Estimation of adipose pools in hemodialysis patients from anthropometric measures.
J Ren Nutr. 2008 Nov; 18(6):473-8.JR

Abstract

OBJECTIVE

Adiposity, measured as increased body mass index (BMI), is associated with reduced all-cause and cardiovascular (CV) mortality in hemodialysis (HD) patients, whereas CV risk increases with BMI in the general population. A major limitation of BMI as a measure of adiposity is its failure to distinguish muscle and fat compartments. In addition, the biology of different adipose compartments is not the same. The visceral adipose tissue (VAT) mass is especially biologically active, secreting a variety of cytokines and adipokines. Alternate methods of estimating body composition were found to have a greater association with CV risk factors than BMI in several populations. We measured total adipose tissue, subcutaneous adipose tissue, and VAT in 48 prevalent HD patients, using magnetic resonance imaging.

METHODS AND RESULTS

Based on these measurements, we developed parsimonious multiple-regression models to estimate these adipose compartments using age, sex, BMI, weight, maximum abdominal circumference (MAC), and race. The parsimonious models for VAT included only age, race, and MAC (adjusted r(2) = 0.776, P < .0001), whereas the subcutaneous adipose tissue model included sex, weight, age, and BMI (adjusted r(2) = 0.91, P < .0001) rather than MAC. The total adipose tissue model included BMI, sex, weight, and age (adjusted r(2) = 0.905, P < .0001).

CONCLUSION

We propose that measurements of MAC, in addition to height and weight, be included in studies relating body composition to outcomes, because this measure provides a better estimate of the metabolically active VAT pool.

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Authors+Show Affiliations

Kaysen GA
Renal Research Institute, New York, New York, USA. gakaysen@ucdavis.edu
Kotanko P
No affiliation info available
Zhu F
No affiliation info available
Sarkar SR
No affiliation info available
Heymsfield SB
No affiliation info available
Kuhlmann MK
No affiliation info available
Levin NW
No affiliation info available

MeSH

AbdomenAdiposityAge FactorsAnthropometryBody CompositionBody Mass IndexCardiovascular DiseasesCause of DeathFemaleHumansIntra-Abdominal FatMaleMiddle AgedObesityRenal DialysisRisk FactorsSex FactorsSubcutaneous FatWaist Circumference

Pub Type(s)

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

Language

eng

PubMed ID

18940649