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内脏脂肪指数作为台湾相对健康人群慢性肾脏病的预测指标。

Visceral Adiposity Index as a Predictor of Chronic Kidney Disease in a Relatively Healthy Population in Taiwan.

机构信息

Department of Family Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan.

Department of Family Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University College of Medicine, Taoyuan, Taiwan.

出版信息

J Ren Nutr. 2018 Mar;28(2):91-100. doi: 10.1053/j.jrn.2017.07.006. Epub 2017 Nov 14.

Abstract

OBJECTIVES

Abdominal obesity is an independent risk factor for cardiovascular disease and chronic kidney disease (CKD). Visceral adiposity index (VAI), a simple formula representing visceral adipose dysfunction, has already been proven to have a strong correlation with various cardiometabolic disorders. Limited studies are available regarding the relationship between VAI and renal function decline. Therefore, the purpose of this study was to evaluate the relationship between VAI and renal function and to estimate the risk of chronic kidney disease in a relatively healthy adult population in Taiwan.

DESIGN

The design of the study is retrospective cross-sectional analysis.

SUBJECTS

This study involved 23,570 subjects aged ≥18 years who underwent annual heath checkups between January and December 2013. A multivariate logistic regression model was used to assess the relationship between VAI and CKD. Receiver-operating characteristic curve and Youden index were developed to determine the discrimination power of VAI for metabolic syndrome and CKD.

INTERVENTION

None, observational study.

MAIN OUTCOME MEASURE

The main outcome measure of this study was CKD.

RESULTS

In our study, the adjusted odds ratio (OR) of abnormal VAI for CKD was 1.5 (95% confidence interval [CI], 1.08-2.08; P = .016) in all subjects. A higher VAI was superior in association with CKD in men than women (OR, 1.62; 95% CI, 1.13-2.32; P = .009 vs. OR, 1.28; 95% CI, 0.66-2.47; P = .469, respectively). The area under the curve for VAI was 0.694 (95% CI, 0.660-0.729; P < .001), and using a Youden index with a cut-off VAI value of 2.96 for CKD discrimination obtained a sensitivity of 67.7% and specificity of 65.1%.

CONCLUSIONS

A higher VAI score was associated with increased risks of CKD. VAI would be an applicable tool for early detection of CKD in relatively healthy adults in Taiwan, especially men.

摘要

目的

腹部肥胖是心血管疾病和慢性肾脏病(CKD)的独立危险因素。内脏脂肪指数(VAI)是一种代表内脏脂肪功能障碍的简单公式,已被证明与各种代谢紊乱密切相关。关于 VAI 与肾功能下降之间的关系,目前的研究还很有限。因此,本研究旨在评估 VAI 与肾功能之间的关系,并估计在台湾相对健康的成年人群中慢性肾脏病的风险。

设计

本研究的设计为回顾性横断面分析。

研究对象

本研究共纳入 23570 名年龄≥18 岁的受试者,他们于 2013 年 1 月至 12 月期间接受了年度健康检查。采用多变量逻辑回归模型评估 VAI 与 CKD 之间的关系。通过绘制受试者工作特征曲线和 Youden 指数,确定 VAI 对代谢综合征和 CKD 的鉴别能力。

干预措施

无,观察性研究。

主要观察指标

本研究的主要观察指标为 CKD。

结果

在本研究中,所有受试者中异常 VAI 与 CKD 的校正比值比(OR)为 1.5(95%置信区间[CI],1.08-2.08;P=0.016)。VAI 较高与男性 CKD 的相关性优于女性(OR,1.62;95%CI,1.13-2.32;P=0.009 与 OR,1.28;95%CI,0.66-2.47;P=0.469)。VAI 的曲线下面积为 0.694(95%CI,0.660-0.729;P<0.001),使用截断值为 2.96 的 Youden 指数进行 CKD 鉴别,可获得 67.7%的敏感性和 65.1%的特异性。

结论

较高的 VAI 评分与 CKD 风险增加相关。VAI 可能是台湾相对健康成年人早期发现 CKD 的一种适用工具,尤其是男性。

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