Nutrition Program, Federal University of São Paulo, São Paulo, Brazil.
Am J Nephrol. 2010;31(2):104-9. doi: 10.1159/000259896. Epub 2009 Nov 17.
Waist circumference (WC), a simple anthropometric measure, is associated with visceral adipose tissue (VAT) in cross-sectional studies, and thus has been used as a surrogate marker for VAT. However, associations between changes over time in WC and VAT have not been studied in chronic kidney disease (CKD) patients.
This prospective study included 87 nondialysis-dependent CKD patients (54 males, 56.2 +/- 10.4 years, BMI 27.3 +/- 5.1, GFR 35.9 +/- 14.6 ml/min/1.73 m(2)). VAT area was measured by computed tomography (CT) and WC was measured at the umbilicus level at baseline and after 12 months.
Changes in WC correlated significantly but weakly with changes in VAT (r = 0.26, p = 0.016), likely due to a substantially smaller change in WC compared to changes in VAT. This was also reflected by a kappa coefficient of 0.26, i.e. indicative of poor agreement between WC and CT measurements in regards to quantification of changes in VAT. Likewise, the receiver operating characteristic curve analysis identified WC as poor predictor of changes in VAT (area under the curve = 0.62).
Anthropometric measurement of WC is poorly correlated with changes in VAT measured by CT in nondialysis-dependent CKD patients. Therefore, caution should be taken when using WC as a surrogate marker of VAT changes in this population.
腰围（WC）是一种简单的人体测量指标，与内脏脂肪组织（VAT）在横断面研究中相关，因此被用作 VAT 的替代标志物。然而，在非透析依赖性慢性肾脏病（CKD）患者中，WC 随时间的变化与 VAT 之间的相关性尚未得到研究。
本前瞻性研究纳入了 87 名非透析依赖性 CKD 患者（54 名男性，56.2±10.4 岁，BMI 27.3±5.1，GFR 35.9±14.6 ml/min/1.73 m2）。通过计算机断层扫描（CT）测量 VAT 面积，在基线和 12 个月时在脐水平测量 WC。
WC 的变化与 VAT 的变化显著相关，但相关性较弱（r=0.26，p=0.016），这可能是由于与 VAT 的变化相比，WC 的变化幅度较小。这也反映在 κ 值为 0.26，即 WC 和 CT 测量在 VAT 定量方面的一致性较差。同样，接受者操作特征曲线分析表明 WC 是 VAT 变化的预测指标较差（曲线下面积=0.62）。
在非透析依赖性 CKD 患者中，WC 的人体测量与 CT 测量的 VAT 变化相关性较差。因此，在该人群中，WC 作为 VAT 变化的替代标志物应谨慎使用。
