He Yuan, Li Fan, Wang Fei, Ma Xu, Zhao Xiaolan, Zeng Qiang
National Research Institute for Family Planning Health Management Institute, People's Liberation Army General Hospital, Beijing Southwest Hospital, Third Military Medical University, Chongqing, China.
Medicine (Baltimore). 2016 Jun;95(25):e3769. doi: 10.1097/MD.0000000000003769.
This study aims to investigate the association of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with chronic kidney disease (CKD).A cross-sectional survey was conducted in a nationally representative sample of 123,629 Chinese urban adults who participated in health examinations between 2008 and 2009. BMI, WC, and WHtR were measured, as well as serum and urine biochemical tests. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m or urine protein positivity (proteinuria)≥1+ with dipstick testing.WHtR had the largest areas under ROC curve for CKD in men and women, followed by WC and BMI. Higher levels of BMI, WC, and WHtR were each associated with an increased odds for CKD among men. For per unit size change, the multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of CKD were 1.19 (95% CI, 1.13-1.25) for BMI, 1.12 (95% CI, 1.08-1.16) for WC, and 1.13 (95% CI, 1.10-1.17) for WHtR. The corresponding values were significant in multivariable models among women aged 40 years and above. Using Chinese-recommended cutoffs for BMI (≥24 kg/m), WC (≥85 cm for men, and ≥80 cm for women), and WHtR (≥0.05), WHtR was superior in the association with CKD than BMI for men, whereas WC was superior for women.Increased obesity indices were positively associated with the odds of CKD. Central obesity, defined by WC and WHtR, may be more closely correlated with CKD for Chinese urban adults.
本研究旨在调查体重指数(BMI)、腰围(WC)和腰高比(WHtR)与慢性肾脏病(CKD)之间的关联。对2008年至2009年间参加健康体检的123629名具有全国代表性的中国城市成年人进行了横断面调查。测量了BMI、WC和WHtR,以及血清和尿液生化指标。CKD的定义为估计肾小球滤过率(eGFR)<60 mL/min/1.73 m或尿蛋白阳性(蛋白尿)≥1+(试纸检测)。在男性和女性中,WHtR在CKD的ROC曲线下面积最大,其次是WC和BMI。男性中,较高水平的BMI、WC和WHtR均与CKD的患病几率增加相关。对于每单位大小变化,CKD的多变量调整优势比(OR)和95%置信区间(CI)在BMI方面为1.19(95%CI,1.13 - 1.25),WC方面为1.12(95%CI,1.08 - 1.16),WHtR方面为1.13(95%CI,1.10 - 1.17)。在年龄40岁及以上的女性中,相应数值在多变量模型中具有统计学意义。采用中国推荐的BMI(≥24 kg/m)、WC(男性≥85 cm,女性≥80 cm)和WHtR(≥0.5)的截断值,在男性中,WHtR与CKD的关联比BMI更显著,而在女性中,WC更显著。肥胖指数增加与CKD的患病几率呈正相关。由WC和WHtR定义的中心性肥胖可能与中国城市成年人的CKD关联更为密切。