title: Metabolic abnormalities, but not obesity, contribute to the mildly reduced eGFR in middle-aged and elderly Chinese.
abstract: BACKGROUND
  The role of obesity as a determinant of kidney dysfunction has not reached an agreement and the underlying reason may be due to the heterogeneity of obese phenotypes. The aim of the study was to explore the associations of different obese phenotypes with the change of estimated glomerular filtration rate (eGFR) and the roles of obesity and metabolic abnormalities in this association.
  
  
  METHODS
  eGFR was calculated in 8,586 participants (≥ 40 years old). eGFR 60-90 mL/min/1.73 m(2) was defined as the mildly reduced eGFR. Multiple logistic regression analysis was used to determine odds ratios (ORs) for mildly reduced eGFR in the metabolically healthy obese (MHO), metabolically abnormal non-obese (MANO) and metabolically abnormal obese (MAO) groups, using the metabolically healthy non-obese (MHNO) subjects as the reference group. Meanwhile, the associations of body mass index (BMI), waist circumference (WC) and metabolic abnormalities (including hypertension, hyperglycemia and dyslipidemia) with the risk of mildly reduced eGFR were also investigated.
  
  
  RESULTS
  The proportion of MHNO, MHO, MANO and MAO subjects was 8.3, 17.1, 10.1 and 64.5 %, respectively. Increased ORs were observed in MANO (OR 1.51, P = 0.014) and MAO (OR 1.47, P = 0.015) groups, after adjusting for age, gender, smoking, drinking, BMI and WC. When further adjusting for metabolic abnormalities, MANO (OR 1.24, P = 0.247) and MAO (OR 1.17, P = 0.366) subjects would not present increased risk of mildly reduced eGFR any more. Oppositely, fasting insulin (OR 1.03, P < 0.001), hyperglycemia (OR 1.25, P = 0.002) and dyslipidemia (OR 1.25, P = 0.002), but not hypertension, BMI and WC, significantly increased the risk of mildly reduced eGFR.
  
  
  CONCLUSIONS
  Metabolic abnormalities, but not simple obesity, may contribute to the mildly reduced eGFR in middle-aged and elderly Chinese.
authors.affiliation: Department of Endocrinology of Qilu Hospital, Shandong University, Jinan, 250012, Shandong, China.
authors.forename: Chuan
authors.initials: C
authors.lastname: Wang
authors.forename: Kai
authors.initials: K
authors.lastname: Liang
authors.forename: Xiuping
authors.initials: X
authors.lastname: Zhang
authors.forename: Chengqiao
authors.initials: C
authors.lastname: Li
authors.forename: Weifang
authors.initials: W
authors.lastname: Yang
authors.forename: Zeqiang
authors.initials: Z
authors.lastname: Ma
authors.forename: Yu
authors.initials: Y
authors.lastname: Sun
authors.forename: Jun
authors.initials: J
authors.lastname: Song
authors.forename: Peng
authors.initials: P
authors.lastname: Lin
authors.forename: Lei
authors.initials: L
authors.lastname: Gong
authors.forename: Meijian
authors.initials: M
authors.lastname: Wang
authors.forename: Fuqiang
authors.initials: F
authors.lastname: Liu
authors.forename: Wenjuan
authors.initials: W
authors.lastname: Li
authors.forename: Juan
authors.initials: J
authors.lastname: Xiao
authors.forename: Fei
authors.initials: F
authors.lastname: Yan
authors.forename: Junpeng
authors.initials: J
authors.lastname: Yang
authors.forename: Lingshu
authors.initials: L
authors.lastname: Wang
authors.forename: Meng
authors.initials: M
authors.lastname: Tian
authors.forename: Jidong
authors.initials: J
authors.lastname: Liu
authors.forename: Ruxing
authors.initials: R
authors.lastname: Zhao
authors.forename: Xinguo
authors.initials: X
authors.lastname: Hou
authors.forename: Li
authors.initials: L
authors.lastname: Chen
mesh_terms: D000368:Aged; D044466:Asian People; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D008659:Metabolic Diseases / Q000503:physiopathology*; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology*
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