Nonalcoholic fatty liver disease (NAFLD) – a new factor that interplays between inflammation, malnutrition, and atherosclerosis in elderly hemodialysis patients
Ivana Mikolasevic,1 Vesna Lukenda,2 Sanjin Racki,1 Sandra Milic,3 Branka Sladoje-Martinovic,1 Lidija Orlic1 1Department of Nephrology, Dialysis and Transplantation, Rijeka University Hospital Center, Rijeka, Croatia; 2Department of Internal Medicine, Dr Josip Bencevic General Hospital, Slavonski Br...
Guardado en:
| Autores principales: | , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Dove Medical Press
2014
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/147995e3f30f4db9b94ab4670a82a4e6 |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:147995e3f30f4db9b94ab4670a82a4e6 |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:147995e3f30f4db9b94ab4670a82a4e62021-12-02T06:49:45ZNonalcoholic fatty liver disease (NAFLD) – a new factor that interplays between inflammation, malnutrition, and atherosclerosis in elderly hemodialysis patients1178-1998https://doaj.org/article/147995e3f30f4db9b94ab4670a82a4e62014-08-01T00:00:00Zhttps://www.dovepress.com/nonalcoholic-fatty-liver-disease-nafld-ndash-a-new-factor-that-interpl-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Ivana Mikolasevic,1 Vesna Lukenda,2 Sanjin Racki,1 Sandra Milic,3 Branka Sladoje-Martinovic,1 Lidija Orlic1 1Department of Nephrology, Dialysis and Transplantation, Rijeka University Hospital Center, Rijeka, Croatia; 2Department of Internal Medicine, Dr Josip Bencevic General Hospital, Slavonski Brod, Croatia; 3Department of Gastroenterology, Rijeka University Hospital Center, Rijeka, Croatia Background/aim: In the past decade, in most regions of the world, an increasing number of adults aged 65 years and older were started on renal replacement therapy each year. In contrast to the general population for whom overnutrition or obesity is associated with increased cardiovascular risk, for patients who are maintained on hemodialysis (HD), malnutrition and malnutrition-inflammation complex syndrome are associated with poor outcome. In recent years, nonalcoholic fatty liver disease (NAFLD) has been considered to be the liver manifestation of metabolic syndrome, and the development of NAFLD is strongly associated with all components of metabolic syndrome (arterial hypertension, dyslipidemia, obesity, and diabetes mellitus type 2) in the general population. The primary end point of this study was to determine the patient’s survival in relation to nutritional and inflammatory state and the presence or absence of NAFLD. The secondary end point of this analysis was the association among NAFLD and various clinical and laboratory data, with the nutritional and inflammatory state of our elderly HD patients. Methods: Using a single-center, prospective, cohort study design, we followed the progress of 76 patients who were ≥65 years and treated with chronic HD for at least 6 months, at the Department of Nephrology, Dialysis and Transplantation. All patients were followed for a minimum of 18 months or until death. Survival was defined as the time from study initiation to death (or end of study, if still alive).Results: The main findings of our study were a remarkable positive correlation between NAFLD and high-sensitivity C-reactive protein (hs-CRP) (r=0.659; P<0.0001) and consequent negative correlation with the nutritional parameter, serum albumin (r=-0.321; P=0.004). Interestingly, we showed that in contrast to the general population, where NAFLD is associated with obesity, in the present study, there was no statistically significant association between NAFLD and overnutrition in elderly HD patients. Furthermore, the presence of NAFLD, low serum albumin levels, and high hs-CRP were strong predictors of poor outcome in our elderly HD patients. Conclusion: Our results indicated that NAFLD probably interplays between inflammation, malnutrition, and atherosclerosis in elderly HD patients. NAFLD could be a new factor that contributes to type 2 malnutrition in elderly HD patients, who may be amenable to adequate nutritional and HD support. Keywords: cardiovascular risk, serum albumin, high-sensitivity C-reactive protein (hs-CRP)Mikolasevic ILukenda VRacki SMilic SSladoje-Martinovic BOrlic LDove Medical Pressarticlehemodialysiselderlymalnutritionnonalcoholic fatty liver diseaseGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 9, Pp 1295-1303 (2014) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
hemodialysis elderly malnutrition nonalcoholic fatty liver disease Geriatrics RC952-954.6 |
| spellingShingle |
hemodialysis elderly malnutrition nonalcoholic fatty liver disease Geriatrics RC952-954.6 Mikolasevic I Lukenda V Racki S Milic S Sladoje-Martinovic B Orlic L Nonalcoholic fatty liver disease (NAFLD) – a new factor that interplays between inflammation, malnutrition, and atherosclerosis in elderly hemodialysis patients |
| description |
Ivana Mikolasevic,1 Vesna Lukenda,2 Sanjin Racki,1 Sandra Milic,3 Branka Sladoje-Martinovic,1 Lidija Orlic1 1Department of Nephrology, Dialysis and Transplantation, Rijeka University Hospital Center, Rijeka, Croatia; 2Department of Internal Medicine, Dr Josip Bencevic General Hospital, Slavonski Brod, Croatia; 3Department of Gastroenterology, Rijeka University Hospital Center, Rijeka, Croatia Background/aim: In the past decade, in most regions of the world, an increasing number of adults aged 65 years and older were started on renal replacement therapy each year. In contrast to the general population for whom overnutrition or obesity is associated with increased cardiovascular risk, for patients who are maintained on hemodialysis (HD), malnutrition and malnutrition-inflammation complex syndrome are associated with poor outcome. In recent years, nonalcoholic fatty liver disease (NAFLD) has been considered to be the liver manifestation of metabolic syndrome, and the development of NAFLD is strongly associated with all components of metabolic syndrome (arterial hypertension, dyslipidemia, obesity, and diabetes mellitus type 2) in the general population. The primary end point of this study was to determine the patient’s survival in relation to nutritional and inflammatory state and the presence or absence of NAFLD. The secondary end point of this analysis was the association among NAFLD and various clinical and laboratory data, with the nutritional and inflammatory state of our elderly HD patients. Methods: Using a single-center, prospective, cohort study design, we followed the progress of 76 patients who were ≥65 years and treated with chronic HD for at least 6 months, at the Department of Nephrology, Dialysis and Transplantation. All patients were followed for a minimum of 18 months or until death. Survival was defined as the time from study initiation to death (or end of study, if still alive).Results: The main findings of our study were a remarkable positive correlation between NAFLD and high-sensitivity C-reactive protein (hs-CRP) (r=0.659; P<0.0001) and consequent negative correlation with the nutritional parameter, serum albumin (r=-0.321; P=0.004). Interestingly, we showed that in contrast to the general population, where NAFLD is associated with obesity, in the present study, there was no statistically significant association between NAFLD and overnutrition in elderly HD patients. Furthermore, the presence of NAFLD, low serum albumin levels, and high hs-CRP were strong predictors of poor outcome in our elderly HD patients. Conclusion: Our results indicated that NAFLD probably interplays between inflammation, malnutrition, and atherosclerosis in elderly HD patients. NAFLD could be a new factor that contributes to type 2 malnutrition in elderly HD patients, who may be amenable to adequate nutritional and HD support. Keywords: cardiovascular risk, serum albumin, high-sensitivity C-reactive protein (hs-CRP) |
| format |
article |
| author |
Mikolasevic I Lukenda V Racki S Milic S Sladoje-Martinovic B Orlic L |
| author_facet |
Mikolasevic I Lukenda V Racki S Milic S Sladoje-Martinovic B Orlic L |
| author_sort |
Mikolasevic I |
| title |
Nonalcoholic fatty liver disease (NAFLD) – a new factor that interplays between inflammation, malnutrition, and atherosclerosis in elderly hemodialysis patients |
| title_short |
Nonalcoholic fatty liver disease (NAFLD) – a new factor that interplays between inflammation, malnutrition, and atherosclerosis in elderly hemodialysis patients |
| title_full |
Nonalcoholic fatty liver disease (NAFLD) – a new factor that interplays between inflammation, malnutrition, and atherosclerosis in elderly hemodialysis patients |
| title_fullStr |
Nonalcoholic fatty liver disease (NAFLD) – a new factor that interplays between inflammation, malnutrition, and atherosclerosis in elderly hemodialysis patients |
| title_full_unstemmed |
Nonalcoholic fatty liver disease (NAFLD) – a new factor that interplays between inflammation, malnutrition, and atherosclerosis in elderly hemodialysis patients |
| title_sort |
nonalcoholic fatty liver disease (nafld) – a new factor that interplays between inflammation, malnutrition, and atherosclerosis in elderly hemodialysis patients |
| publisher |
Dove Medical Press |
| publishDate |
2014 |
| url |
https://doaj.org/article/147995e3f30f4db9b94ab4670a82a4e6 |
| work_keys_str_mv |
AT mikolasevici nonalcoholicfattyliverdiseasenafldndashanewfactorthatinterplaysbetweeninflammationmalnutritionandatherosclerosisinelderlyhemodialysispatients AT lukendav nonalcoholicfattyliverdiseasenafldndashanewfactorthatinterplaysbetweeninflammationmalnutritionandatherosclerosisinelderlyhemodialysispatients AT rackis nonalcoholicfattyliverdiseasenafldndashanewfactorthatinterplaysbetweeninflammationmalnutritionandatherosclerosisinelderlyhemodialysispatients AT milics nonalcoholicfattyliverdiseasenafldndashanewfactorthatinterplaysbetweeninflammationmalnutritionandatherosclerosisinelderlyhemodialysispatients AT sladojemartinovicb nonalcoholicfattyliverdiseasenafldndashanewfactorthatinterplaysbetweeninflammationmalnutritionandatherosclerosisinelderlyhemodialysispatients AT orlicl nonalcoholicfattyliverdiseasenafldndashanewfactorthatinterplaysbetweeninflammationmalnutritionandatherosclerosisinelderlyhemodialysispatients |
| _version_ |
1718399674182795264 |