title: Association of anthropometric obesity measures with chronic kidney disease risk in a non-diabetic patient population.
abstract: BACKGROUND
  Obesity is a risk factor for both chronic kidney disease (CKD) and cardiovascular disease. The association of simple indices of obesity with CKD remains poorly understood. Evidence suggests that measures of central obesity such as waist circumference (WC) and waist-to-hip ratio (WHR) are more accurate predictors of morbidity and cardiovascular risk than body mass index (BMI). This study aimed to investigate the association of BMI, WC and WHR with CKD risk in a population screened for type 2 diabetes.
  
  
  METHODS
  Data were drawn from a population-based screening programme of 6475 volunteers without pre-existing diabetes. A number of investigations and cardiovascular health-related assessments were performed. Participants were categorized into two groups: those with an estimated glomerular filtration rate (eGFR) ≥60 and <60 mL/min/1.73m(2). Participants were also categorized as low, medium and high risk according to each anthropometric variable.
  
  
  RESULTS
  CKD was independently associated with higher WC and BMI (P < 0.01) but not WHR (P = 0.47). Increasing obesity measured by BMI and WC was associated with a reduction in eGFR for both men and women (P < 0.001). Increasing risk categories for BMI and WC were also associated with lower eGFR in men and women (P < 0.001). Combining anthropometric measures provided no additional measure of risk for underlying CKD.
  
  
  CONCLUSIONS
  WC may be a simple and reliable clinical tool for the detection of underlying CKD within primary care. Given the complex interaction between adiposity and uraemia, a combined screening tool using BMI and WC or WHR is unlikely to provide any additional benefit to risk analysis.
authors.affiliation: Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK. jb343@le.ac.uk
authors.forename: James O
authors.initials: JO
authors.lastname: Burton
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Gray
authors.forename: David R
authors.initials: DR
authors.lastname: Webb
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Davies
authors.forename: Kamlesh
authors.initials: K
authors.lastname: Khunti
authors.forename: Winston
authors.initials: W
authors.lastname: Crasto
authors.forename: Sue J
authors.initials: SJ
authors.lastname: Carr
authors.forename: Nigel J
authors.initials: NJ
authors.lastname: Brunskill
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D015992:Body Mass Index; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology*; D011237:Predictive Value of Tests; D012307:Risk Factors; D055105:Waist Circumference; D049629:Waist-Hip Ratio