Nutrients (Jun 2019)

Impact of Percent Body Fat on All-Cause Mortality among Adequate Dialysis Patients with and without Insulin Resistance: A Multi-Center Prospective Cohort Study

  • Tuyen Van Duong,
  • Te-Chih Wong,
  • Hsi-Hsien Chen,
  • Tso-Hsiao Chen,
  • Yung-Ho Hsu,
  • Sheng-Jeng Peng,
  • Ko-Lin Kuo,
  • Hsiang-Chung Liu,
  • En-Tzu Lin,
  • Shwu-Huey Yang

DOI
https://doi.org/10.3390/nu11061304
Journal volume & issue
Vol. 11, no. 6
p. 1304

Abstract

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The association between body fat and mortality in hemodialysis patients remains controversial. We examined the effect of percent body fat (PBF) on all-cause mortality among adequate hemodialysis patients with and without insulin resistance (IR). A prospective cohort study was conducted on 365 adequate hemodialysis patients (equilibrated Kt/V ≥ 1.2) from seven hospitals. Patients’ characteristics and clinical and biochemical parameters were assessed at baseline between September 2013 and April 2017. Patients were followed up for all-cause mortality until April 2018. The median value of homeostatic model assessment (HOMA-IR) was used to classify IR. Cox proportional hazard models were utilized to examine predictors of all-cause mortality. During 1.4 (1.0−3.2) years of follow-up, 46 patients died. In patients with IR (HOMA-IR ≥ 5.18), PBF was significantly higher in the survival group than in the death group (31.3 ± 9.0 vs. 25.4 ± 8.2, p = 0.005). After controlling for confounding factors, PBF was significantly associated with lower risk for all-cause mortality in patients with IR (hazard ratio, 0.94; 95% confidence interval, 0.89−1.00; p = 0.033). The association was not observed in patients without IR. In conclusion, percent body fat shows a protective effect on survival in hemodialysis patients with IR.

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