Waist-to-height ratio is the best index of obesity in association with chronic kidney disease.
OBJECTIVE
Obesity is a risk factor for chronic kidney disease (CKD) and cardiovascular disease. The association between different indexes of obesity and CKD is unknown. This study evaluated the association between indexes of obesity and CKD.


METHODS
We reviewed 4611 participants including 2613 men and 1998 women in this community-based cross-sectional study from 2003 to 2005. CKD was defined as a glomerular filtration rate slower than 60 mL/min per 1.73 m(2) by the Modification of Diet in Renal Disease formula. Indexes of obesity included body mass index, waist circumference, waist-to-hip ratio, and waist-to-height ratio (WheiR). Traditional risk factors including diabetes, hypertension, smoking, and metabolic syndrome were also taken into consideration.


RESULTS
A total of 221 (4.8%) participants including 137 men and 84 women were found to have CKD. Participants with CKD were significantly older than those without (P < 0.001). In univariate logistic regression with adjustment for age, all indexes of obesity were associated with CKD (P < 0.001). In multivariate logistic regression with adjustment for age and gender, WheiR was significantly associated with CKD, independent of hypertension and diabetes (P = 0.028). The adjusted odds ratios of WheiR (every 0.1 increment) was 2.74 (95% confidence interval 1.18-6.72).


CONCLUSIONS
Obesity, especially central obesity, is associated with CKD and the association is independent of hypertension, diabetes, and metabolic syndrome. In commonly used obesity indexes, WheiR is particularly associated with CKD.
Lin
Chih-Hsueh
CH
Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
Chou
Che-Yi
CY
Lin
Cheng-Chieh
CC
Huang
Chiu-Ching
CC
Liu
Chiu-Shong
CS
Lai
Shih-Wei
SW
D000367:Age Factors; D000368:Aged; D001827:Body Height / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000453:epidemiology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000209:etiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011237:Predictive Value of Tests; D012307:Risk Factors; D012737:Sex Factors; D049629:Waist-Hip Ratio