Abstract: FR-PO551
Abdominal Obesity in Normal Weight versus Overweight and Obese Hemodialysis Patients: Associations with Nutrition, Inflammation, Muscle Strength, and Quality of Life
Session Information
- Physical Activity, Body Composition, Metabolism: Clinical
October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Beberashvili, Ilia, Nephrology Division, Zerifin, Israel
- Azar, Ada, Nutrition Department, Zerifin, Israel
- Abu hamad, Ramzia, Nephrology Division, Zerifin, Israel
- Sinuani, Inna, Assuta Ashdod Medical Center , Ashdod, Israel
- Feldman, Leonid, Nephrology Division, Zerifin, Israel
- Efrati, Shai, Nephrology Division, Zerifin, Israel
Background
The biological basis of abdominal obesity leading to more severe outcomes in maintenance hemodialysis (MHD) patients with normal body mass index (BMI) is unclear. We compared the phenotype of abdominal obesity in different BMI categories of MHD patients.
Methods
We performed a cross-sectional study of 188 MHD patients (52.7% women; mean age, 69.4±11.5 years) with abdominal obesity in different BMI groups using WHO criteria. Appetite and dietary intake, body composition, handgrip strength, malnutrition-inflammation score (MIS), inflammatory biomarkers, adipokines and health-related quality of life (QoL) questionnaires were studied.
Results
According to multivariable analyses, abdominally obese patients with normal BMIs consumed less protein per day (p=0.04), had lower measurements of surrogates of lean (p<0.001) and fat mass (p<0.001), higher total cholesterol, TNF-α (p<0.05), and adiponectin to leptin ratios (p=0.003) compared to overweight and obese patients with abdominal obesity. Multivariable analyses showed no differences in handgrip strength among the study groups.The abdominally obese study participants with normal weight had significantly lower scores in role-physical (p=0.003) and pain (p=0.04) scales after multivariable adjustments.
Conclusion
Normal weight MHD patients with abdominal obesity exhibit a more proatherogenic profile in terms of inflammatory markers and adipokines expression, lower body composition reserves and lower physical ability compared to abdominal obesity patients with overweight and obesity. This at least partially explains the abdominal obesity paradox in MHD population in which worse clinical outcomes are seen in abdominally obese patients with normal BMIs, as opposed to overweight and obese patients who are also abdominally obese.
Funding
- NIDDK Support