Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Obes Res Clin Pract. 2020 Mar-Apr;14(2):168-175. doi: 10.1016/j.orcp.2020.03.006. Epub 2020 Apr 16.
Obesity and related health risk in different obesity phenotypes has always been a controversial subject. The present study was conducted with the aim of investigating the risk of kidney function decline (KFD) incidence in different abdominal obesity phenotypes.
In this prospective observational cohort study, 7002 individuals (56.1% female), aged ≥20 years, were followed for the incidence of KFD defined as 40% decline in eGFR. Abdominal obesity was defined based on waist circumference cut-offs ≥89/91cm for men/women, respectively. Metabolic health was defined as ≤1 criterion of the metabolic syndrome criteria, according to the Joint Interim Statement (JIS) definition.
At baseline 4273 individuals (61.0%) were abdominally obese, among whom, 1188 (27.8%) belonged to the metabolically healthy abdominal obese (MHAO) phenotype. Totally, 251 incidences of KFD was indicated throughout the 12-year follow-up. After adjusting for the confounding variables, MHAO phenotype was not associated with increased risk of KFD in both males and females. Furthermore, results indicated that hazard ratios (HRs) for incidence of KFD did not increase in males with unhealthy obesity phenotypes. However, females with metabolically unhealthy abdominal obese (MUAO) phenotype had increased risk of KFD.
Findings of this study indicated that MHAO phenotype was not associated with KFD incidence, regardless of the participants gender. Furthermore, MUAO phenotype was associated with higher risk of KFD only in females. Further studies with longer follow up and larger sample size are needed to shed more light upon the regarded relationship and the influential role of gender.
不同肥胖表型的肥胖症及相关健康风险一直是一个有争议的话题。本研究旨在探讨不同腹型肥胖表型发生肾功能下降（KFD）的风险。
在这项前瞻性观察性队列研究中，对 7002 名年龄≥20 岁的个体进行了随访，以观察 KFD 的发生率，其定义为 eGFR 下降 40%。根据腰围切点≥89/91cm（分别适用于男性/女性），将腹型肥胖定义为腹部肥胖。根据联合临时声明（JIS）的定义，代谢健康定义为符合代谢综合征标准的≤1 个标准。
在基线时，4273 名个体（61.0%）为腹型肥胖，其中 1188 名（27.8%）属于代谢健康的腹型肥胖（MHAO）表型。在 12 年的随访中，共出现 251 例 KFD 病例。在校正混杂因素后，MHAO 表型与男性和女性 KFD 的发生风险增加无关。此外，结果表明，不健康的男性腹型肥胖表型发生 KFD 的风险比（HR）没有增加。然而，患有代谢不健康的腹型肥胖（MUAO）表型的女性发生 KFD 的风险增加。
本研究结果表明，无论参与者的性别如何，MHAO 表型与 KFD 的发生无关。此外，MUAO 表型仅与女性 KFD 的发生风险增加有关。需要进行更多具有更长随访时间和更大样本量的研究，以进一步阐明这种关系以及性别所起的作用。
