Obesity Assessment Using Waist Circumference or Body Mass Index for Predicting Mortality of Elderly Hemodialysis Patients

摘要

This retrospective observational cohort study, demonstrating obesity defined by waist circumference rather than body mass index at baseline was associated with an increased cardiovascular mortality in the elderly sarcopenic dialysis patients after multi-variable adjustment (1). In non-dialysis elderly population, some previous relevant studies have shown obesity defined by serum triglyceride and waist circumference could better predicting mortality than body mass index (2, 3). In this study, cardiovascular events accounted for 59.7% of death. In prediction of cardiovascular mortality, the author proposed waist circumference might be a better way to define obesity based on increased visceral fat than body mass index, which misclassified 37 out of 91 (40%) abdominal obese patients as non-obese patients presented in the study (1). Misclassification of obesity, using body mass index, was also reported in a previous study of chronic kidney disease patients with sarcopenia (4).