title: Body mass index and preclinical kidney disease in Indian adults aged 40 years and above without chronic kidney disease.
abstract: BACKGROUND
  Obesity is associated with diabetes and hypertension, two major risk factors for chronic kidney disease (CKD). Recently, it has been shown that obesity is associated with preclinical kidney disease defined by elevated levels of cystatin C among those without CKD in US adults. However, the association of obesity with cystatin C is not known in industrialized Asian populations.
  
  
  METHODS
  We examined 2,052 Indian adults aged 40-80 years in Singapore who were free of CKD defined as a serum creatinine-based estimated glomerular filtration rate (eGFRcr) <60 mL/min/1.73 m(2) and/or the presence of microalbuminuria. Body mass index (BMI) values were categorized into normal (18.5-24.9), overweight (25-29.9) and obese (≥30 kg/m(2)). Elevated serum cystatin C was defined as cystatin C ≥1 mg/L.
  
  
  RESULTS
  Overweight and obesity were significantly associated with elevated levels of cystatin C after adjusting for potential confounders including diabetes and hypertension and eGFRcr. Compared to those with normal weight, the odds ratio (95 % confidence interval) of elevated cystatin C was 1.49 (1.17-1.88) for overweight and 3.20 (2.33-4.39) for obese. This association was consistently present when BMI was analyzed as a continuous variable and also in subgroups of men, women and in those without diabetes mellitus or hypertension.
  
  
  CONCLUSIONS
  Higher BMI levels are associated with preclinical kidney disease in Indian adults aged 40 years and above without CKD.
authors: Singapore Eye Research Institute, 11 Third Hospital Avenue, #06-13, SNEC Bldg, Singapore, 168751, Singapore, charumathi.sabanayagam@seri.com.sg.
authors: Charumathi
authors: C
authors: Sabanayagam
authors: Tien Yin
authors: TY
authors: Wong
authors: Jiemin
authors: J
authors: Liao
authors: Sunil
authors: S
authors: Sethi
authors: Boon Wee
authors: BW
authors: Teo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000453:epidemiology; D015992:Body Mass Index; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D055316:Cystatin C / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D015994:Incidence; D007194:India / Q000208:ethnology; D007668:Kidney / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology
chemical_list: D055316:Cystatin C; D003404:Creatinine