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Abstract: FR-PO555

Density of Brown Adipose Tissue in Japanese Hemodialysis Patients: Association with Protein-Energy Wasting

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

  • Kanno, Yoshihiko, Tokyo Medical University, Tokyo, Japan
  • Nagai, Miho, Tokyo Medical University, Tokyo, Japan
  • Kurosawa, Yuko, Tokyo Medical University, Tokyo, Japan
  • Fuse, Sayuri, Tokyo Medical University, Tokyo, Japan
  • Ishizu, Takashi, Tsukuba Central Hospital, Ushiku, Japan
  • Hamaoka, Takafumi, Tokyo Medical University, Tokyo, Japan
Background

Patients receiving chronic hemodialysis are on catabolic status in energy-consuming cycle, according to complex factors due to the pathogenesis of original disease, renal failure and dialysis therapy. Nutritional disorder in CKD patients with decreases of skeletal muscle and body fat has proposed to be called as Protein-Energy wasting (PEW) by International Society of Renal Nutrition and Metabolism (ISRNM). On the other hand, the pathogenesis of PEW is still unknown. In recent years, the importance of energy metabolism control via brown adipose tissue (BAT) gathers attraction, despite the difficulty in measuring its density. We have developed its portable measuring system, and investigated BAT densities and nutritional states in Japanese HD patients.

Methods

We assessed BAT densities in Japanese HD patients (66.5 ± 10.4 years) and healthy adults (65.3 ± 10.4 years) based on total hemoglobin concentrations in the supraclavicular region measured with near-infrared time-resolved spectroscopy. We also assessed correlation between BAT densities and bioelectrical impedance analysis for the evaluation of body composition in HD patients.

Results

The BAT density in 33 HD patients was 75.6 ± 31.4 μM, which tended to be higher (p = 0.059) compared with 61.1 ± 4.3 μM in healthy subjects of the matched age over 40 years old. Furthermore, BAT density and body fat mass were negatively correlated in HD patients. BAT in healthy subjects were negatively correlates visceral fat area in previous studies. But in our study, despite the fact that the visceral fat area was significantly higher in HD patients, BAT tended to be higher in HD patients. The stimulation by cold and consequently increase in sympathetic nerve activity directly to BAT causes an increase in BAT density. It is known that muscle sympathetic nerve activity is elevated in patients with CKD complicated hypertension. It may be involved as a cause of increase in BAT density.

Conclusion

BAT may be one of the principal factors for malnutrition with energy-consuming cycles in HD patients.