Annual variation in body fat is associated with systemic inflammation in chronic kidney disease patients Stages 3 and 4: A longitudinal study

Abstract

Background. In dialysis patients, cross-sectional studies show that total and abdominal body fat associate with inflammatory markers. Whether this is true in earlier disease stages is unknown. We evaluated the cross-sectional and longitudinal (12-month interval) association between body fat markers and C-reactive protein (CRP) in pre-dialysis chronic kidney disease (CKD) patients. Methods. We studied, over a period of 1 year, clinically stable CKD patients at Stages 3-4 who were under treatment in a single outpatient clinic. Fifty-seven patients were included and 44 concluded the observational period [males: 66%; age: 62.9 ± 13.9 years; body mass index (BMI): 25.5 ± 5.1 kg/m 2; estimated glomerular filtration rate (eGFR): 34 ± 12.3 mL/min/1.73m 2]. Total body fat (skinfold thicknesses), waist circumference (WC), laboratory measurements (serum creatinine, total cholesterol, albumin, high-sensitivity CRP and leptin) and food intake (24-h food recall) were assessed at baseline and after 12 ± 2 months. Results. Most patients had anthropometric parameters in the range of overweight/obesity and none had signs of protein-energy wasting. In univariate analysis, changes (delta: end-baseline) in CRP were associated (P < 0.05) with changes in BMI (r = 0.39) and WC (r = 0.33). In multiple regression analysis, these associations remained significant (P < 0.05) even after adjusted by potential confounders (sex, diabetes, baseline age and eGFR). Conclusions.During a follow-up of 12 months, changes in BMI and WC were directly associated with changes in CRP. Our results support the concept that interventions aimed at reducing weight and/or abdominal adiposity in pre-dialysis CKD patients may also translate into reduced systemic inflammation. © 2011 The Author.