Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-476, Tehran, Iran.
Department of Surgery, Hartford Hospital/HealthCare, Hartford, CT, 06106, USA.
BMC Nephrol. 2024 Sep 27;25(1):320. doi: 10.1186/s12882-024-03757-x.
Obesity is a known risk factor for chronic kidney disease (CKD), but the impact of obesity severity and duration on CKD incidence is unclear.
Cumulative Excess Weight (CEW) and Cumulative Excess Waist Circumference (CEWC) scores were calculated, which represent the accumulation of deviations from expected body mass index and waist circumference values over time until the development of CKD or the end of the follow-up period. Time-dependent Cox models were used to investigate the sex-stratified association of CEW and CEWC with CKD incidence while controlling for confounding variables.
Out of the 8697 participants who were evaluated in this study, 56% (4865) were women and the mean age was 40 ± 14. During the 15-year follow-up period, 41.7% (3629) of the participants developed CKD. Among the CKD patients, 65.4% (829) of men and 77.9% (1839) of women had a BMI higher than 25, and high WC was found to be 73.7% (934) and 55.3% (1306) for men and women, respectively. We found a significant association between one standard deviation change of CEW and the development of CKD in both sexes (fully adjusted hazard ratios and 95% CI of CEW in men and women were 1.155 [1.081-1.232) and 1.105 (1.047-1.167)]. However, the association between CEWC and CKD development was only significant among men participants [HR = 1.074 (1.006-1.147)].
Over a 15-year follow-up, the accumulation of general and central obesity was associated with an increased incidence of CKD development.
肥胖是慢性肾脏病（CKD）的已知危险因素，但肥胖严重程度和持续时间对 CKD 发病率的影响尚不清楚。
计算累积超重（CEW）和累积超腰围（CEWC）评分，这些评分代表随着时间的推移，身体质量指数和腰围预期值的偏差累积，直到 CKD 发展或随访期结束。使用时间依赖性 Cox 模型，在控制混杂因素的情况下，研究 CEW 和 CEWC 与 CKD 发病率的性别分层关联。
在这项研究中评估的 8697 名参与者中，56%（4865 人）为女性，平均年龄为 40±14 岁。在 15 年的随访期间，41.7%（3629 人）的参与者发生了 CKD。在 CKD 患者中，65.4%（829 人）的男性和 77.9%（1839 人）的女性 BMI 高于 25，男性和女性的高 WC 分别为 73.7%（934 人）和 55.3%（1306 人）。我们发现 CEW 的一个标准差变化与两性 CKD 的发展之间存在显著关联（男性和女性 CEW 的完全调整后的危险比和 95%CI 分别为 1.155[1.081-1.232]和 1.105[1.047-1.167]）。然而，CEWC 与 CKD 发展之间的关联仅在男性参与者中显著[HR=1.074（1.006-1.147）]。
在 15 年的随访期间，全身性和中心性肥胖的积累与 CKD 发展的发生率增加有关。
