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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Asymmetric dimethylarginine serum concentration in normal weight and obese CKD patients treated with hemodialysis
Elham Alipoor1,2, Shiva Salehi2, Sahar Dehghani2
1Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Obese patients on hemodialysis had lower asymmetric dimethylarginine (ADMA) levels, associated with better nutritional status and lower blood pressure compared to normal weight individuals. This finding offers insights into cardiovascular risk factors in renal failure patients.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Clinical Nutrition
Background:
- Asymmetric dimethylarginine (ADMA) is a cardiovascular risk factor that elevates in renal failure.
- Understanding ADMA levels in hemodialysis patients with varying body weights is crucial for risk stratification.
Purpose of the Study:
- To investigate and compare serum ADMA levels in normal weight versus obese patients undergoing regular hemodialysis.
- To explore the relationship between ADMA levels, nutritional status, and cardiovascular parameters in these patient groups.
Main Methods:
- A cross-sectional study involving 43 normal weight and 43 obese hemodialysis patients.
- Assessment of ADMA, malnutrition-inflammation score (MIS), anthropometry, lipid profiles, glucose homeostasis, blood pressure, and hs-CRP.
Main Results:
- Obese patients exhibited significantly lower ADMA levels (P=0.03) compared to normal weight patients.
- Obese patients also showed lower MIS (P<0.001) and blood pressure (P=0.018 for systolic, P=0.028 for mean arterial).
- Higher fasting blood glucose, lipid ratios (TG/HDL, TC/HDL, LDL/HDL), and hs-CRP were observed in the obese group.
Conclusions:
- Circulating ADMA levels are lower in obese hemodialysis patients compared to their normal weight counterparts.
- This lower ADMA is linked to a better nutritional inflammatory status (lower MIS) and reduced blood pressure in obese patients.
- Findings suggest a complex interplay between obesity, ADMA, and cardiovascular risk in patients with renal failure.
Introduction:
Asymmetric dimethylarginine (ADMA), a cardiovascular risk factor, increases in renal failure. The aim of this study was to investigate ADMA levels in normal weight and obese patients on hemodialysis.
Methods:
In this cross-sectional study, 43 normal weight and 43 obese patients on regular hemodialysis were examined. Malnutrition-inflammation score (MIS), anthropometry, circulating ADMA, lipid profiles including triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and lipid ratios, glucose homeostasis parameters, blood pressure, and high-sensitivity C-reactive protein (hs-CRP) were assessed.
Results:
Serum levels of ADMA were significantly lower in the obese compared to the normal weight patients (10268.2 ± 10092.4 vs. 13765.2 ± 9951.3 ng/l, P = 0.03). At the same time MIS score (6.1 ± 2.4 vs. 10.7 ± 3.2, P < 0.001), systolic blood pressure (119 ± 26.8 vs. 134.2 ± 24.7 mmHg, P = 0.018) and mean arterial pressure (91.3 ± 18.6 vs. 100.9 ± 15.9 mmHg, P = 0.028) were significantly lower in the obese than the normal weight group. Fasting blood glucose (P = 0.045), TG/HDL (P = 0.03), TC/HDL (P = 0.019), and LDL/HDL (P = 0.005) ratios, and hs-CRP (P = 0.015) levels were significantly higher in the obese than in the normal weight group.
Conclusion:
Circulating ADMA was significantly lower in obese than in normal weight patients on hemodialysis, which was concomitant with lower MIS, indicating a better nutritional inflammatory status, and lower blood pressure.
