title: Metabolically Healthy Obesity and Development of Chronic Kidney Disease: A Cohort Study.
abstract: BACKGROUND
  The risk for chronic kidney disease (CKD) among obese persons without obesity-related metabolic abnormalities, called metabolically healthy obesity, is largely unexplored.
  
  
  OBJECTIVE
  To investigate the risk for incident CKD across categories of body mass index in a large cohort of metabolically healthy men and women.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Kangbuk Samsung Health Study, Kangbuk Samsung Hospital, Seoul, South Korea.
  
  
  METHODS
  62 249 metabolically healthy, young and middle-aged men and women without CKD or proteinuria at baseline.
  
  
  METHODS
  Metabolic health was defined as a homeostasis model assessment of insulin resistance less than 2.5 and absence of any component of the metabolic syndrome. Underweight, normal weight, overweight, and obesity were defined as a body mass index less than 18.5 kg/m2, 18.5 to 22.9 kg/m2, 23 to 24.9 kg/m2, and 25 kg/m2 or greater, respectively. The outcome was incident CKD, defined as an estimated glomerular filtration rate less than 60 mL/min/1.73 m2.
  
  
  RESULTS
  During 369 088 person-years of follow-up, 906 incident CKD cases were identified. The multivariable-adjusted differences in 5-year cumulative incidence of CKD in underweight, overweight, and obese participants compared with normal-weight participants were -4.0 (95% CI, -7.8 to -0.3), 3.5 (CI, 0.9 to 6.1), and 6.7 (CI, 3.0 to 10.4) cases per 1000 persons, respectively. These associations were consistently seen in all clinically relevant subgroups.
  
  
  CONCLUSIONS
  Chronic kidney disease was identified by a single measurement at each visit.
  
  
  CONCLUSIONS
  Overweight and obesity are associated with an increased incidence of CKD in metabolically healthy young and middle-aged participants. These findings show that metabolically healthy obesity is not a harmless condition and that the obese phenotype, regardless of metabolic abnormalities, can adversely affect renal function.
  
  
  BACKGROUND
  None.
authors: Yoosoo
authors: Y
authors: Chang
authors: Seungho
authors: S
authors: Ryu
authors: Yuni
authors: Y
authors: Choi
authors: Yiyi
authors: Y
authors: Zhang
authors: Juhee
authors: J
authors: Cho
authors: Min-Jung
authors: MJ
authors: Kwon
authors: Young Youl
authors: YY
authors: Hyun
authors: Kyu-Beck
authors: KB
authors: Lee
authors: Hyang
authors: H
authors: Kim
authors: Hyun-Suk
authors: HS
authors: Jung
authors: Kyung Eun
authors: KE
authors: Yun
authors: Jiin
authors: J
authors: Ahn
authors: Sanjay
authors: S
authors: Rampal
authors: Di
authors: D
authors: Zhao
authors: Byung-Seong
authors: BS
authors: Suh
authors: Eun Cheol
authors: EC
authors: Chung
authors: Hocheol
authors: H
authors: Shin
authors: Roberto
authors: R
authors: Pastor-Barriuso
authors: Eliseo
authors: E
authors: Guallar
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D000067329:Obesity, Metabolically Benign / Q000150:complications*; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors