title: Sex differences in the association between obesity and albuminuria among Korean adults: a cross-sectional study using the Korea National Health and Nutrition Examination Survey data.
abstract: BACKGROUND
  The association between obesity and albuminuria in the general population remains unclear. We aimed to identify the association between obesity and albuminuria as well as sex differences regarding the associations using several obesity indices, including waist circumference (WC), body mass index (BMI), and waist-to-height ratio (WHR).
  
  
  METHODS
  This study included 3841 subjects (1730 males and 2111 females; age 20-80 years) who participated in the Fifth Korea National Health and Nutrition Examination Survey conducted in 2011. Subjects with hypertension, diabetes, renal failure, or a malignant tumor and those who were pregnant or menstruating were excluded. Albuminuria was defined as a urinary albumin-to-creatinine ratio ≥30 mg/g. Anthropometric parameters were categorized into sex-specific quartiles. Logistic regression models were used to assess the associations between each anthropometric parameter and albuminuria.
  
  
  RESULTS
  All of the obesity indices of the fourth quartile group of females showed a twofold higher risk for albuminuria than the second quartile group, and it was persistently significant after adjusting for age, smoking, and physical activity. After further adjustment for high blood pressure and impaired fasting glucose and triglyceride levels, WC and BMI of the fourth quartile group of females still showed a significantly higher risk for albuminuria than the second quartile group (odds ratios 1.96 and 2.24; 95 % confidence intervals 1.03-3.74 and 1.15-4.37). None of the associations between albuminuria and the obesity indices were significant in males.
  
  
  CONCLUSIONS
  Higher WC and BMI were significantly associated with the risk of albuminuria among females, but not males.
authors.affiliation: Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, 431-796, Republic of Korea.
authors.forename: Hye-Mi
authors.initials: HM
authors.lastname: Noh
authors.affiliation: Daejeon Woori Spine Hospital, Daejeon, Republic of Korea.
authors.forename: Un-Young
authors.initials: UY
authors.lastname: Kim
authors.affiliation: Department of Family Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea.
authors.forename: Yong Soon
authors.initials: YS
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Kidney Research Institute, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, Republic of Korea.
authors.forename: Young Rim
authors.initials: YR
authors.lastname: Song
authors.affiliation: Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, 431-796, Republic of Korea.
authors.forename: Hye-Young
authors.initials: HY
authors.lastname: Oh
authors.affiliation: Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, 431-796, Republic of Korea.
authors.forename: Kyung-Hee
authors.initials: KH
authors.lastname: Park
authors.affiliation: Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, 431-796, Republic of Korea.
authors.forename: Yu-Jin
authors.initials: YJ
authors.lastname: Paek
authors.affiliation: Department of Family Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea. Rohky@hallym.or.kr.
authors.forename: Yong Kyun
authors.initials: YK
authors.lastname: Roh
authors.affiliation: Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, 431-796, Republic of Korea. hongjisong5@gmail.com.
authors.forename: Hong Ji
authors.identifier: http://orcid.org/0000-0002-3563-9504
authors.initials: HJ
authors.lastname: Song
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000175:diagnosis / Q000453:epidemiology*; D015992:Body Mass Index; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009749:Nutrition Surveys; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology*; D016017:Odds Ratio; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D055105:Waist Circumference; D049629:Waist-Hip Ratio; D055815:Young Adult
keywords: Albuminuria; Body mass index (BMI); Obesity; Waist circumference (WC); Waist-to-height ratio (WHR)