Neck circumference predicts renal function decline in overweight women: A community-based prospective cohort study.
Chronic kidney disease (CKD) is characterized by increased risks of morbidity and mortality. Upper-body subcutaneous fat, which is commonly estimated from the neck circumference (NC), was revealed to be the main reservoir of circulating nonesterified fatty acids in overweight patients. Despite a close association between NC and metabolic complications, the relationship of NC with renal function has not been fully investigated. In this study, the impact of NC on the development of incident CKD was elucidated.The data were retrieved from the Korean Genome and Epidemiology Study cohort. The subjects were followed at 2-year intervals from 2003 to 2011. Overweight was defined as a body mass index of ≥23 kg/m. A total of 4298 cohort subjects were screened. After exclusion, 2268 overweight subjects were included for the final analysis. The primary end point was incident CKD, which was defined as a composite of estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m or the development of proteinuria.The mean patient age was 36.3 ± 3.0 years, and 1285 (56.7%) were men. They were divided into 2 groups according to the median NC in male and female subjects, separately. In both sexes, hypertension (men, P < 0.001; women, P = 0.009) and diabetes (men, P = 0.002; women, P < 0.001) were significantly more prevalent in the big NC group than in the small NC group. In contrast, eGFR was significantly lower only in male subjects of the big NC group (P < 0.001), whereas it was comparable between the small and big NC groups (P = 0.167). In multivariate Cox proportional hazards regression analysis, NC values were independently associated with incident CKD development in female subjects after adjusting for multiple confounding factors (per 1 cm increase, hazard ratio [95% confidence interval] = 1.159 [1.024-1.310], P = 0.019) but not in male subjects.NC is independently associated with the development of CKD in overweight female subjects, suggesting that it could be a practical risk factor for CKD.
Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea Division of Nephrology, Department of Internal Medicine, Myongji Hospital, Seonam University College of Medicine Severance Biomedical Science Institute, Brain Korea 21 PLUS, Yonsei University, Seoul, Republic of Korea.
Chang-Yun
CY
Yoon
Jung Tak
JT
Park
Jong Hyun
JH
Jhee
Youn Kyung
YK
Kee
Changhwan
C
Seo
Misol
M
Lee
Min-Uk
MU
Cha
Su-Young
SY
Jung
Seohyun
S
Park
Hae-Ryong
HR
Yun
Young Eun
YE
Kwon
Hyung Jung
HJ
Oh
Seung Hyeok
SH
Han
Tae-Hyun
TH
Yoo
Shin-Wook
SW
Kang
D000328:Adult; D001837:Body Weights and Measures; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000033:anatomy & histology*; D050177:Overweight / Q000453:epidemiology / Q000503:physiopathology*; D011446:Prospective Studies; D011507:Proteinuria / Q000652:urine; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000503:physiopathology*; D056910:Republic of Korea / Q000453:epidemiology; D012737:Sex Factors; D050151:Subcutaneous Fat / Q000033:anatomy & histology*