Kang Seok Hui, Cho Kyu Hyang, Park Jong Won, Yoon Kyung Woo, Do Jun Young
Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea.
Kidney Blood Press Res. 2015;40(3):223-30. doi: 10.1159/000368498. Epub 2015 Apr 30.
BACKGROUND/AIMS: Advances in bioimpedance analysis (BIA) technologies now enable visceral fat area (VFA) to be assessed using this method. The aim of this study was to evaluate the clinical relevance and usefulness of VFA as a predictor of chronic kidney disease (CKD) and metabolic syndrome (MS), using BIA.
We identified 24,791 adults who underwent voluntary routine health checkups at Yeungnam University Hospital. In total 22,480 patients were recruited into our study. Participants were divided into 3 tertiles based on their VFA: low, middle, and high tertiles. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m(2).
The higher tertile of VFA was associated with a higher prevalence of diabetes mellitus, hypertension, and male sex. Waist-to-hip ratio, body mass index, blood pressure, lean mass, body fat %, and fasting glucose, total cholesterol, triglyceride, GGT, AST, ALT, and uric acid levels all increased as the VFA tertile increased (P < 0.001 for all variables). The prevalence of CKD was 6.9% in the low tertile, 13.9% in the middle tertile, and 25.2% in the high tertile (P < 0.001). The prevalence of MS was 2.2% in the low tertile, 12.8% in the middle tertile, and 36.7% in the high tertile (P < 0.001). The AUROC values for VFA were higher than those for BMI and WHR. For VFA, the sensitivity and specificity for predicting CKD were 62.66% (95% CI, 61.0-64.3) and 64.22% (95% CI, 63.5-64.9), respectively, and 77.65% (95% CI, 76.3-79.0), and 68.81% (95% CI, 68.1-69.5), respectively for predicting MS.
Our results demonstrated that the VFA, measured by BIA, is a simple method for predicting the risk of CKD and MS.
背景/目的：生物电阻抗分析（BIA）技术的进步使得现在能够使用该方法评估内脏脂肪面积（VFA）。本研究的目的是使用BIA评估VFA作为慢性肾脏病（CKD）和代谢综合征（MS）预测指标的临床相关性和实用性。
我们确定了24791名在庆南大学医院接受自愿常规健康检查的成年人。总共22480名患者被纳入我们的研究。参与者根据其VFA分为三个三分位数：低、中、高三分位数。CKD被定义为估计肾小球滤过率（eGFR）<60 mL/min/1.73m²。
VFA较高的三分位数与糖尿病、高血压的较高患病率以及男性性别相关。随着VFA三分位数的增加，腰臀比、体重指数、血压、瘦体重、体脂百分比以及空腹血糖、总胆固醇、甘油三酯、γ-谷氨酰转移酶、天冬氨酸转氨酶、丙氨酸转氨酶和尿酸水平均升高（所有变量P<0.001）。CKD的患病率在低三分位数中为6.9%，在中三分位数中为13.9%，在高三分位数中为25.2%（P<0.001）。MS的患病率在低三分位数中为2.2%，在中三分位数中为12.8%，在高三分位数中为36.7%（P<0.001）。VFA的受试者工作特征曲线下面积（AUROC）值高于体重指数（BMI）和腰臀比（WHR）。对于VFA，预测CKD的敏感性和特异性分别为62.66%（95%CI，61.0-64.3）和64.22%（95%CI，63.5-64.9），预测MS的敏感性和特异性分别为77.65%（95%CI，76.3-79.0）和68.81%（95%CI，68.1-69.5）。
我们的结果表明，通过BIA测量的VFA是预测CKD和MS风险的一种简单方法。
