Lee Dong Yoon, Yu Gyeong Im, Kim Yu-Mi, Kim Mi Kyung, Shin Min-Ho, Lee Mi-Young
Department of Preventive Medicine, Keimyung University School of Medicine, Daegu 42601, Korea.
Department of Preventive Medicine, Hanyang University College of Medicine, Seoul 04763, Korea.
J Clin Med. 2022 May 19;11(10):2876. doi: 10.3390/jcm11102876.
Studies that have assessed the associations between obesity and the estimated glomerular filtration rate (eGFR) have reported inconsistent results. This cross-sectional study was performed to investigate the associations between three waist circumference (WC)-related obesity metrics (waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and waist-to-height ratio (WHt.5R)) and eGFRs. This study included 2133 men and 3443 women who were older than 40 years with eGFRs ≥ 60 mL/min/1.73 m² from the Korean Multi-Rural Communities Cohort. We calculated the residual body mass index (BMI) to reduce multicollinearity among the obesity metrics and performed multiple linear regression. For both sexes, among the adjusted models, most of the general obesity metrics were significantly associated with eGFRs. Particularly for women, the WC-related and general obesity metrics had a stronger effect on eGFRs in the quartile models that included the BMI and the residual BMI, respectively. When WC-related obesity metrics had a stronger effect than the general obesity metric, for both sexes, WHtR showed a significant impact than WHt.5R and WHR on eGFRs. Reducing multicollinearity had an important role in assessing the obesity metrics' association with eGFRs. Overall, applying the residual method in further studies might help with evaluating the obesity paradox on renal function.
评估肥胖与估算肾小球滤过率(eGFR)之间关联的研究报告了不一致的结果。本横断面研究旨在调查三种与腰围(WC)相关的肥胖指标(腰臀比(WHR)、腰围身高比(WHtR)和腰围身高比(WHt.5R))与eGFR之间的关联。本研究纳入了来自韩国多农村社区队列的2133名男性和3443名40岁以上且eGFR≥60 mL/min/1.73 m²的女性。我们计算了残余体重指数(BMI)以减少肥胖指标之间的多重共线性,并进行了多元线性回归。对于男女两性,在调整模型中,大多数一般肥胖指标与eGFR均显著相关。特别是对于女性,与WC相关的肥胖指标和一般肥胖指标分别在纳入BMI和残余BMI的四分位数模型中对eGFR有更强的影响。当与WC相关的肥胖指标比一般肥胖指标影响更强时,对于男女两性,WHtR对eGFR的影响比WHt.5R和WHR更显著。减少多重共线性在评估肥胖指标与eGFR的关联中具有重要作用。总体而言,在进一步研究中应用残余法可能有助于评估肾功能方面的肥胖悖论。