Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan,
Kidney Blood Press Res. 2020;45(3):407-418. doi: 10.1159/000506461. Epub 2020 Mar 30.
Visceral adiposity index (VAI), calculated with body mass index, high density lipoprotein-cholesterol, triglycerides and waist circumference, has been proposed as a marker of visceral fat accumulation and dysfunction in adipose tissue.
The impact of VAI on incident chronic kidney disease (CKD) in a historical cohort study of 15,159 (8,260 men and 6,899 women) participants was investigated. CKD was defined when estimated glomerular filtration rate was <60 mL/min/1.73 m2 or proteinuria (positive: ≥1+). We divided the participants into 2 groups according to sex and into quartiles according to VAI (Q1-4). We performed Cox proportional hazard models, adjusting for age, smoking status, exercise, alcohol consumption, systolic blood pressure, hemoglobin A1c, uric acid, and creatinine.
During the median 3.3-year follow-up for men and 3.2-year follow-up for women, 1,078 participants (629 men and 449 women) developed CKD. The 4,000 days cumulative incidence rate of CKD for men and women were 3.7 and 3.9% in Q1, 5.2 and 5.9% in Q2, 6.5 and 7.0% in Q3, and 8.4 and 9.3% in Q4 respectively. Compared to Q1, the hazard ratios of incident CKD in Q2, Q3 and Q4 for men and women were 1.23 (95% CI 0.91-1.66, p = 0.184) and 1.30 (0.87-1.96, p = 0.203), 1.42 (1.06-1.90, p = 0.018) and 1.38 (0.94-2.05, p = 0.105), and 1.51 (1.12-2.02, p = 0.006) and 1.65 (1.12-2.46, p = 0.013) respectively. Additionally, the area under the curve of VAI for incidence of CKD was superior to that of VAI in men (0.595 vs. 0.552, p < 0.001) and equal to in women (0.597 vs. 0.591, p = 0.708).
The VAI can be a predictor of incident CKD.
内脏脂肪指数（VAI）通过体质量指数、高密度脂蛋白胆固醇、甘油三酯和腰围计算得出，它被认为是内脏脂肪堆积和脂肪组织功能障碍的标志物。
本研究在一项历史队列研究中对 15159 名参与者（8260 名男性和 6899 名女性）进行了 VAI 对新发慢性肾脏病（CKD）的影响研究。当估算肾小球滤过率<60mL/min/1.73m2 或蛋白尿（阳性：≥1+）时，定义为 CKD。我们根据性别将参与者分为 2 组，并根据 VAI（Q1-4）分为四分位数。我们使用 Cox 比例风险模型进行调整，调整因素包括年龄、吸烟状况、运动、饮酒、收缩压、糖化血红蛋白、尿酸和肌酐。
在男性中位随访 3.3 年和女性中位随访 3.2 年后，1078 名参与者（629 名男性和 449 名女性）发生 CKD。男性和女性的 4000 天累积 CKD 发生率分别为 Q1 组的 3.7%和 3.9%、Q2 组的 5.2%和 5.9%、Q3 组的 6.5%和 7.0%、Q4 组的 8.4%和 9.3%。与 Q1 相比，Q2、Q3 和 Q4 组男性和女性的新发 CKD 风险比分别为 1.23（95%CI：0.91-1.66，p=0.184）和 1.30（0.87-1.96，p=0.203）、1.42（1.06-1.90，p=0.018）和 1.38（0.94-2.05，p=0.105）以及 1.51（1.12-2.02，p=0.006）和 1.65（1.12-2.46，p=0.013）。此外，VAI 预测 CKD 发生率的曲线下面积优于男性（0.595 比 0.552，p<0.001）和女性（0.597 比 0.591，p=0.708）。
VAI 可作为新发 CKD 的预测指标。
