Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Department of Internal Medicine, Gachon University College of Medicine, Incheon, Republic of Korea.
Sci Rep. 2020 Feb 11;10(1):2375. doi: 10.1038/s41598-020-59382-9.
The impact of obesity on health-related quality of life (HRQoL) in chronic kidney disease (CKD) population has not been elucidated, despite the impairment of HRQoL in the obese among general population. We hypothesized that the impact of obesity on HRQoL might be confounded by impaired renal function in CKD population, and that CKD would attenuate the impact of obesity on HRQoL. To compare the impact of obesity on HRQoL according to kidney function, 17,001 subjects from Korea National Health and Nutrition Examination Survey (2008-2011) were categorized by estimated glomerular filtration rate (eGFR), as follows: group 1, eGFR ≥ 90 mL/min/1.73 m; group 2, eGFR of 60-89 mL/min/1.73 m; group 3, eGFR < 60 mL/min/1.73 m. The association between obesity parameters (body mass index, waist circumference and, truncal fat mass) and HRQoL parameters (EQ-5D index and EQ-VAS) were cross-sectionally analyzed. Despite robust correlations between obesity parameters and low EQ-5D index or EQ-VAS in general population, no significant association was observed in group 3 population. Impact of obesity on HRQoL in CKD population was only limitedly observed in the mobility domain of EQ-5D, as mobility limitation was associated with increased body mass index or waist circumference regardless of kidney function. Therefore, the impact of obesity on HRQoL seems significantly attenuated in CKD population, suggesting that the risk of obesity should not be over-estimated in patients with CKD, especially with respect to HRQoL.
肥胖对慢性肾脏病(CKD)人群健康相关生活质量(HRQoL)的影响尚未阐明,尽管肥胖人群的 HRQoL 已经受损。我们假设肥胖对 HRQoL 的影响可能会受到 CKD 人群肾功能受损的影响,而 CKD 会减弱肥胖对 HRQoL 的影响。为了根据肾功能比较肥胖对 HRQoL 的影响,我们从韩国国家健康和营养检查调查(2008-2011 年)中选择了 17001 名受试者,根据估算肾小球滤过率(eGFR)进行分组:第 1 组,eGFR≥90mL/min/1.73m;第 2 组,eGFR 为 60-89mL/min/1.73m;第 3 组,eGFR<60mL/min/1.73m。横断面分析了肥胖参数(体重指数、腰围和躯干脂肪量)与 HRQoL 参数(EQ-5D 指数和 EQ-VAS)之间的关系。尽管肥胖参数与一般人群中的低 EQ-5D 指数或 EQ-VAS 之间存在很强的相关性,但在第 3 组人群中未观察到显著相关性。在 CKD 人群中,肥胖对 HRQoL 的影响仅在 EQ-5D 的移动性领域中受到限制,因为无论肾功能如何,移动性受限都与体重指数或腰围的增加有关。因此,肥胖对 CKD 人群 HRQoL 的影响似乎明显减弱,这表明在 CKD 患者中,不应过分高估肥胖的风险,尤其是在 HRQoL 方面。