title: Combined body mass index with high-sensitivity C-reactive protein as independent predictors for chronic kidney disease in a relatively healthy population in Taiwan.
abstract: Obesity, a chronic inflammatory state, increases risk of cardiovascular disease and insulin resistance, which are the leading cause of end-stage renal disease (ESRD). We evaluated the relationship between body mass index (BMI) and high-sensitivity C-reactive protein (hsCRP) level and impaired kidney function to determine the predictive value of both markers for estimating chronic kidney disease (CKD) risk in a healthy adult population in Taiwan.
  
  
  
  In a retrospective cross-sectional study of 4100 subjects ⩾18 years, a multivariate logistic regression model was used to assess the relationship among BMI, high hsCRP levels and CKD. Receiver-operating characteristic curve and Youden index were developed to define the discrimination power of combining BMI with hsCRP for CKD prediction and to determine the best predictive index.
  
  
  
  Overweight/obese subjects with high hsCRP levels had the highest odds ratio for CKD (P=0.048). In females, combining BMI with hsCRP for CKD prediction was superior to that of males (0.890 vs 0.623, respectively; both P<0.001). For females, the Youden index was 25.65 kg/m(2) for BMI and 1.04 μg/ml for hsCRP.
  
  
  
  Overweight/obesity with higher hsCRP levels is associated with reduced renal function and increased risk for CKD. BMI and hsCRP levels can be used as surrogate markers for CKD risk, especially for females.
authors.affiliation: Department of Family Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Y-W
authors.initials: YW
authors.lastname: Tsai
authors.affiliation: Department of Family Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: M-C
authors.initials: MC
authors.lastname: Lu
authors.affiliation: Department of Family Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Y-H
authors.initials: YH
authors.lastname: Lin
authors.affiliation: Department of Family Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Y-C
authors.initials: YC
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital at Taipei, Taipei City, Taiwan.
authors.forename: W-C
authors.initials: WC
authors.lastname: Li
authors.affiliation: Department of Family Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Chen
authors.affiliation: Department of Family Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.|Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: S-S
authors.initials: SS
authors.lastname: Chang
mesh_terms: D000328:Adult; D015415:Biomarkers; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications*; D007333:Insulin Resistance; D007676:Kidney Failure, Chronic / Q000097:blood / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D016017:Odds Ratio; D012372:ROC Curve; D012016:Reference Values; D051436:Renal Insufficiency, Chronic; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein