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Association between novel indices of malnutrition-inflammation complex syndrome and cardiovascular disease in hemodialysis patients.
Hemodial Int. 2005 Apr; 9(2):159-68.HI

Abstract

BACKGROUND

Inflammation and malnutrition are recognized as important risk factors for cardiovascular disease (CVD) in hemodialysis (HD) patients. Owing to substantial short-term variability of serum C-reactive protein (CRP), more reliable markers of malnutrition-inflammation complex syndrome should be sought with stronger associations with the risk of CVD in HD patients. We therefore explored the clinical relevance of a composite inflammatory index (prognostic inflammatory and nutritional index [PINI]) and of muscle protein mass indicators, derived from creatinine kinetics.

METHODS

This cross-sectional study included 177 HD patients (89 women and 88 men; median age, 67.73 years). CVD and risk factors were assessed using medical charts, clinical examination, and biochemical measurements performed at inclusion. Lean body mass (LBM) was derived from creatinine kinetic modeling, whereas PINI was calculated as the ratio (CRP xalpha1-acid-glycoprotein)/(albumin x transthyretin). Patients were divided according to the presence or absence of established CVD.

RESULTS

The traditional risk factors diabetes (odds ratio [OR], 5.83; p = 0.0045) and smoking (OR, 3.50; p < 0.02) were associated with an increase in prevalent CVD. Low transthyretin (OR, 3.79; p < 0.02) and high levels of CRP (OR, 2.70; p < 0.05), PINI (OR, 3.44; p < 0.02), observed LBM (OR, 3.01; p < 0.05), and the ratio of observed/expected LBM (OR, 4.24; p < 0.01) were associated with CVD after adjustment for age, sex, dialysis center, and dialysis vintage. After additional adjustment for diabetes and smoking, only PINI (OR, 2.85; p = 0.0446) and observed/expected LBM (OR, 2.96; p = 0.0361) were still significant.

CONCLUSION

PINI and LBM are associated with increased relative risk for having CVD and could be used routinely to examine the degree of severity of malnutrition inflammation complex syndrome.

Authors+Show Affiliations

Biochemistry Laboratory, Centre Hospitalier Universitaire de Montpellier, Montpellier, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16191065

Citation

Terrier, Nathalie, et al. "Association Between Novel Indices of Malnutrition-inflammation Complex Syndrome and Cardiovascular Disease in Hemodialysis Patients." Hemodialysis International. International Symposium On Home Hemodialysis, vol. 9, no. 2, 2005, pp. 159-68.
Terrier N, Senécal L, Dupuy AM, et al. Association between novel indices of malnutrition-inflammation complex syndrome and cardiovascular disease in hemodialysis patients. Hemodial Int. 2005;9(2):159-68.
Terrier, N., Senécal, L., Dupuy, A. M., Jaussent, I., Delcourt, C., Leray, H., Rafaelsen, S., Bosc, J. Y., Maurice, F., Canaud, B., & Cristol, J. P. (2005). Association between novel indices of malnutrition-inflammation complex syndrome and cardiovascular disease in hemodialysis patients. Hemodialysis International. International Symposium On Home Hemodialysis, 9(2), 159-68.
Terrier N, et al. Association Between Novel Indices of Malnutrition-inflammation Complex Syndrome and Cardiovascular Disease in Hemodialysis Patients. Hemodial Int. 2005;9(2):159-68. PubMed PMID: 16191065.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between novel indices of malnutrition-inflammation complex syndrome and cardiovascular disease in hemodialysis patients. AU - Terrier,Nathalie, AU - Senécal,Lynne, AU - Dupuy,Anne-Marie, AU - Jaussent,Isabelle, AU - Delcourt,Cécile, AU - Leray,Hélène, AU - Rafaelsen,Silje, AU - Bosc,Jean-Yves, AU - Maurice,François, AU - Canaud,Bernard, AU - Cristol,Jean-Paul, PY - 2005/9/30/pubmed PY - 2005/12/13/medline PY - 2005/9/30/entrez SP - 159 EP - 68 JF - Hemodialysis international. International Symposium on Home Hemodialysis JO - Hemodial Int VL - 9 IS - 2 N2 - BACKGROUND: Inflammation and malnutrition are recognized as important risk factors for cardiovascular disease (CVD) in hemodialysis (HD) patients. Owing to substantial short-term variability of serum C-reactive protein (CRP), more reliable markers of malnutrition-inflammation complex syndrome should be sought with stronger associations with the risk of CVD in HD patients. We therefore explored the clinical relevance of a composite inflammatory index (prognostic inflammatory and nutritional index [PINI]) and of muscle protein mass indicators, derived from creatinine kinetics. METHODS: This cross-sectional study included 177 HD patients (89 women and 88 men; median age, 67.73 years). CVD and risk factors were assessed using medical charts, clinical examination, and biochemical measurements performed at inclusion. Lean body mass (LBM) was derived from creatinine kinetic modeling, whereas PINI was calculated as the ratio (CRP xalpha1-acid-glycoprotein)/(albumin x transthyretin). Patients were divided according to the presence or absence of established CVD. RESULTS: The traditional risk factors diabetes (odds ratio [OR], 5.83; p = 0.0045) and smoking (OR, 3.50; p < 0.02) were associated with an increase in prevalent CVD. Low transthyretin (OR, 3.79; p < 0.02) and high levels of CRP (OR, 2.70; p < 0.05), PINI (OR, 3.44; p < 0.02), observed LBM (OR, 3.01; p < 0.05), and the ratio of observed/expected LBM (OR, 4.24; p < 0.01) were associated with CVD after adjustment for age, sex, dialysis center, and dialysis vintage. After additional adjustment for diabetes and smoking, only PINI (OR, 2.85; p = 0.0446) and observed/expected LBM (OR, 2.96; p = 0.0361) were still significant. CONCLUSION: PINI and LBM are associated with increased relative risk for having CVD and could be used routinely to examine the degree of severity of malnutrition inflammation complex syndrome. SN - 1492-7535 UR - https://www.unboundmedicine.com/medline/citation/16191065/Association_between_novel_indices_of_malnutrition_inflammation_complex_syndrome_and_cardiovascular_disease_in_hemodialysis_patients_ L2 - https://doi.org/10.1111/j.1492-7535.2005.01127.x DB - PRIME DP - Unbound Medicine ER -