Visceral Fat, Arterial Stiffness, and Endothelial Function in Peritoneal Dialysis Patients

Background: The relationship between overweight or obesity and mortality in peritoneal dialysis (PD) patients remains controversial. Both pulse-wave velocity (PWV) and endothelial dysfunction are related to an increased risk of cardiovascular disease. However, the association between PWV, endothelial dysfunction, and visceral adipose tissue in PD patients is not well-understood. Methods: One hundred and sixteen PD patients were enrolled in this cross-sectional study. The overall fat ratio and visceral-fat level of PD patients were measured by multiple-frequency bioelectrical impedance analysis (BIA). Carotid-femoral pulse-wave velocity (C-F PWV) was measured as an indicator of aortic stiffness. Endothelial function was evaluated by brachial-artery flow-mediated dilation (FMD). The association between these monitored parameters was assessed by statistical analyses. Results: Bivariate correlation analysis showed that C-F PWV was positively correlated with visceral-fat level (r = 0.343, P < .001), whereas FMD was negatively correlated with visceral-fat level (r = -0.354, P < .01). Multiple regression analysis indicated that age, diabetic status, visceral-fat level, and duration of dialysis were determinants of PWV (adjusted R-2 = 0.316, P < .001), whereas visceral-fat level and glucose load were the determinants of FMD (adjusted R-2 = 0.130, P < .01). Conclusion: Visceral-fat level was an independent predictor of PWV and FMD in PD patients, and could be considered one of the risk factors for cardiovascular disease in PD patients. Crown Copyright (C) 2008 Published by the National Kidney Foundation, Inc. All rights reserved.