title: Significance of estimated glomerular filtration rate in predicting brain or heart attacks in obese and non-obese populations.
abstract: BACKGROUND
  The Japanese Specific Health Checkup mainly focuses on metabolic syndrome for preventing cardiovascular events. Subjects are stratified by measuring waist circumference, body mass index, blood pressure, triglycerides, and fasting plasma glucose. However, estimated glomerular filtration rate (eGFR) is not considered essential.
  
  
  METHODS
  A longitudinal cohort study assessed the association of eGFR with new-onset brain or heart attacks in a large Japanese nationwide Specific Health Checkup database. A total of 109,349 Japanese subjects (mean age 63.2 years, 39.5 % men) were examined for the events 2 years later. The odds ratios were calculated for new events in the total and subgroup populations divided by BMI < or ≥25 kg/m(2), obese and non-obese, respectively.
  
  
  RESULTS
  Obese subjects were more often male and had proteinuria (dipstick test ≥1+), lower eGFR, and higher systolic and diastolic BP, fasting plasma glucose, hemoglobin A1c, and triglycerides (TG). Rates of new-onset brain or heart attacks were 3.1 and 4.0 % in the groups of non-obese and obese subjects, respectively. In the total population, eGFR as well as higher BMI (≥25 kg/m(2)), higher BP (high-normal hypertension or greater), higher TG (≥150 mg/dl), and proteinuria were significant risk factors for developing brain or heart attacks. The eGFR was significant in non-obese subjects, but not in the obese.
  
  
  CONCLUSIONS
  As the ultimate aim of 'Specific Health Checkup' is to prevent cardiovascular events, our study suggests that eGFR should be evaluated in non-obese subjects.
authors.affiliation: Dialysis Division, University of Miyazaki Hospital, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan. ysato@med.miyazaki-u.ac.jp.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Hemovascular Medicine and Artificial Organs, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
authors.forename: Shouichi
authors.initials: S
authors.lastname: Fujimoto
authors.affiliation: Steering Committee for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups", Fukushima, Japan.
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Konta
authors.affiliation: Steering Committee for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups", Fukushima, Japan.
authors.forename: Kunitoshi
authors.initials: K
authors.lastname: Iseki
authors.affiliation: Steering Committee for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups", Fukushima, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Moriyama
authors.affiliation: Steering Committee for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups", Fukushima, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Yamagata
authors.affiliation: Steering Committee for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups", Fukushima, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Tsuruya
authors.affiliation: Steering Committee for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups", Fukushima, Japan.
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kimura
authors.affiliation: Steering Committee for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups", Fukushima, Japan.
authors.forename: Ichiei
authors.initials: I
authors.lastname: Narita
authors.affiliation: Steering Committee for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups", Fukushima, Japan.
authors.forename: Masahide
authors.initials: M
authors.lastname: Kondo
authors.affiliation: Steering Committee for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups", Fukushima, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Asahi
authors.affiliation: iAnalysis LLC, Tokyo, Japan.
authors.forename: Issei
authors.initials: I
authors.lastname: Kurahashi
authors.affiliation: Department of Integrated Science and Engineering for Sustainable Society, Chuo University, Tokyo, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohashi
authors.affiliation: Steering Committee for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups", Fukushima, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Watanabe
mesh_terms: D015992:Body Mass Index; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D007564:Japan / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D009765:Obesity / Q000150:complications*; D011237:Predictive Value of Tests; D011507:Proteinuria / Q000150:complications; D012307:Risk Factors
keywords: Body mass index; Cardiovascular disease; Cerebrovascular disease; Estimated GFR; Specific Health Checkup