{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T18:41:13Z","timestamp":1760985673200,"version":"build-2065373602"},"reference-count":32,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2018,4,12]],"date-time":"2018-04-12T00:00:00Z","timestamp":1523491200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Although an increased body mass index is associated with lower mortality in patients undergoing hemodialysis (HD), known as the \u201cobesity paradox,\u201d the relationship of abdominal fat levels with all-cause mortality has rarely been studied. We investigated the impact of computed-tomography-measured abdominal fat levels (visceral fat area (VFA) and subcutaneous fat area (SFA)) on all-cause mortality in this population. A total of 201 patients undergoing HD were enrolled and cross-classified by VFA and SFA levels according to each cutoff point, VFA of 78.7 cm2 and SFA of 93.2 cm2, based on the receiver operator characteristic (ROC) curve as following; group 1 (G1): lower VFA and lower SFA, G2: higher VFA and lower SFA, G3: lower VFA and higher SFA, G4: higher VFA and higher SFA. During a median follow-up of 4.3 years, 67 patients died. Kaplan\u2013Meier analysis revealed 10-year survival rates of 29.0%, 50.0%, 62.6%, and 72.4% in G1, G2, G3, and G4 (p &lt; 0.0001), respectively. The adjusted hazard ratio was 0.30 (95% confidence interval [CI] 0.05\u20131.09, p = 0.070) for G2 vs. G1, 0.37 (95% CI 0.18\u20130.76, p = 0.0065) for G3 vs. G1, and 0.21 (95% CI 0.07\u20130.62, p = 0.0035) for G4 vs. G1, respectively. In conclusion, combined SFA and VFA levels were negatively associated with risks for all-cause mortality in patients undergoing HD. These results are a manifestation of the \u201cobesity paradox.\u201d<\/jats:p>","DOI":"10.3390\/nu10040480","type":"journal-article","created":{"date-parts":[[2018,4,12]],"date-time":"2018-04-12T12:19:27Z","timestamp":1523535567000},"page":"480","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["The Impact of Abdominal Fat Levels on All-Cause Mortality Risk in Patients Undergoing Hemodialysis"],"prefix":"10.3390","volume":"10","author":[{"given":"Takahiro","family":"Yajima","sequence":"first","affiliation":[{"name":"Department of Nephrology, Matsunami General Hospital, 185-1 Dendai, Kasamatsu, Gifu 501-6062, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kumiko","family":"Yajima","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Matsunami General Hospital, 185-1 Dendai, Kasamatsu, Gifu 501-6062, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Division of Medical Statistics, Fujita Health University School of Medicine, Aichi 470-1192, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keigo","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Matsunami General Hospital, 185-1 Dendai, Kasamatsu, Gifu 501-6062, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2018,4,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Prospective Studies Collaboration, Whitlock, G., Lewington, S., Sherliker, P., Clarke, R., Emberson, J., Halsey, J., Qizilbash, N., Collins, R., and Peto, R. 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