) and diabetic nephropathy (16.5%); 21.7% of patients had another etiology. The outcome measures were cardiovascular events including congestive heart failure, hypovolemic shock, myocardial infarction, unstable angina, frequent arrhythmia requiring hospitalization, coronary revascularization, stroke and amputation or revascularization due to peripheral artery disease; cardiovascular death; and death due to any cause.

During the follow-up period, 20.6% of patients experienced a cardiovascular event. Cardiovascular-related deaths occurred in 8.2% of patients, and the overall mortality rate was 11.3%. Greater visceral fat area (VFA) size was associated with cardiovascular events (VFA 71.3 cm2, HR = 9.21; 95% CI, 1.49-56.76), and a 1 cm2 increase was associated with greater risk for cardiovascular-related mortality (HR = 1.11; 95% CI, 1.01-1.22), overall mortality (HR = 1.08; 95% CI, 1.02-1.14) and cardiac structure parameters, and patients developing left ventricular hypertrophy (OR = 1.02; 95% CI, 1-1.03). Nonetheless, researchers wrote coronary artery calcifications were not associated with cardiovascular events or mortality.

“Increased VFA can be used as an independent predictor for [cardiovascular events], [cardiovascular death] and all-cause mortality,” researchers wrote. “The effect of VFA exerts on cardiac reconstruction might be the underlying mechanism. Further studies are warranted for the management of VFA in the hemodialysis population.”

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