Obesity indices for prediction of chronic kidney disease:  a cross-sectional study in 26 655 Chinese adults.
OBJECTIVE
To investigate the associations between chronic kidney disease (CKD) and body mass index (BMI), waist circumference(WC), waist-to-height ratio (WheiR) in Chinese adults.


METHODS
A total of 26 655 participants, who voluntarily attended annual health examination at the Health Management Center in the Third Xiangya Hospital of Central South University from June 2013 to February 2014, were enrolled for this study. Logistic regression and receiver operating characteristic (ROC) curve analysis were performed.


RESULTS
The prevalence rate of CKD was 9.6% and 3.1% in male and female subjects, respectively. Multivariate logistic regression analysis showed that BMI, WC and WheiR were independent risk factors for CKD in diabetic male and hypertensive male subjects (P<0.01). However, no association between these obesity indices and CKD was found in women after multivariate adjustment. In diabetic male subjects, when BMI≥28.7 kg/m(2), WC=90.7 cm and WheiR=0.56, the sensitivity and specificity prediction for CKD was 24.8%, 58.5%, 45.5% and 83.3%, 54.4%, 69.6%, respectively. In hypertensive male subjects, when the optimum cut-off points for BMI, WC and WheiR were ≥ 27.0 kg/m(2), 91.2 cm and 0.54, the sensibility prediction for CKD were 41.0%, 47.0% and 50.1%, respectively, while the specificity prediction were 68.0%, 63.0% and 61.4%, respectively. The area under the ROC curve of BMI, WC, WheiR for CKD prediction were 0.56, 0.57, 0.59 in diabetic male subjects and 0.54, 0.56, 0.57 in hypertensive male subjects, respectively.


CONCLUSIONS
BMI, WC and WheiR are associated with the increased risk for CKD in diabetic or hypertensive male subjects. However, the value for these obesity indices is limited in screening CKD.
Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha 410013, China.
Jishi
J
Liu
Health Management Center, Third Xiangya Hospital, Central South University, Changsha 410013, China.
Zhiheng
Z
Chen
Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha 410013, China.
Wei
W
Li
Health Management Center, Third Xiangya Hospital, Central South University, Changsha 410013, China.
Guo
G
Xu
Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha 410013, China.
Jun
J
Liu
Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha 410013, China.
Bin
B
Yi
Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha 410013, China.
Juan
J
Mao
Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha 410013, China.
Jing
J
Huang
Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha 410013, China.
Shikun
S
Yang
Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha 410013, China.
Hao
H
Zhang
D000328:Adult; D044466:Asian People; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D012372:ROC Curve; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000453:epidemiology; D012307:Risk Factors; D055105:Waist Circumference; D065927:Waist-Height Ratio