The main cause of mortality in chronic kidney disease (CKD) patients is the cardiovascular disease. Besides the traditional risk factors, chronic inflammatory condition as well as the reduced protective factors seems to be involved in the development of cardiovascular complications in these patients. In the general population the role of body fat, especially of visceral fat, on the development of the metabolic syndrome with consequent increase of cardiovascular risk is well established. However, in CKD patients few studies evaluated the association of inflammatory markers and adipokines with different body compartments, and the results are conflicting. Moreover, the role of visceral fat on such relationship has never been studied. Thus, the aim of the present study is to analyze the relationship of both total body fat and visceral fat with inflammatory markers and adipokines in CKD patients not yet on dialysis. The sample will include 120 adult patients with glomerular filtration rate from 15 to 89 ml/minute. Inflammatory markers such as C-reactive protein (high sensitivity), interleukin-1, interleukin-6 and tumor necrosis factor-alpha, and the adipokines leptin and adiponectin (ELISA) will be measured. Body composition (total body fat and lean body mass) will be assessed by dual-energy X-ray absorptiometry (DEXA) and abdominal fat (subcutaneous and visceral) by computed tomography. The nutritional evaluation will be conducted using anthropometric parameters (body weight, height, body mass index, triceps and subscapular skinfold thicknesses, midarm muscle circumference, and waist circumference) and the subjective global assessment. The following laboratory parameters will be measured: serum and urinary urea and creatinine, fasting glucose and insulin, serum albumin, total cholesterol and fractions, and triglycerides. Insulin sensitivity will be determined by calculating the homeostatic model assessment (HOMA). All measurements will be performed at baseline and repeated after 12 months. The statistical analyses will be conducted by means of SPSS software 11.0 version for Windows.
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