The relationships of epicardial fat tissue thickness with insulin resistance, atherosclerosis and inflammation in hemodialysis patients

A paradoxical survival advantage of obesity in end stage renal disease (ESRD) patients was determined with large scale trials. Nevertheless, data derived from studies performed in last years supported the idea that this survival advantage resulted from the increase in muscle mass and an increase in fat tissue mass is related to insulin resistance, inflammation and atherosclerosis in ESRD patients. Epicardial adipose tissue (EAT), a visceral fat compartment surronding the heart, has been shown to be related to the cardiovascular risk factors in general population. In this study, we sought to evaluate utilization of EAT measurements in predicting cardiometabolic risks in ESRD patients.According to our findings in ESRD patients, echocardiographic EAT thickness measurements were associated with dialysis adequacy, whole body fat tissue mass evaluated by bioimpedance analysis, anthropometrical measurements, insulin resistance assessed by HOMA method, dyslipidemia, impaired cardiac morphology, left ventricular mass and carotid intima-media thickness. In this population, there were no relations between EAT and proinflammatory cytokines, hs-CRP and visfatin.In conclusion, echocardiographic EAT measurement, an easy and non-invasive diagnostic tool for assessment of visceral adipose tissue without need of additional cost can provide considerable contribution in defining the accompanying cardiometabolic risks in ESRD patients.