DIABETES ASSOCIATED OXIDATIVE STRESS AND INFLAMMATION ALTERS THE PROTECTIVE EFFECT OF OBESITY ON SURVIVAL IN CHD PATIENTS

In contrast to the adverse outcomes of obesity in general population, increased body mass index (BMI) is associated with improved survival in hemodialysis (CHD) patients. The aim of this retrospective study was to evaluate the association between obesity and mortality by diabetic status among 98 maintenance CHD patients. The median follow up was 33 (19, 56) months. Mean age was 49±13 years, 66% were male and 48 % had obesity. 45% of obese subjects were diabetic. Among the subgroups of study population, survival of diabetic obese patients was significantly lower compared to non-diabetic obese subjects (p=0.007) (Figure 1). The subgroup comparisons showed that diabetic obese patients tend to have higher truncal fat percentage (p<0.001) and lower lean body mass standardized by body surface area compared to nondiabetic counterparts although difference was not statistically significance. Diabetic obese patients had higher leptin (p=0.001) and high sensitivity C-reactive protein levels (0.005). Additionally, protein thiols (P-SH) were significantly decreased in diabetic obese participants (p=0.03). Although, elevated body fatness appears to be protective for CHD population, presence of overt diabetes alters this advantage by increasing inflammation and oxidative stress