Central obesity as assessed by conicity index and a-body shape index associates with cardiovascular risk factors and mortality in kidney failure patients

Abstract

BackgroundAnthropometric indices of central obesity, waist circumference (WC), conicity index (CI), and a-body shape index (ABSI), are prognostic indicators of cardiovascular (CV) risk. The association of CI and ABSI with other CV risk indices, markers of nutritional status and inflammation, and clinical outcomes in chronic kidney disease (CKD) stage 5 (CKD5) patients was investigated.MethodsIn a cross-sectional study with longitudinal follow up of 203 clinically stable patients with CKD5 (median age 56 years; 68% males, 17% diabetics, 22% with CV disease, and 39% malnourished), we investigated CI and ABSI and their associations with atherogenic index of plasma (AIP), Framingham CV risk score (FRS), Agatston scoring of coronary artery calcium (CAC) and aortic valve calcium (AVC), handgrip strength (HGS), high sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6). CV events (CVE) and all-cause mortality during up to 10-years follow up were analyzed by multivariate survival analysis of restricted mean survival time (RMST).ResultsChronic kidney disease patients with middle and highest CI and ABSI tertiles (indicating greater abdominal fat deposition), compared to those with the lowest CI and ABSI tertiles, tended to be older, more often men and diabetic, had significantly higher levels of hsCRP, IL-6, AIP, FRS, CAC and AVC scores. CI and ABSI were positively correlated with CAC, FRS, AIP, hsCRP and IL-6. Both CI and ABSI were negatively correlated with HGS. In age-weighted survival analysis, higher CI and ABSI were associated with higher risk of CVE (Wald test = 4.92, p = 0.027; Wald test = 4.95, p = 0.026, respectively) and all-cause mortality (Wald test = 5.24, p = 0.022; Wald test = 5.19, p = 0.023, respectively). In RMST analysis, low vs. high and middle tertiles of CI and ABSI associated with prolonged CVE-free time and death-free time, and these differences between groups increased over time.ConclusionAbdominal fat deposit indices, CI and ABSI, predicted CV outcomes and all-cause mortality, and were significantly associated with the inflammatory status in CKD patients.

Is There a Relationship between Anthropometric Indices and Muscular, Motor, and Cardiorespiratory Components of Health-Related Fitness in Active European Older Adults?

“…Faramarzi, Bagheri, and Banitalebi [45] conducted a study to determine the effect of a combined strength and aerobic programme on anthropometric indices, observing that improvements in aerobic endurance (Vo 2 max) were related to a decrease in BAI, results that are consistent with those obtained in this study. The effect of sequence order of combined strength and endurance training on new adiposity indices in overweight older adult women was studied by Ryu [46], who conducted a study to analyse the association between conicity index (CI) and cardiovascular risk factors (handgrip strength), observing that those with high CI values had low strength levels; these results are consistent with those obtained in this research study. The correlations identified between BMI, BAI, IQ, and physical parameters (flexibility, balance, cardiorespiratory endurance) reveal the influence of weight and fat mass distribution in older adults as conditioning factors of these correlations.…”

The Associations Between Abdominal Obesity and Coronary Artery Calcification in Chronic Kidney Disease Population

“…Additionally, numerous investigations have revealed that visceral fat exerts a more pronounced influence on CAD than does subcutaneous fat. [23][24][25] Consequently, compared with BMI, waist circumference (WC) has emerged as a superior parameter for assessing abdominal obesity (AO) in relation to CAD risk.…”