Gao Pengjie, Wang Danni, Zhuo Yan, Kamili Kamila, Li Xiyang, Xu Suining, Tian Gang
Department of Cardiology, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China.
Sci Rep. 2025 Apr 18;15(1):13459. doi: 10.1038/s41598-025-98109-6.
Obesity promotes chronic kidney disease and albuminuria. Whether weight-adjusted-waist index (WWI) is correlated with albuminuria reflected by urinary albumin-to-creatinine ratio (UACR) in normal body mass index (BMI) population and the effect of hypertension and hyperglycemia on the association remain unclear. This cross-sectional study included adults with complete WWI and UACR data in the National Health and Nutrition Examination Survey (NHANES) database from 2001 to 2018. WWI was defined as waist circumference (WC) divided by the square root of weight. Linear regression, restricted cubic splines (RCS) curve and logistic regression were performed to evaluate the relationship between WWI and albuminuria risk. The relationship in different blood pressure and glucose subgroups were further investigated. 10,105 participants were finally included. The prevalence of albuminuria was 5.05%. WWI in albuminuria group was higher. RCS curve analysis showed the relationship between WWI and albuminuria risk increased linearly in patients with hypertension or hyperglycemia, while a U-shaped curve relationship in normoglycemic or non-hypertensive individuals. Logistic regression results indicated increased WWI was an independent risk factor for albuminuria reflected by UACR in normal BMI population even after adjusting for confounding factors, especially in males. When patients only had hypertension with normal blood glucose, WWI was still independently associated with albuminuria. Elevated WWI increased albuminuria risk in normal BMI adults, especially in males and patients with hypertension or hyperglycemia, even in hypertension patients without hyperglycemia. Assessment of WWI to identify early renal dysfunction should be emphasized.
肥胖会促进慢性肾病和蛋白尿的发生。在正常体重指数(BMI)人群中,体重调整腰围指数(WWI)与尿白蛋白肌酐比值(UACR)所反映的蛋白尿是否相关,以及高血压和高血糖对这种关联的影响尚不清楚。这项横断面研究纳入了2001年至2018年美国国家健康与营养检查调查(NHANES)数据库中具有完整WWI和UACR数据的成年人。WWI定义为腰围(WC)除以体重的平方根。采用线性回归、限制性立方样条(RCS)曲线和逻辑回归来评估WWI与蛋白尿风险之间的关系。进一步研究了不同血压和血糖亚组中的这种关系。最终纳入了10105名参与者。蛋白尿的患病率为5.05%。蛋白尿组的WWI更高。RCS曲线分析表明,在高血压或高血糖患者中,WWI与蛋白尿风险之间呈线性增加关系,而在血糖正常或非高血压个体中呈U形曲线关系。逻辑回归结果表明,即使在调整混杂因素后,在正常BMI人群中,WWI升高仍是UACR所反映的蛋白尿的独立危险因素,尤其是在男性中。当患者仅患有高血压且血糖正常时,WWI仍与蛋白尿独立相关。WWI升高会增加正常BMI成年人的蛋白尿风险,尤其是男性以及高血压或高血糖患者,即使是无高血糖的高血压患者。应强调评估WWI以识别早期肾功能障碍。