title: U-shaped association between central body fat and the urinary albumin-to-creatinine ratio and microalbuminuria.
abstract: BACKGROUND
  The prevalence of obese and overweight patients has increased dramatically worldwide. Both are common risk factors for chronic kidney disease (CKD) as indicated by a diminished estimated glomerular filtration rate (eGFR) or microalbuminuria. This study aimed to investigate whether anthropometric parameters [waist circumference (WC), waist-to-height ratio (WHtR) and body mass index (BMI)] are associated with renal function in a population-based study of Caucasian subjects.
  
  
  METHODS
  Data from 3749 subjects (1825 women) aged 20 to 81 years from the Study of Health in Pomerania (SHIP) were analysed. Renal indices, including the urinary albumin-to-creatinine ratio (uACR), microalbuminuria, eGFR and CKD, were studied. Parameters of anthropometry (WC, WHtR and BMI) were categorised into sex-specific quintiles.
  
  
  RESULTS
  Analysis of variance (ANOVA) models, adjusting for age, sex, type 2 diabetes mellitus and hypertension, revealed that a high and low WC or WHtR and low BMI were independently related to a higher uACR. Logistic regression models confirmed these results with respect to uACR and showed that subjects with a high or low WC or a high WHtR had increased odds of microalbuminuria. The ANOVA models revealed no relations of the investigated anthropometric parameters with eGFR. However, subjects with high values for these parameters had increased odds of CKD.
  
  
  CONCLUSIONS
  Our results demonstrate U-shaped associations between markers of central fat distribution and uACR or microalbuminuria in the general population, suggesting that both obese and very thin subjects have a higher risk of renal impairment.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Dittmann
authors.forename: Anke
authors.initials: A
authors.lastname: Hannemann
authors.forename: Henri
authors.initials: H
authors.lastname: Wallaschofski
authors.forename: Rainer
authors.initials: R
authors.lastname: Rettig
authors.forename: Sylvia
authors.initials: S
authors.lastname: Stracke
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
authors.forename: Matthias
authors.initials: M
authors.lastname: Nauck
authors.forename: Nele
authors.initials: N
authors.lastname: Friedrich
mesh_terms: D050153:Abdominal Fat / Q000378:metabolism*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000175:diagnosis* / Q000652:urine*; D015415:Biomarkers / Q000378:metabolism / Q000652:urine; D015331:Cohort Studies; D003404:Creatinine / Q000652:urine*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D055105:Waist Circumference / Q000502:physiology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D003404:Creatinine