title: Association of visceral fat area with chronic kidney disease and metabolic syndrome risk in the general population: analysis using multi-frequency bioimpedance.
abstract: OBJECTIVE
  Advances in bioimpedance analysis (BIA) technologies now enable visceral fat area (VFA) to be assessed using this method. The aim of this study was to evaluate the clinical relevance and usefulness of VFA as a predictor of chronic kidney disease (CKD) and metabolic syndrome (MS), using BIA.
  
  
  METHODS
  We identified 24,791 adults who underwent voluntary routine health checkups at Yeungnam University Hospital. In total 22,480 patients were recruited into our study. Participants were divided into 3 tertiles based on their VFA: low, middle, and high tertiles. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m(2).
  
  
  RESULTS
  The higher tertile of VFA was associated with a higher prevalence of diabetes mellitus, hypertension, and male sex. Waist-to-hip ratio, body mass index, blood pressure, lean mass, body fat %, and fasting glucose, total cholesterol, triglyceride, GGT, AST, ALT, and uric acid levels all increased as the VFA tertile increased (P < 0.001 for all variables). The prevalence of CKD was 6.9% in the low tertile, 13.9% in the middle tertile, and 25.2% in the high tertile (P < 0.001). The prevalence of MS was 2.2% in the low tertile, 12.8% in the middle tertile, and 36.7% in the high tertile (P < 0.001). The AUROC values for VFA were higher than those for BMI and WHR. For VFA, the sensitivity and specificity for predicting CKD were 62.66% (95% CI, 61.0-64.3) and 64.22% (95% CI, 63.5-64.9), respectively, and 77.65% (95% CI, 76.3-79.0), and 68.81% (95% CI, 68.1-69.5), respectively for predicting MS.
  
  
  CONCLUSIONS
  Our results demonstrated that the VFA, measured by BIA, is a simple method for predicting the risk of CKD and MS.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea.
authors.forename: Seok Hui
authors.initials: SH
authors.lastname: Kang
authors.forename: Kyu Hyang
authors.initials: KH
authors.lastname: Cho
authors.forename: Jong Won
authors.initials: JW
authors.lastname: Park
authors.forename: Kyung Woo
authors.initials: KW
authors.lastname: Yoon
authors.forename: Jun Young
authors.initials: JY
authors.lastname: Do
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D017097:Electric Impedance; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology; D050152:Intra-Abdominal Fat / Q000473:pathology*; D008297:Male; D024821:Metabolic Syndrome / Q000473:pathology*; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000473:pathology*; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment; D049629:Waist-Hip Ratio