Journal Article

Annual variation in body fat is associated with systemic inflammation in chronic kidney disease patients Stages 3 and 4: a longitudinal study

Laura Kawakami Carvalho, Maria Ines Barreto Silva, Barbara da Silva Vale, Rachel Bregman, Renata Brum Martucci, Juan Jesus Carrero and Carla Maria Avesani

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 27, issue 4, pages 1423-1428
Published in print April 2012 | ISSN: 0931-0509
Published online August 2011 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfr450
Annual variation in body fat is associated with systemic inflammation in chronic kidney disease patients Stages 3 and 4: a longitudinal study

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Background.

In dialysis patients, cross-sectional studies show that total and abdominal body fat associate with inflammatory markers. Whether this is true in earlier disease stages is unknown. We evaluated the cross-sectional and longitudinal (12-month interval) association between body fat markers and C-reactive protein (CRP) in pre-dialysis chronic kidney disease (CKD) patients.

Methods.

We studied, over a period of 1 year, clinically stable CKD patients at Stages 3–4 who were under treatment in a single outpatient clinic. Fifty-seven patients were included and 44 concluded the observational period [males: 66%; age: 62.9 ± 13.9 years; body mass index (BMI): 25.5 ± 5.1 kg/m2; estimated glomerular filtration rate (eGFR): 34 ± 12.3 mL/min/1.73m2]. Total body fat (skinfold thicknesses), waist circumference (WC), laboratory measurements (serum creatinine, total cholesterol, albumin, high-sensitivity CRP and leptin) and food intake (24-h food recall) were assessed at baseline and after 12 ± 2 months.

Results.

Most patients had anthropometric parameters in the range of overweight/obesity and none had signs of protein-energy wasting. In univariate analysis, changes (delta: end—baseline) in CRP were associated (P < 0.05) with changes in BMI (r = 0.39) and WC (r = 0.33). In multiple regression analysis, these associations remained significant (P < 0.05) even after adjusted by potential confounders (sex, diabetes, baseline age and eGFR).

Conclusions.

During a follow-up of 12 months, changes in BMI and WC were directly associated with changes in CRP. Our results support the concept that interventions aimed at reducing weight and/or abdominal adiposity in pre-dialysis CKD patients may also translate into reduced systemic inflammation.

Keywords: adiposity; chronic kidney disease; inflammation; overweight

Journal Article.  3736 words.  Illustrated.

Subjects: Nephrology

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