Dong Ying, Wang Zengwu, Chen Zuo, Wang Xin, Zhang Linfeng, Nie Jingyu, Zheng Congyi, Wang Jiali, Shao Lan, Tian Ye, Gao Runlin
Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Pecking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 102308, China.
Fuwai Hospital, Pecking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 100037, China.
BMC Nephrol. 2018 Feb 17;19(1):40. doi: 10.1186/s12882-018-0837-1.
The aim of the study was to assess the association between chronic kidney disease (CKD) and obesity in predicting CKD among Chinese adults, distinguishing between 5 different adiposity indices: visceral fat index (VFI), percentage body fat (PBF), body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR).
A total of 29,516 participants aged 35 years or above were selected using a stratified multistage random sampling method across China during 2012-2015. CKD was defined as an estimated glomerular filtration (eGFR) < 60 ml/min/1.72m.
The overall weighted prevalence of CKD was 3.94% (3.62% in males and 4.25% in females). All five adiposity indices had significant negative correlations to eGFR (P < 0.05). The area under the ROC (receiver operating characteristic) curves (AUC) for PBF was almost significantly larger than the other adiposity indices (P < 0.001). In addition, PBF yielded the highest Youden index in identifying CKD (male: 0.15; female: 0.20). In the logistic analysis, PBF had the highest crude odds ratios (ORs) in both males (OR: 1.819, 95% CI 1.559-2.123) and females (OR: 2.268, 95% CI 1.980-2.597). After adjusted for age, smoking status, alcohol use, education level, marital status, rural vs. urban area, geographic regions, and diagnosis of hypertension, diabetes mellitus, myocardial infarction and stroke, the ORs on PBF remained significant for both genders (P < 0.05).
Obesity is associated with an increased risk of CKD. Furthermore, PBF was a better predictor for identifying CKD than other adiposity indices (BMI, WC, WHtR, and VFI).
本研究旨在评估慢性肾脏病（CKD）与肥胖在中国成年人中预测CKD的相关性，区分5种不同的肥胖指数：内脏脂肪指数（VFI）、体脂百分比（PBF）、体重指数（BMI）、腰围（WC）和腰高比（WHtR）。
2012年至2015年期间，采用分层多阶段随机抽样方法在中国选取了29516名35岁及以上的参与者。CKD定义为估算肾小球滤过率（eGFR）<60 ml/min/1.72m²。
CKD的总体加权患病率为3.94%（男性为3.62%，女性为4.25%）。所有五个肥胖指数与eGFR均呈显著负相关（P<0.05）。PBF的ROC（受试者工作特征）曲线下面积（AUC）几乎显著大于其他肥胖指数（P<0.001）。此外，PBF在识别CKD方面产生了最高的约登指数（男性：0.15；女性：0.20）。在逻辑分析中，PBF在男性（OR：1.819，95%CI 1.559 - 2.123）和女性（OR：2.268，95%CI 1.980 - 2.597）中均具有最高的粗比值比（OR）。在调整年龄、吸烟状况、饮酒情况、教育水平、婚姻状况、城乡地区、地理区域以及高血压、糖尿病、心肌梗死和中风的诊断后，PBF的OR对两性均仍具有显著性（P<0.05）。
肥胖与CKD风险增加相关。此外，与其他肥胖指数（BMI、WC、WHtR和VFI）相比，PBF是识别CKD的更好预测指标。
