title: Estimated visceral adipose tissue, but not body mass index, is associated with reductions in glomerular filtration rate based on cystatin C in the early stages of chronic kidney disease.
abstract: Information on the association between obesity and initial phases of chronic kidney disease (CKD) is still limited, principally those regarding the influence of visceral adipose tissue. We investigated whether the visceral adipose tissue is more associated with reductions in glomerular filtration rate (GFR) than total and abdominal obesity in hypertensive individuals with stage 1-2 CKD. A cross-sectional study was implemented which involved 241 hypertensive patients undergoing treatment at a primary health care facility. GFR was estimated using equations based on creatinine and cystatin C levels. Explanatory variables included body mass index (BMI), waist circumference (WC), and estimated visceral adipose tissue (eVAT). The mean age was 59.6 ± 9.2 years old and 75.9% were female. According to BMI, 28.2% of subjects were obese. Prevalence of increased WC and eVAT was 63.9% and 58.5%, respectively. Results from the assessment of GFR by BMI, WC, and eVAT categories showed that only women with increased eVAT (≥150 cm(2)) had a lower mean GFR by Larsson (P = 0.016), Levey 2 (P = 0.005), and Levey 3 (P = 0.008) equations. The same result was not observed when the MDRD equation was employed. No association was found between BMI, WC, eVAT, and GFR using only serum creatinine. In the early stages of CKD, increased eVAT in hypertensive women was associated with decreased GFR based on cystatin C.
authors.affiliation: Departamento of Health Sciences, Federal University of Maranhão, São Luís, Brazil.
authors.forename: Ana Karina Teixeira da Cunha
authors.initials: AK
authors.lastname: França
authors.affiliation: Collective Health Postgraduate Program, Federal University of Maranhão, São Luís, Brazil.
authors.forename: Alcione Miranda
authors.initials: AM
authors.lastname: Dos Santos
authors.affiliation: Clinical Chemistry Service, Kidney Disease Prevention Centre, University Hospital, Federal University of Maranhão, São Luís, Brazil.
authors.forename: João Victor
authors.initials: JV
authors.lastname: Salgado
authors.affiliation: Kidney Disease Prevention Centre, University Hospital, Federal University of Maranhão, São Luís, Brazil.
authors.forename: Elane Viana
authors.initials: EV
authors.lastname: Hortegal
authors.affiliation: Collective Health Postgraduate Program, Federal University of Maranhão, São Luís, Brazil.
authors.forename: Antônio Augusto Moura
authors.initials: AA
authors.lastname: da Silva
authors.affiliation: Department of Medicine I, Federal University of Maranhão, São Luís, Brazil.
authors.forename: Natalino
authors.initials: N
authors.lastname: Salgado Filho