title: Estimating Negative Effect of Abdominal Obesity on Mildly Decreased Kidney Function Using a Novel Index of Body-Fat Distribution.
abstract: Abdominal obesity is a major risk factor of chronic kidney disease (CKD). Conventional obesity-related indicators, included body mass index (BMI), waist circumference (WC), and conicity index (C-index), have some limitations. We examined the usefulness of trunk/body fat mass ratio (T/Br) to predict negative effect of abnormal fat distribution on excretory kidney function. We analyzed anthropometric, biochemical and densitometric data from a nation-wide, population-based, case-control study (the Korean National Health and Nutrition Examination Survey [KNHANES] IV and V). A total of 11,319 participants were divided into 2 groups according to estimated glomerular filtration rate (eGFR, mL·min⁻¹·1.73 m⁻²) as follows: Group I (n = 7,980), eGFR ≥ 90 and ≤ 120; and group II (n = 3,339), eGFR ≥ 60 and < 90. Linear regression analysis revealed that T/Br was closely related to eGFR (β = -0.3173, P < 0.001), and the correlation remained significant after adjustment for age, gender, BMI, WC, C-index, systolic blood pressure (BP), hemoglobin, and smoking amount (β = -0.0987, P < 0.001). Logistic regression analysis showed that T/Br (odds ratio [OR] = 1.046; 95% confidence interval [CI] = 1.039-1.054) was significantly associated with early decline of kidney function, and adjustment for age, gender, BMI, C-index, systolic BP, hemoglobin, serum glucose level, high-density lipoprotein (HDL)-cholesterol, and smoking amount did not reduce the association (OR = 1.020; 95% CI = 1.007-1.033). T/Br is useful in estimating the negative impact of abdominal obesity on the kidney function.
authors.affiliation: Department of Nephrology, Hanmaeum Changwon Hospital, Changwon, Korea.
authors.forename: Il Hwan
authors.identifier: http://orcid.org/0000-0003-4195-2561
authors.initials: IH
authors.lastname: Oh
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Jong Wook
authors.identifier: http://orcid.org/0000-0001-9624-6862
authors.initials: JW
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Chang Hwa
authors.identifier: http://orcid.org/0000-0001-5786-3358
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea. sjpjoon@hanyang.ac.kr.
authors.forename: Joon Sung
authors.identifier: http://orcid.org/0000-0003-4740-3061
authors.initials: JS
authors.lastname: Park
mesh_terms: D000328:Adult; D019540:Area Under Curve; D001794:Blood Pressure; D050218:Body Fat Distribution; D015992:Body Mass Index; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D056128:Obesity, Abdominal / Q000150:complications / Q000473:pathology*; D016017:Odds Ratio; D012372:ROC Curve; D051436:Renal Insufficiency, Chronic / Q000209:etiology; D012307:Risk Factors; D055105:Waist Circumference
chemical_list: D008076:Cholesterol, HDL
keywords: Abdominal Obesity; Densitometry; Glomerular Filtration Rate; Trunk/Body Fat Mass Ratio