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    PERI-AORTIC FAT TISSUE THICKNESS IN PERITONEAL DIALYSIS PATIENTS
    (MULTIMED INC, 2013) Turkmen, Kultigin; Ozbek, Orhan; Kayrak, Mehmet; Samur, Cigdem; Guler, Ibrahim; Tonbul, Halil Zeki
    Background: Thoracic peri-aortic fat tissue (PFT) and epicardial adipose tissue (EAT) are metabolically active visceral fat deposits surrounding the thoracic aorta and the heart, respectively. Various studies have demonstrated a positive predictive value of both PFT and EAT for coronary artery disease in the general population. In the present study, we aimed to investigate PFT thickness and the independent predictors of PFT in peritoneal dialysis (PD) patients. Methods: Our cross-sectional study enrolled 35 PD patients (10 women, 25 men) and 30 age-and-sex-matched healthy subjects (15 women, 15 men). We measured PFT, thoracic artery calcification (TAC), EAT, and coronary artery calcification (CAC) by electrocardiogram-gated 64-multi-detector computed tomography. Results: The measured PFT, EAT, CAC, and TAC were significantly higher in the PD group than in the healthy subjects (p < 0.05 each). In the PD group, PFT and TAC were significantly correlated (r = 0.33, p = 0.007). Also, PFT measurements were positively correlated with EAT and total CAC in the PD and the control group alike (r = 0.58, p = 0.001 and r = 0.54, p = 0.01 respectively). A stepwise linear regression analysis revealed that age, duration of hypertension, and being a PD patient were independent predictors of PFT. Conclusions: Measured PFT was higher in PD patients than in healthy subjects and, in the PD population, was also shown to be related to calcification scores and EAT.
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    The Relationship between Epicardial Adipose Tissue and Malnutrition, Inflammation, Atherosclerosis/Calcification Syndrome in ESRD Patients
    (AMER SOC NEPHROLOGY, 2011) Turkmen, Kultigin; Kayikcioglu, Hatice; Ozbek, Orhan; Solak, Yalcin; Kayrak, Mehmet; Samur, Cigdem; Anil, Melih
    Background and objectives Malnutrition, inflammation, atherosclerosis/calcification (MIAC) and endothelial dysfunction are the most commonly encountered risk factors in the pathogenesis of cardiovascular disease in ESRD patients. Epicardial adipose tissue (EAT) is the true visceral fat depot of the heart. The relationship between CAD and EAT was shown in patients with high risk of coronary artery disease. In this study, we aimed to investigate the relationship between EAT and MIAC syndrome in ESRD patients. Design, setting, participants, & measurements Eighty ESRD patients and 27 healthy subjects enrolled in this cross-sectional study. EAT and coronary artery calcification score were measured by a multidetector computed tomography (MDCT) scanner. Patients with serum albumin <3.5 mg/dl were defined as patients with malnutrition; those with serum C-reactive protein level >10 ng/dl (normal range, 0-5 ng/dl) had inflammation; and those with CACS >10 had atheroscleosis/calcification. Results Total CACS and EAT measurements were significantly higher in ESRD patients when compared with healthy subjects. There was a statistically significant relationship between EAT and CACS in ESRD patients (r = 0.48). EAT measurements were higher in PD patients than HD patients. Twenty-four of the patients had no component, 31 had one component, 17 had two components, and nine had all of the MIAC components. EAT was found to be significantly increased when the presence of MIAC components increased. EAT was positively correlated with age, body mass index, and presence of MIAC. These parameters were also found as independent predictors of increased EAT. Conclusions We found a relationship between EAT and components of MTAC syndrome in ESRD patients. J Am Soc Nephrol 6: 1920-1925, 2011. doi: 10.2215/CJN.00890111