モリモト　サトシ   Morimoto Satoshi   森本　聡    所属   医学部 医学科（東京女子医科大学病院）    職種   准教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Impact of Abdominal Fat Distribution on Mortality and Its Changes Over Time in Patients Undergoing Hemodialysis: A Prospective Cohort Study.
掲載誌名	正式名：Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 略　 称：J Ren Nutr ISSNコード：15328503/10512276
掲載区分	国外
巻・号・頁	33(4),pp.575-583
著者・共著者	Iida Takeshi†, Morimoto Satoshi*, Okuda Hidenobu, Amari Yoshifumi, Yurugi Takatomi, Nakajima Fumitaka, Ichihara Atsuhiro
担当区分	2nd著者,責任著者
発行年月	2023/07
概要	OBJECTIVE:Measures of fat distribution and visceral fat accumulation maintain a direct association with mortality in the general population. However, among patients undergoing hemodialysis (HD), there are few reports of this association. This study aimed to investigate the impact of computed tomography (CT)-measured abdominal fat levels, including the visceral fat area (VFA) and subcutaneous fat area (SFA), on all-cause mortality in patients undergoing HD and investigate whether there are sex-specific particularities regarding the associations between the abovementioned parameters.METHODS:A total of 258 participants were selected from the population of patients undergoing stable HD. The baseline characteristics were collected by records and interviews. The following variables were assessed at baseline and every year: body mass index, abdominal circumference, VFA, and SFA. Abdominal circumference and body fat distribution were assessed at the level of the umbilicus via CT. All CT scans were performed on a nondialysis day with the subject in a supine position. The primary end point was the 5-year all-cause mortality.RESULTS:This prospective cohort study revealed that age, cardiothoracic ratio, %VFA (VFA/[VFA + SFA]), and albumin were independent predictors of death via multivariable analyses. Regarding the %VFA, its area under the curve (0.599), which did not suffice to predict mortality, was higher than that of VFA, SFA, and body mass index. Also, the effect was recognized mainly in male patients. The %VFA of patients who survived for 60 months increased over time.CONCLUSION:These data suggest that patients (especially men) with a high VFA-to-abdominal fat ratio have a high risk of death. Thus, more attention should be paid to such patients.
DOI	10.1053/j.jrn.2023.03.004
PMID	36963738