title: U-shaped association between body mass index and proteinuria in a large Japanese general population sample.
abstract: BACKGROUND
  There is little data on the association between body mass index (BMI) and proteinuria.
  
  
  METHODS
  This was a cross-sectional cohort study assessing the association between BMI and proteinuria in a large Japanese population. Using a nationwide health check-up database of 212,251 Japanese aged >20 years with no pre-existing cardiovascular diseases (185,183 men, median age 66 years; 127,068 women, median age 65 years), we examined the association between BMI and proteinuria (≥ 1+ on dipstick).
  
  
  RESULTS
  Subjects were divided into 11 subgroups by BMI grading in 1 kg/m(2) intervals from 18.5-27.5 kg/m(2). A BMI of approximately 22 ± 0.5 kg/m(2) was considered optimal for Japanese; therefore, this subgroup was set as a reference when logistic analysis was applied. Age, waist circumference, height, weight, smoking and drinking habits, use of medications such as antihypertensive, antidiabetic, or antihyperlipidemic, as well as proteinuria, estimated glomerular filtration rate (eGFR), chemistry data, and blood pressure levels were significantly different between subgroups in both genders. The odds ratio for proteinuria showed a U-shape in men and women, even after adjustment for significant covariates such as age, waist circumference, systolic blood pressure, eGFR, fasting plasma glucose, triglyceride, low-density lipoprotein, antihypertensive use, antidiabetic use, antihyperlipidemic use, and lifestyle factors (smoking and drinking). Gender differences were also prominent--a BMI <20.4 kg/m(2) was significantly associated with proteinuria in men compared to a BMI <18.4 kg/m(2) in women. On the other hand, a BMI ≥ 25.5 kg/m(2) was also significantly associated with proteinuria in men compared to a BMI ≥ 22.5 kg/m(2) in women.
  
  
  CONCLUSIONS
  We found that BMI levels were associated with proteinuria in a U-shaped manner and showed marked gender differences. Health guidance should not only focus on higher BMI subjects, but also on thin subjects, in terms of the prevention of chronic kidney disease.
authors: Dialysis Division, University of Miyazaki Hospital, Miyazaki, Japan, ysato@fc.miyazaki-u.ac.jp.
authors: Yuji
authors: Y
authors: Sato
authors: Shouichi
authors: S
authors: Fujimoto
authors: Tsuneo
authors: T
authors: Konta
authors: Kunitoshi
authors: K
authors: Iseki
authors: Toshiki
authors: T
authors: Moriyama
authors: Kunihiro
authors: K
authors: Yamagata
authors: Kazuhiko
authors: K
authors: Tsuruya
authors: Hideaki
authors: H
authors: Yoshida
authors: Koichi
authors: K
authors: Asahi
authors: Issei
authors: I
authors: Kurahashi
authors: Yasuo
authors: Y
authors: Ohashi
authors: Tsuyoshi
authors: T
authors: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D015992:Body Mass Index; D016009:Chi-Square Distribution; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008019:Life Style / Q000208:ethnology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000175:diagnosis / Q000208:ethnology*; D016017:Odds Ratio; D011507:Proteinuria / Q000175:diagnosis / Q000208:ethnology*; D011934:Reagent Strips; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000208:ethnology*; D012307:Risk Factors; D012737:Sex Factors; D013851:Thinness / Q000175:diagnosis / Q000208:ethnology*; D016482:Urinalysis / Q000295:instrumentation
chemical_list: D011934:Reagent Strips
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