Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China.
Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China.
J Nutr. 2021 Jun 1;151(6):1394-1400. doi: 10.1093/jn/nxab022.
Risk of chronic kidney disease (CKD) is higher in normal-weight metabolically unhealthy people, especially when combined with hypertension. In this context, whether the visceral adiposity index (VAI), which reflects body fat distribution and metabolism, can be used to identify the risk of CKD among normal-weight hypertensive patients is unclear.
This study aimed to evaluate the association between VAI and renal function in normal-weight hypertensive patients.
In this cross-sectional study, 8591 hypertensive patients with normal BMI from the China H-type Hypertension Registry Study were analyzed. The VAI was calculated with serum triglycerides, serum HDL cholesterol, waist circumference, and BMI. VAI was ln-transformed for analysis on account of the skewed distribution. Estimated glomerular filtration rate (eGFR) was calculated using the CKD-Epidemiology Collaboration equation. CKD was defined as an eGFR <60 mL · min-1 · 1.73 m-2. Multivariable linear and multivariable logistic regression analyses were performed to evaluate the association of VAI with eGFR and CKD.
The prevalence rate of CKD was 10.1%. Multivariable linear regression analyses showed that an elevated lnVAI reduced eGFR by 2.63 mL · min-1 · 1.73 m-2 (95% CI: -3.54, -1.72 mL · min-1 · 1.73 m-2). Multivariable logistic regression analysis showed that an elevated lnVAI was independently associated with the prevalence of CKD (OR: 1.59; 95% CI: 1.31, 1.93). As possible confounding factors were removed the association became greater. The higher the VAI was, the greater the decrease in eGFR and the higher the risk of CKD. No significant interactions were found in any of the subgroups (age, sex, physical activity, current smoking, current drinking, fasting glucose, LDL cholesterol, blood pressure, and antihypertensive drugs).
VAI, as a simple surrogate measure of visceral fat accumulation, is independently and inversely associated with renal function in normal-weight Chinese hypertensive adults.This trial was registered at chictr.org.cn as ChiCTR1800017274.
正常体重代谢不健康的人患慢性肾脏病（CKD）的风险较高，尤其是合并高血压时。在这种情况下，反映体脂分布和代谢的内脏脂肪指数（VAI）是否可用于识别正常体重高血压患者的 CKD 风险尚不清楚。
本研究旨在评估 VAI 与正常体重高血压患者肾功能之间的关系。
本横断面研究分析了来自中国 H 型高血压登记研究的 8591 例正常 BMI 的高血压患者。使用血清甘油三酯、血清高密度脂蛋白胆固醇、腰围和 BMI 计算 VAI。由于偏态分布，对 VAI 进行了 ln 转换分析。使用 CKD-EPI 协作方程计算估计肾小球滤过率（eGFR）。CKD 定义为 eGFR<60 mL·min-1·1.73 m-2。进行多变量线性和多变量逻辑回归分析以评估 VAI 与 eGFR 和 CKD 的关系。
CKD 的患病率为 10.1%。多变量线性回归分析表明，升高的 lnVAI 使 eGFR 降低 2.63 mL·min-1·1.73 m-2（95%CI：-3.54，-1.72 mL·min-1·1.73 m-2）。多变量逻辑回归分析表明，升高的 lnVAI 与 CKD 的患病率独立相关（OR：1.59；95%CI：1.31，1.93）。当去除可能的混杂因素时，关联变得更大。VAI 越高，eGFR 下降越大，CKD 的风险越高。在任何亚组（年龄、性别、体力活动、当前吸烟、当前饮酒、空腹血糖、LDL 胆固醇、血压和降压药物）中均未发现显著的交互作用。
VAI 作为内脏脂肪堆积的简单替代指标，与中国正常体重高血压成年人的肾功能独立且呈负相关。本试验在中国临床试验注册中心注册，注册号为 ChiCTR1800017274。
