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. 2023 Mar 14;12(6):2239.
doi: 10.3390/jcm12062239.

Malnutrition and Insulin Resistance May Interact with Metabolic Syndrome in Prevalent Hemodialysis Patients

Shuzo Kobayashi  1 , Yasuhiro Mochida  1 , Kunihiro Ishioka  1 , Machiko Oka  1 , Kyoko Maesato  2 , Hidekazu Moriya  1 , Sumi Hidaka  1 , Takayasu Ohtake  1
Affiliations

Malnutrition and Insulin Resistance May Interact with Metabolic Syndrome in Prevalent Hemodialysis Patients

Shuzo Kobayashi et al. J Clin Med. .

Abstract

Background: We sought to determine the prevalence of metabolic syndrome (Mets) and whether 100 cm2 of visceral fatty area (VFA) measured by computed tomography (CT) validates the criteria of waist circumference (WC) in hemodialysis (HD) patients.

Methods: The study comprised 141 HD patients. Mets was defined according to the criteria of Adult Treatment Panel III (ATP III) and the modified criteria of National Cholesterol Education Program (NCEP) that defines abdominal obesity as a WC of >=85 cm in men and >=90 cm in women.

Results: The prevalence of Mets was 31.9% in men and 13.6% in women. However, the prevalence of patients with a body mass index over 25 in all HD patients was only 11.2%. The visceral fatty area (VFA) measured by CT showed a strong positive correlation with WC. The patients with Mets, comparing with those without Mets, have significantly shorter duration of HD, higher high-sensitive C-reactive protein, and higher Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). In the patients with Mets, there was a significant negative correlation between HOMA-IR and serum albumin levels. Multivariate logistic regression analysis showed that HOMA-IR and short duration of HD were chosen as independent risk factors for Mets.

Conclusions: Mets is more prevalent in HD patients. In Japanese HD patients, 100 cm2 of VFA corresponded to a WC of 85 cm in men and 90 cm in women, thus confirming the validity of the modified criteria. HOMA-IR and serum albumin were significantly correlated in HD patients with Mets.

Keywords: abdominal obesity; atherosclerosis; hemodialysis; inflammation; metabolic syndrome.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The relationship between visceral fat area and waist circumferences in men (a), the relationship between visceral fat area and waist circumferences in women. (b). Abbreviations: VFA visceral fat area, WC waist circumference.
Figure 2
Figure 2
The relationship between HOMA-IR and HD duration (months) (p < 0.05, r = −0.179). Abbreviations: HOMA-IR Homeostasis Model Assessment of Insulin resistance, HD hemodialysis.
Figure 3
Figure 3
The relationship between HOMA-IR and serum albumin in patients with Mets (a) and relationship between HOMA-IR and serum albumin in patients without Mets (b).
See this image and copyright information in PMC

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