Department of Medicine, College of Medicine, Hanyang University, Seoul, South Korea; Department of Biomedical Informatics, College of Medicine, Yonsei University, Seoul, South Korea.
Department of Biomedical Science, Seoul National University Graduate School, Seoul, South Korea; Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea; Cancer Research Institute, Seoul National University, Seoul, South Korea.
Nutr Metab Cardiovasc Dis. 2021 Mar 10;31(3):782-792. doi: 10.1016/j.numecd.2020.10.021. Epub 2020 Nov 5.
We investigated the association of baseline obesity measures, i.e. body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist-hip ratio (WHR), and their trajectories over time with incident chronic kidney disease (CKD).
Utilizing data from 2001 to 2014 for 9796 Korean adults without CKD at baseline, the association of baseline obesity measures with incident CKD was evaluated using logistic regression. Further, among 5605 subjects with repeated measures, the effect of the trajectories in obesity measures on CKD incidence was investigated via Cox regression. Baseline obesity in terms of BMI, WC, and HC increased the odds of incident CKD (odds ratio (OR) 1.19, 95% confidence interval (CI) 1.05-1.33; OR 1.22, 95% CI 1.07-1.38; and OR 1.25, 95% CI 1.11-1.41, respectively), while baseline WHR did not show such an association. A "became non-obese" BMI, WC, or WHR trajectory, and a "constantly not large" HC trajectory decreased the hazard of incident CKD (hazard ratio (HR) 0.70, 95% CI 0.50-0.99; HR 0.61, 95% CI 0.40-0.92; HR 0.55, 95% CI 0.35-0.85; and HR 0.81, 95% CI 0.69-0.95, respectively) when compared with a "constantly obese or became obese" trajectory.
Both baseline obesity and obesity trajectories over time were associated with CKD incidence. BMI and WC were equally good measures of CKD risk, while WHR was not. Separately examining WC and HC components of WHR (= WC/HC) may explain WHR's inconsistency, and WHR's usefulness as a measure of CKD risk should be reevaluated.
我们研究了基线肥胖指标（即体重指数 [BMI]、腰围 [WC]、臀围 [HC] 和腰臀比 [WHR]）及其随时间的变化轨迹与新发慢性肾脏病（CKD）的关系。
利用 2001 年至 2014 年 9796 名无基线 CKD 的韩国成年人的数据，采用 logistic 回归评估基线肥胖指标与新发 CKD 的关系。进一步，在 5605 名有重复测量的受试者中，通过 Cox 回归研究肥胖指标变化轨迹对 CKD 发病的影响。BMI、WC 和 HC 基线肥胖增加了新发 CKD 的几率（比值比 [OR] 1.19，95%置信区间 [CI] 1.05-1.33；OR 1.22，95% CI 1.07-1.38；和 OR 1.25，95% CI 1.11-1.41），而基线 WHR 则没有显示出这种关联。“从不肥胖”BMI、WC 或 WHR 轨迹和“始终不大”HC 轨迹降低了新发 CKD 的风险（风险比 [HR] 0.70，95% CI 0.50-0.99；HR 0.61，95% CI 0.40-0.92；HR 0.55，95% CI 0.35-0.85；和 HR 0.81，95% CI 0.69-0.95），与“始终肥胖或变肥胖”轨迹相比。
基线肥胖和随时间变化的肥胖轨迹均与 CKD 发病相关。BMI 和 WC 是 CKD 风险的同等良好指标，而 WHR 则不然。单独检查 WHR 的 WC 和 HC 组成部分（= WC/HC）可能解释 WHR 的不一致性，应重新评估 WHR 作为 CKD 风险衡量指标的有用性。
