
Association between Inflammation and Malnutrition as Risk Factors of Cardiovascular Disease
Author(s) -
George A. Kaysen
Publication year - 2005
Publication title -
blood purification
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 57
eISSN - 1421-9735
pISSN - 0253-5068
DOI - 10.1159/000089437
Subject(s) - inflammation , medicine , adipose tissue , albumin , systemic inflammation , endocrinology , body mass index , dialysis , malnutrition , lipoprotein , obesity , serum albumin , cholesterol
Cardiovascular disease is the leading cause of death among dialysis patients. The relative risk of mortality increases as serum albumin concentration and body mass index decline. While these are generally associated with nutritional status, inflammation causes sarcopenia and decreased albumin concentration by reducing synthesis of proteins and increasing their catabolic rate. While inflammation can arise from atherosclerotic blood vessels, systemic inflammation from any source can alter the vascular endothelium and plasma protein composition in ways that promotes vascular injury. High-density lipoprotein synthesis is decreased and the high-density lipoprotein present is less capable of reducing inflammation. Activation of neutrophils favors lipoprotein oxidation. Surprisingly, while obesity is associated with cytokine production in patients without renal failure, as well as among dialysis patients, increased body mass index, whether reflecting muscle mass or adipose tissue, is associated with a decline in mortality rates.