Associations of body size with metabolic syndrome and mortality in moderate chronic kidney disease.
OBJECTIVE
Obesity is associated with metabolic syndrome and poor outcomes in those with normal kidney function but better survival in dialysis patients. We examined whether chronic kidney disease (CKD) modifies the association of obesity with metabolic syndrome and mortality.


METHODS
Analyses of 15,355 participants in limited access, public use Atherosclerosis Risk in Communities Study database.


RESULTS
The prevalence of metabolic syndrome in (BMI) groups < 20, 20 to 24.9, 25 to 29.9, 30 to 34.9, and > or = 35 kg/m2 were 1, 6, 17, 28, and 35% and 9, 15, 32, 46, and 58% in participants without (n = 14,894) and with CKD (n = 461), respectively. Using BMI 20 to 24.9 kg/m2 as the reference, there was a U-shaped association of BMI with mortality in a parametric survival model of death. An interaction term of BMI and CKD added to the model was significant. In participants with (BMI) > or = 25 kg/m2, each 1-kg/m2 increase in BMI was associated with increased hazard of death only in those without CKD. Adjustment for components of metabolic syndrome, markers of inflammation, and cardiovascular conditions abolished these associations in participants without CKD but became protective in participants with CKD.


CONCLUSIONS
The prevalence of obesity parallels metabolic syndrome in populations with and without CKD. However, the presence of CKD modifies the associations of obesity with mortality.
Kwan
Bonnie C H
BC
Division of Nephrology & Hypertension, University of Utah School of Medicine, Salt Lake City, UT, USA.
Murtaugh
Maureen A
MA
Beddhu
Srinivasan
S
D049628:Body Size; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology* / Q000401:mortality*; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011446:Prospective Studies; D012720:Severity of Illness Index