Author/Editor     Bevc, Sebastjan; Zorman, Tadej; Purg, Darinka; Ekart, Robert; Hojs, Radovan
Title     Cardiovascular mortality and microinflammation in abdominal obese hemodialysis patient
Translated title     Srčnožilna umrljivost in mikrovnetje pri trebušno debelih hemodializnih bolnikih
Type     članek
Vol. and No.     Letnik 6, št. 2
Publication year     2013
Volume     str. 39-46
ISSN     1855-5640 - Acta medico-biotechnica : AMB
Language     eng
Abstract     Namen: Trebušno maščevje ima pomembne provnetne lastnosti in predstavlja vir različnih vnetnih posrednikov. Z ozirom na dejstvo, da so pri hemodializnih (HD) bolnikih povišane koncentracije nekaterih vnetnih posrednikov, bi lahko imelo trebušno maščevje pomembno vlogo v patogenezi mikrovnetja, ki je dokazano povezano s pospešeno aterosklerozo. Namen naše raziskave je bil določiti vpliv mikrovnetja na srčnožilno umrljivost trebušno debelih HD bolnikov. Metode: V raziskavo smo vključili enainsedemdeset HD bolnikov (povprečna starost 59.3 12.8 let). Izmerili smo jim obseg pasu in trebušno debelost opredelili skladno s priporočili Mednarodnega združenja za sladkorno bolezen (International Diabetes Fede- ration). Določili smo serumske koncentracije lipidov (trigliceridi, HDL in LDL holesterol) in vnetnih posrednikov (interlevkin 6, tumor nekrozni dejavnikalfa, žilnocelična adhezivna molekula1 (VCAM1), medcelična adhezivna molekula1 (ICAM1)). Bolnike smo spremljali od dneva določitve vnetnih posrednikov (november 2003) do njihove smrti oziroma do 10. novembra 2009. Rezultati: Povprečna vrednost obsega pasu je bila za moške 97.6 1 +/- 6.1 cm in 92.2 +/- 15.9 cm za ženske. Trebušno debelost smo ugotovili pri 62 % vključenih bolnikih. S Coxovo regresijsko analizo smo ugotovili, da sta vnetna posrednika VCAM1 (p<0.031) in ICAM1 (p<0.024) napovednika srčnožilne umrljivosti pri trebušno debelih HD bolnikih. Četudi smo v omenjeno analizo vključili starost in ostale znane dejavnike tveganja za razvoj ateroskleroze (arterijska hipertenzija, kajenje, HDL in LDL holesterol, trigliceridi), sta oba vnetna posrednika ostala napovednika srčnožilne umrljivosti. Zaključek: Rezultati naše raziskave potrjujejo povezanost mikrovnetja in srčnožilne umrljivosti pri trebušno debelih HD bolnikih.Purpose: Abdominal adipose tissue has important inflammatory properties and is a source of various inflammatory mediators. Given that concentrations of some inflammatory mediators are high among hemodialysis (HD) patients, abdominal obesity may play an important role in the pathogenesis of microinflammation which is known to be associated with accelerated atherosclerosis. The aim of our study was to determine the impact of microinflammation on cardiovascular (CV) mortality in abdominal obese HD patients. Methods: Seventy-one HD patients (mean age 59.3 +/- 12.8 years) were included in our study. Waist circumference (WAC) was measured and abdominal obesity was defined according to the International Diabetes Federation. Serum levels of lipids (triglycerides, high density lipoproteins (HDL) cholesterol, low density lipoproteins (LDL) cholesterol and inflammatory mediators (interleukin-6, tumor necrosis factor alpha, vascular cellular adhesion molecule-1 (VCAM1), intercellular adhesion molecule-1 (ICAM1)) were measured. Patients were observed from the date of measurement (November 2003) of inflammatory mediators until their death or to 10th ofNovember 2009.Results: The mean WAC value for men was 97.6 16.1 cm, and for women 92.2 15.9 cm. Abdominalobesity was found in 62% of the enrolled patients. Coxregression analysis showed that the inflammatory mediators VCAM-1 (p<0.031) and ICAM-1 (p<0.024) were predictors of CV mortality in abdominal obese HD patients. Both inflammatory mediators remained predictors of CV mortality if age and other known risk factors for atherosclerosis (arterial hypertension, smoking, HDL andLDL cholesterol and triglycerides) were included in the analysis. Conclusion: The results of our study indicate that microinflammation is associated with CV mortality in abdominal obese HD patients.
Keywords     mikrovnetje
označevalci vnetnega dogajanja
srčnožilna umrljivost
trebušna debelost
hemodializa