Çolak Hülya, Kilicarslan Baris, Tekce Hikmet, Tanrisev Mehmet, Tugmen Cem, Aktas Gulali, Kursat Seyhun
Department of Nephrology, Tepecik Education and Research Hospital, Izmir, Turkey.
Ther Apher Dial. 2015 Feb;19(1):56-62. doi: 10.1111/1744-9987.12276.
Cardiovascular (CV) diseases are still the most important cause of morbidity and mortality in both patients receiving hemodialysis (HD) treatment and individuals with renal transplantation (Rtx). Measurement of epicardial adipose tissue (EAT) thickness is an easily applied, cheap, and useful recent method predicting increased CV risk. We aimed to compare EAT changes in HD and Rtx patients and the association between EAT and inflammatory and CV volume markers in both groups. A total of 124 patients: 45 Rtx, 43 HD patients and 36 healthy controls were enrolled in the study. Laboratory parameters and inflammatory markers (interleukin-6 [IL-6] and high sensitive C-reactive protein [Hs-CRP]) were evaluated from venous blood samples after an overnight fast. EAT thickness was measured with transthoracic echocardiography. The levels of Hs-CRP, IL-6, systolic and diastolic blood pressures, left atrial (LA) diameter, left atrial index (LAI), left ventricular mass (LVM) and LVM index (LVMI) were significantly higher in the HD patients than in the other groups. EAT was positively correlated with age, body mass index (BMI), time on dialysis, serum creatinine, total cholesterol, Low density lipoprotein-cholesterol, and LVM in Rtx group and positively correlated with age, BMI, duration of dialysis, Hs-CRP, IL-6, LAI and LVMI and inversely correlated with inferior vena cava collapse index (IVC-CI) in HD group. EAT thickness of RTx patients (whose previous HD duration was similar to those in HD group) are similar to the healthy population and significantly thinner than patients on HD.
心血管（CV）疾病仍然是接受血液透析（HD）治疗的患者和肾移植（Rtx）个体发病和死亡的最重要原因。测量心外膜脂肪组织（EAT）厚度是一种易于应用、成本低廉且有用的预测CV风险增加的新方法。我们旨在比较HD和Rtx患者的EAT变化以及两组中EAT与炎症和CV容量标志物之间的关联。共有124名患者纳入研究：45名Rtx患者、43名HD患者和36名健康对照者。过夜禁食后从静脉血样本中评估实验室参数和炎症标志物（白细胞介素-6 [IL-6]和高敏C反应蛋白 [Hs-CRP]）。通过经胸超声心动图测量EAT厚度。HD患者的Hs-CRP、IL-6、收缩压和舒张压、左心房（LA）直径、左心房指数（LAI）、左心室质量（LVM）和左心室质量指数（LVMI）水平显著高于其他组。在Rtx组中，EAT与年龄、体重指数（BMI）、透析时间、血清肌酐、总胆固醇、低密度脂蛋白胆固醇和LVM呈正相关；在HD组中，EAT与年龄、BMI、透析持续时间、Hs-CRP、IL-6、LAI和LVMI呈正相关，与下腔静脉塌陷指数（IVC-CI）呈负相关。Rtx患者（其先前HD持续时间与HD组相似）的EAT厚度与健康人群相似，且明显薄于HD患者。
