Programa de Pós-graduação em Nutrição, Universidade Federal de Pernambuco, Recife, PE, Brasil,
Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil.
Arch Endocrinol Metab. 2021 Nov 24;65(6):811-820. doi: 10.20945/2359-3997000000421. Epub 2021 Nov 11.
Cardiovascular diseases represent the main cause of death in chronic kidney disease (CKD). We aimed to evaluate the prevalence and association of the hypertriglyceridemia-waist phenotype (HWP) and visceral adiposity index (VAI) with cardiometabolic risk factors (CR) in patients with CKD on hemodialysis (HD).
The study is based on a cross-sectional design with 265 HD patients in two cities in northeastern Brazil. The VAI was calculated considering the variables body mass index (BMI), waist circumference (WC), triglycerides (TG) and high density lipoprotein cholesterol (HDL-c). HWP was defined as the concomitant elevation of WC and TG. The Poisson Regression Model with robust variance estimation was adjusted considering a hierarchical approach for explanatory variables. Prevalence ratios (PR) were also estimated. The level of significance adopted was 5%.
In our study HWP and VAI prevalence's were 29.82% and 58.49%, respectively. In the final model, there was an association between VAI and female gender (PR = 1.46; p < 0.0001) and high body fat (% BF) (PR = 1.33; p < 0.0019). HWP was associated with females (PR = 1.80; p = 0.002), alcohol consumption (PR = 1.58; p = 0.033), obesity (PR = 1.89; p = 0.0001), high %BF (PR = 1.76; p = 0.012) and reduced HDL-c (PR = 1.48; p = 0.035).
The HWP stood out as the association with more CR factors, representing a promising method for tracking cardiometabolic risk in HD patients, mainly female.
心血管疾病是慢性肾脏病（CKD）患者死亡的主要原因。本研究旨在评估血脂异常-腰围表型（HWP）和内脏脂肪指数（VAI）与接受血液透析（HD）治疗的 CKD 患者心血管代谢风险因素（CR）的相关性。
本研究基于巴西东北部两个城市的 265 名 HD 患者的横断面设计。VAI 是通过考虑体重指数（BMI）、腰围（WC）、甘油三酯（TG）和高密度脂蛋白胆固醇（HDL-c）等变量计算得出的。HWP 定义为 WC 和 TG 同时升高。采用具有稳健方差估计的 Poisson 回归模型进行调整，并考虑了分层解释变量的方法。还估计了患病率比（PR）。采用 5%的显著性水平。
在我们的研究中，HWP 和 VAI 的患病率分别为 29.82%和 58.49%。在最终模型中，VAI 与女性（PR=1.46；p<0.0001）和高体脂肪（%BF）（PR=1.33；p<0.0019）呈正相关。HWP 与女性（PR=1.80；p=0.002）、饮酒（PR=1.58；p=0.033）、肥胖（PR=1.89；p=0.0001）、高 %BF（PR=1.76；p=0.012）和低 HDL-c（PR=1.48；p=0.035）相关。
HWP 与更多的 CR 因素相关，是一种有前途的方法，可以跟踪 HD 患者的心血管代谢风险，特别是女性。
