Turkmen Kultigin, Ozer Hakan, Kusztal Mariusz
Division of Nephrology, Department of Internal Medicine, Meram Medical Faculty, Necmettin Erbakan University, Konya 42090, Turkey.
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland.
J Clin Med. 2022 Feb 27;11(5):1308. doi: 10.3390/jcm11051308.
Cardiovascular diseases remain the most common cause of morbidity and mortality in chronic kidney disease patients undergoing hemodialysis. Epicardial adipose tissue (EAT), visceral fat depot of the heart, was found to be associated with coronary artery disease in cardiac and non-cardiac patients. Additionally, EAT has been proposed as a novel cardiovascular risk in the general population and in end-stage renal disease patients. It has also been shown that EAT, more than other subcutaneous adipose tissue deposits, acts as a highly active organ producing several bioactive adipokines, and proinflammatory and proatherogenic cytokines. Therefore, increased visceral adiposity is associated with proinflammatory activity, impaired insulin sensitivity, increased risk of atherosclerosis, and high morbidity and mortality in hemodialysis patients. In the present review, we aimed to demonstrate the role of EAT in the pathophysiological mechanisms of increased cardiovascular morbidity and mortality in hemodialysis patients.
心血管疾病仍然是接受血液透析的慢性肾病患者发病和死亡的最常见原因。心外膜脂肪组织（EAT）是心脏的内脏脂肪库，在心脏病患者和非心脏病患者中均发现其与冠状动脉疾病有关。此外，EAT已被认为是普通人群和终末期肾病患者的一种新型心血管风险因素。研究还表明，与其他皮下脂肪组织相比，EAT是一个高度活跃的器官，能产生多种生物活性脂肪因子、促炎细胞因子和促动脉粥样硬化细胞因子。因此，内脏脂肪增多与促炎活性、胰岛素敏感性受损、动脉粥样硬化风险增加以及血液透析患者的高发病率和高死亡率相关。在本综述中，我们旨在阐述EAT在血液透析患者心血管疾病发病率和死亡率增加的病理生理机制中的作用。
