Department of Nephrology and.
Ren Fail. 2013 Oct;35(9):1193-8. doi: 10.3109/0886022X.2013.823826. Epub 2013 Aug 7.
Epicardial adipose tissue (EAT) is the true visceral fat depot of the heart. The relationship between coronary artery disease and EAT was shown in end-stage renal disease (ESRD) patients. One of the established risk factor in this population is dyslipidemia. We aimed to determine the relationship between atherogenic index of plasma (AIP) and EAT in ESRD patients.
This was a cross-sectional study involving 76 ESRD patients receiving PD or HD for ≥6 months and 42 healthy subjects. EAT was measured by using an electrocardiogram-gated 64-multidetector computed tomography (MDCT). Atherogenic index of plasma was calculated as the logarithmically transformed ratio of the serum trigliseride to HDL-cholesterol.
The etiology of ESRD patients was diabetic nephropathy (n = 16), chronic glomerulonephritis (n = 10), hypertensive nephropathy (n = 23), polycystic kidney disease (n = 7), nephrolithiasis (n = 5) and unknown (n = 15). There were no differences with respect to the following variables between ESRD patients and healthy subjects: age; sex; BMI; predialysis levels of DBP; serum levels of albumin, HDL-cholesterol and hemoglobin. However, ESRD patients had higher serum levels of trigliseride, hs-CRP and AIP when compared to healthy subjects. There was a statistically significant relationship between EAT, BMI and AIP in ESRD patients (r = 0.42, p < 0.001 and r = 0.25, p = 0.028, respectively). The stepwise linear regression analysis revealed that age, as well as BMI were independent predictors of EAT.
We found a relationship between EAT as defined by MDCT and AIP in ESRD patients. Further clinical and experimental studies are needed.
心外膜脂肪组织（EAT）是心脏真正的内脏脂肪库。在终末期肾病（ESRD）患者中已经证明了冠状动脉疾病与 EAT 之间的关系。该人群中的一个既定危险因素是血脂异常。我们旨在确定 ESRD 患者载脂蛋白指数（AIP）与 EAT 之间的关系。
这是一项横断面研究，纳入了 76 名接受 PD 或 HD 治疗≥6 个月的 ESRD 患者和 42 名健康受试者。使用心电图门控 64 层多排 CT（MDCT）测量 EAT。载脂蛋白指数是通过将血清三酰甘油与高密度脂蛋白胆固醇的对数比值计算得出。
ESRD 患者的病因是糖尿病肾病（n=16）、慢性肾小球肾炎（n=10）、高血压性肾病（n=23）、多囊肾病（n=7）、肾结石（n=5）和原因不明（n=15）。ESRD 患者与健康受试者在以下变量方面无差异：年龄；性别；BMI；透析前舒张压水平；血清白蛋白、高密度脂蛋白胆固醇和血红蛋白水平。然而，与健康受试者相比，ESRD 患者的血清三酰甘油、hs-CRP 和 AIP 水平更高。ESRD 患者的 EAT、BMI 和 AIP 之间存在统计学显著关系（r=0.42，p<0.001 和 r=0.25，p=0.028）。逐步线性回归分析显示，年龄以及 BMI 是 EAT 的独立预测因子。
我们发现 MDCT 定义的 EAT 与 ESRD 患者的 AIP 之间存在关系。需要进一步的临床和实验研究。
