Odagiri Keiichi, Mizuta Isagi, Yamamoto Makoto, Miyazaki Yosuke, Watanabe Hiroshi, Uehara Akihiko
Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Higashi-ku, Hamamatsu, Japan.
Yamaha Health Care Center, Naka-ku, Hamamatsu, Japan.
PLoS One. 2014 Feb 12;9(2):e88873. doi: 10.1371/journal.pone.0088873. eCollection 2014.
Obesity is a risk factor for chronic kidney disease (CKD) and cardiovascular disease. The association between waist to height ratio (WheiR) and CKD is unclear. This study evaluated the association between WheiR and CKD.
In this longitudinal cohort study, 4841 Japanese workers (3686 males, 1155 females) 18 to 67 years of age in 2008 were followed up until 2011. CKD was defined as an estimated glomerular filtration rate of <60 mL/min/1.73 m² (by the Modification of Diet in Renal Disease equation for Japanese) or dipstick proteinuria (≥1+). Cox proportional hazards models were used to examine the relationship between WheiR and development of CKD.
A total of 384 (7.9%) participants (300 men and 84 women) were found to have new CKD. The incidence of CKD was 13.7, 24.2, 37.9 and 43.7 per 1000 person-years of follow-up in the lowest, second, third and highest quartiles of WheiR, respectively. After adjustment for potential confounders, the adjusted hazard ratios (95% confidence interval) for CKD were 1.00 (reference), 1.23 (0.85, 1.78), 1.59 (1.11, 2.26) and 1.62 (1.13, 2.32) through the quartiles of WheiR, respectively. WheiR had a significant predictive value for the incidence of both proteinuria and low estimated glomerular filtration rate. After subdivision according to gender, the relationship between WheiR and the incidence of CKD was statistically significant in the unadjusted model. However, after adjusting for potential confounders, WheiR was significantly associated with the incidence of CKD in females, whereas it was not significant in males.
WheiR, which is commonly used as an index of central obesity, is associated with CKD. There was a significant gender difference in the relationship between CKD and WheiR.
肥胖是慢性肾脏病(CKD)和心血管疾病的危险因素。腰高比(WheiR)与CKD之间的关联尚不清楚。本研究评估了WheiR与CKD之间的关联。
在这项纵向队列研究中,对2008年年龄在18至67岁的4841名日本工人(3686名男性,1155名女性)进行随访至2011年。CKD的定义为估计肾小球滤过率<60 mL/(min·1.73 m²)(采用日本肾脏病饮食改良方程)或试纸法蛋白尿(≥1+)。采用Cox比例风险模型来研究WheiR与CKD发生之间的关系。
共有384名(7.9%)参与者(300名男性和84名女性)被发现患有新发CKD。在WheiR的最低、第二、第三和最高四分位数中,CKD的发病率分别为每1000人年随访13.7、24.2、37.9和43.7例。在对潜在混杂因素进行调整后,通过WheiR的四分位数,CKD的调整后风险比(95%置信区间)分别为1.00(参考值)、1.23(0.85,1.78)、1.59(1.11,2.26)和1.62(1.13,2.32)。WheiR对蛋白尿和低估计肾小球滤过率的发生率均具有显著的预测价值。按性别细分后,在未调整模型中,WheiR与CKD发生率之间的关系具有统计学意义。然而,在对潜在混杂因素进行调整后,WheiR与女性CKD发生率显著相关,而在男性中则不显著。
常用于衡量中心性肥胖的WheiR与CKD相关。CKD与WheiR之间的关系存在显著的性别差异。