Endocrinología y Nutrición, Hospital Universitario de Guadalajara, Guadalajara, España.
Profesor asociado de la Universidad Europea (Madrid), Medicina Interna, Hospital Universitario Quironsalud, Pozuelo de Alarcón, Madrid, España.
Nefrologia (Engl Ed). 2021 Mar-Apr;41(2):174-181. doi: 10.1016/j.nefro.2020.09.005. Epub 2020 Dec 29.
Epicardial and mediastinal adipose tissue (EAT, MAT) are linked to metabolic syndrome and coronary artery disease. Patients with chronic kidney disease (CKD) have thicker EAT. We assessed if EAT and MAT could be associated with increased mortality and cardiovascular events in patients with advanced CKD and haemodialysis therapy.
A post-hoc study was performed. We analyzed a prospective series of 104 cases. EAT thickness was quantified by a multislice synchronized computed tomography (MSCT).
The follow-up period was 112.68 (109.94 -115.42) months. The optimal cut-off point of EAT for prediction of total mortality was 11.45mm (92.86% and 43.75%). EAT thickness was associated with serum albumin levels, serum triglyceride levels, phosphorus and calcium phosphate product. The EAT was greater in haemodialysis patients compared to those with advanced CKD (P<.001). Patients with diabetes mellitus had greater EAT and MAT thickness (P=.018). At the end of follow up, the survival average time of patients with EAT thickness <11.45mm was 97.48 months vs. 76.65 months for thickness > 11.45mm (P=.007).
A higher EAT and MAT thickness was associated with increased mortality. Furthermore, EAT was associated with lower free survival time to fatal and non-fatal cardiovascular events. The measurement of EAT and MAT by MSCT could be a prognostic tool to predict cardiovascular events and mortality risk in advanced CKD patients.
心外膜和纵隔脂肪组织（EAT、MAT）与代谢综合征和冠状动脉疾病有关。患有慢性肾脏病（CKD）的患者 EAT 更厚。我们评估了 EAT 和 MAT 是否与接受晚期 CKD 和血液透析治疗的患者的死亡率和心血管事件增加有关。
进行了一项事后研究。我们分析了一项前瞻性系列的 104 例病例。通过多层同步计算机断层扫描（MSCT）定量 EAT 厚度。
随访期为 112.68（109.94-115.42）个月。EAT 预测总死亡率的最佳截断点为 11.45mm（92.86%和 43.75%）。EAT 厚度与血清白蛋白水平、血清甘油三酯水平、磷和钙磷产物相关。与晚期 CKD 患者相比，血液透析患者的 EAT 更大（P<.001）。患有糖尿病的患者的 EAT 和 MAT 厚度更大（P=.018）。随访结束时，EAT 厚度<11.45mm 的患者的生存平均时间为 97.48 个月，而 EAT 厚度>11.45mm 的患者为 76.65 个月（P=.007）。
较高的 EAT 和 MAT 厚度与死亡率增加有关。此外，EAT 与致命和非致命心血管事件的无复发生存时间较短有关。MSCT 测量 EAT 和 MAT 可能是预测晚期 CKD 患者心血管事件和死亡风险的预后工具。
