Metabolically healthy obesity and incident chronic kidney disease: The role of systemic inflammation in a prospective study.
To investigate the association between the metabolically healthy obesity (MHO) phenotype and incident chronic kidney disease (CKD) in a Chinese population and whether systemic inflammation affects this association.



A cohort study was performed with 2,491 Chinese adults. Body mass index ≥ 25.0 kg/m2was defined as obesity. CKD was defined as estimated glomerular filtration rate < 60 mL/min per 1.73 m2or urinary albumin-to-creatinine ratio ≥ 30 mg/g. High-sensitivity C-reactive protein (hsCRP) was used as a surrogate marker of systemic inflammation.



Over a median follow-up period of 3.9 years, 243 of 2,491 participants developed incident CKD (9.8%). Compared with metabolically healthy nonobesity (MHNO), MHO was associated with incident CKD (odds ratio [OR] = 1.65, 95% confidence interval [CI] 1.01-2.69), but not after adjustment for hsCRP. The MHO/hsCRP ≥ 0.20 mg/L group, but not the MHO/hsCRP < 0.20 mg/L group, had an increased OR for incident CKD (OR = 2.66, 95% CI 1.37-5.14), with the MHNO/hsCRP < 0.20 mg/L group as the reference.



MHO was significantly associated with incident CKD, and the level of systemic inflammation partially explained this association.
State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.|Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Lin
L
Lin
State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.|Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Kui
K
Peng
State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.|Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Rui
R
Du
State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.|Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Xiaolin
X
Huang
State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.|Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Jieli
J
Lu
State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.|Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Yu
Y
Xu
State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.|Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Min
M
Xu
State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.|Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.|Department of Endocrine and Metabolic Diseases, Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Yuhong
Y
Chen
State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.|Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Yufang
Y
Bi
State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.|Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Weiqing
W
Wang
D000368:Aged; D015992:Body Mass Index; D002097:C-Reactive Protein; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000453:epidemiology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D000067329:Obesity, Metabolically Benign / Q000453:epidemiology*; D010641:Phenotype; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*
D002097:C-Reactive Protein