title: Four-Year Changes in Visceral Fat Mass and the Risk of Developing Proteinuria in the General Population.
abstract: BACKGROUND
  Previous cross-sectional studies demonstrated the close relationship between visceral obesity and the increased prevalence of proteinuria. But, little is known about the role of changes in visceral fat mass (∆VFM) over several years in the development of proteinuria. In this longitudinal cohort study with the general population, the changes in ∆VFM as well as baseline VFM on proteinuria development were evaluated.
  
  
  METHODS
  Healthy individuals (n = 2393) who participated in two health screening exams were analyzed. Subjects were divided into three groups based on gender-specific tertiles of baseline VFM and ∆VFM. Each patient was tested for proteinuria using a dipstick, and proteinuria was defined as 1+ or greater.
  
  
  RESULTS
  The mean age was 51.9±7.7 years, and the incidence of proteinuria was 3.9% (n = 93). During the 4 years, 52.5% of the subjects experienced a decline in ∆VFM. However, subjects who developed proteinuria exhibited a significant increase in ∆VFM. Even after adjustment for age, smoking, systolic and diastolic BP, serum creatinine, and hs-CRP levels, the highest tertiles for baseline VFM [men, odds ratio (OR) 3.43, 95% confidence interval (CI) 1.22-9.67; women, OR 2.01, 95% CI 1.05-4.15] and ∆VFM (men, OR 2.92, 95% CI 1.22-6.99; women, OR 3.16, 95% CI 1.56-6.39) were independent predictors of proteinuria development. Following adjustment of both parameters, subjects in the highest baseline VFM and ∆VFM tertiles exhibited the greatest risk of proteinuria development, which suggested the additive harmful effects of the two factors.
  
  
  CONCLUSIONS
  Baseline VFM and greater increase in ∆VFM were both important risk factors for developing proteinuria in the general population. Appropriate education and interventions to prevent accumulation of VFM should be the major focus of preemptive strategies.
authors.affiliation: Department of Internal Medicine, Hallym University Sacred Heart Hospital, Kidney Research Institute, Anyang, Korea.
authors.forename: Jwa-Kyung
authors.initials: JK
authors.lastname: Kim
authors.affiliation: Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Young-Jun
authors.initials: YJ
authors.lastname: Kwon
authors.affiliation: Department of Internal Medicine, Hallym University Sacred Heart Hospital, Kidney Research Institute, Anyang, Korea.
authors.forename: Young Rim
authors.initials: YR
authors.lastname: Song
authors.affiliation: Department of Internal Medicine, Hallym University Sacred Heart Hospital, Kidney Research Institute, Anyang, Korea.
authors.forename: Young-Su
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Hallym University Sacred Heart Hospital, Kidney Research Institute, Anyang, Korea.
authors.forename: Hyung Jik
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Hallym University Sacred Heart Hospital, Kidney Research Institute, Anyang, Korea.
authors.forename: Sung Gyun
authors.initials: SG
authors.lastname: Kim
authors.affiliation: Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Young-Su
authors.initials: YS
authors.lastname: Ju
mesh_terms: D050154:Adiposity; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D050152:Intra-Abdominal Fat / Q000503:physiopathology*; D007677:Kidney Function Tests; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011507:Proteinuria / Q000453:epidemiology / Q000209:etiology*; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors
chemical_list: D003404:Creatinine