Xiao Hua, Xiong Chongxiang, Shao Xiaofei, Gao Peichun, Chen Haishan, Ning Jing, Chen Yunying, Zou Ziliang, Hong Guobao, Li Xiaolin, You Xu, Sheng Jieli, Wu Fan, Wang Xin, Zou Hequn
Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou 510630, People's Republic of China.
Diabetes Metab Syndr Obes. 2020 Feb 4;13:257-265. doi: 10.2147/DMSO.S231656. eCollection 2020.
To investigate the correlation between visceral obesity and pathogenesis of chronic kidney disease (CKD) among non-diabetic individuals, and to evaluate the potential of visceral adiposity index (VAI) as a predictor of CKD.
From December 2017 to March 2018, 1877 non-diabetic participants (male n=699, female n=1208) in southern China were recruited for a cross-sectional survey. Males and females were divided into four groups according to gender-specific quartiles of VAI scores. A logistic regression model was established to analyze the correlation between visceral adiposity index and CKD.
Visceral adiposity index was positively correlated with CKD and was negatively associated with estimated glomerular filtration rate (eGFR). Using group one as the control, odds ratios (ORs) were calculated to determine the risk of developing CKD as VAI increased (male: group four 2.73 [P<0.005]; female: Group three 1.76 [P<0.05], Group four 2.88 [P<0.005]). When related factors such as history of hypertension, smoking, alcohol use, and physical inactivity were normalized in the logistic model before calculation, ORs became 2.73 (male: P<0.05), and 2.18 (female: P<0.05), respectively. The results differed after normalizing further for systolic blood pressure (SBP), diastolic blood pressure (DBP), hypersensitive c-reactive protein (hsCRP), interleukin-6 (IL-6), homocysteine (Hcy), superoxide dismutase (SOD), and retinol-binding protein (RBP). There were no significant differences in ORs among the female groups.
Visceral adiposity index was significantly associated with CKD in non-diabetic individuals. It may be a good predictor of the pathogenesis of CKD and was dependent on hsCRP, IL-6, Hcy, SOD, RBP, and blood pressure levels in females and males with VAI scores of 1.41 and higher. Visceral adiposity index may be used to predict CKD in males with VAI less than 0.983.
探讨非糖尿病个体内脏肥胖与慢性肾脏病（CKD）发病机制之间的相关性，并评估内脏脂肪指数（VAI）作为CKD预测指标的潜力。
2017年12月至2018年3月，在中国南方招募了1877名非糖尿病参与者（男性n = 699，女性n = 1208）进行横断面调查。根据VAI评分的性别特异性四分位数将男性和女性分为四组。建立逻辑回归模型分析内脏脂肪指数与CKD之间的相关性。
内脏脂肪指数与CKD呈正相关，与估计肾小球滤过率（eGFR）呈负相关。以第一组作为对照，计算比值比（OR）以确定随着VAI升高发生CKD的风险（男性：第四组2.73 [P < 0.005]；女性：第三组1.76 [P < 0.05]，第四组2.88 [P < 0.005]）。在计算前对逻辑模型中的高血压病史、吸烟、饮酒和缺乏身体活动等相关因素进行校正后，OR分别变为2.73（男性：P < 0.05）和2.18（女性：P < 0.05）。在进一步校正收缩压（SBP）、舒张压（DBP）、超敏C反应蛋白（hsCRP）、白细胞介素-6（IL-6）、同型半胱氨酸（Hcy）、超氧化物歧化酶（SOD）和视黄醇结合蛋白（RBP）后结果有所不同。女性组之间的OR没有显著差异。
在内脏脂肪指数（VAI）≥1.41的男性和女性中，内脏脂肪指数与非糖尿病个体的CKD显著相关。它可能是CKD发病机制的良好预测指标，并且依赖于hsCRP、IL-6、Hcy、SOD、RBP和血压水平。内脏脂肪指数可用于预测VAI < 0.983的男性的CKD。
