Chen Jou-Yin, Wagatsuma Yukiko
Department of Clinical Trials and Clinical Epidemiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Department of Clinical Trials and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
PLoS One. 2025 Apr 29;20(4):e0321012. doi: 10.1371/journal.pone.0321012. eCollection 2025.
Chronic kidney disease (CKD) is irreversible and linked with various adverse health outcomes and diminished quality of life. Although obesity is recognized as a risk factor for the progression of kidney damage, reliance solely on body mass index (BMI) to measure obesity has been increasingly questioned. The use of other indicators that reflect more on abdominal adiposity like waist circumference (WC) have been proposed. This study aims to determine whether WC can serve as an alternative predictor of kidney damage progression.
This prospective study enrolled individuals with normal kidney function during their annual health checkups from April 2016 to March 2019. Data on BMI, WC, WC-related devices, health-related lifestyle, and comorbidities were collected at baseline. WC was categorized using various definitions and analyzed for its association with the risk of kidney damage progression, taking into account BMI categories. The participants were monitored until March 2023 to observe kidney damage progression.
Out of the 4,129 participants, WC showed a higher risk of kidney damage progression in males (HR=1.01-1.39, p-value<0.05). These associations were not observed in females. After adjusting for BMI categories, the associations disappeared. Males in the overweight BMI category, defined as a BMI ≥ 25 kg/m2, showed a significantly increased risk of kidney damage progression (HR = 1.69, p-value < 0.0001).
The findings indicate that waist circumference significantly affects the progression of kidney damage in males. However, the study also reaffirms BMI as a dependable predictor of kidney damage. It underscores the importance of maintaining normal ranges for both BMI and waist circumference to reduce the risk of progressing kidney damage.
慢性肾脏病（CKD）是不可逆的，与各种不良健康结局及生活质量下降相关。尽管肥胖被认为是肾脏损害进展的一个危险因素，但单纯依靠体重指数（BMI）来衡量肥胖越来越受到质疑。有人提出使用其他更多反映腹部肥胖的指标，如腰围（WC）。本研究旨在确定腰围是否可作为肾脏损害进展的替代预测指标。
这项前瞻性研究纳入了2016年4月至2019年3月年度健康检查期间肾功能正常的个体。在基线时收集了关于BMI、腰围、与腰围相关的指标、健康相关生活方式及合并症的数据。使用各种定义对腰围进行分类，并在考虑BMI类别的情况下分析其与肾脏损害进展风险的关联。对参与者进行监测直至2023年3月，以观察肾脏损害的进展情况。
在4129名参与者中，腰围显示男性肾脏损害进展风险更高（风险比=1.01 - 1.39，p值<0.05）。在女性中未观察到这些关联。在调整BMI类别后，这些关联消失。超重BMI类别（定义为BMI≥25 kg/m²）的男性显示肾脏损害进展风险显著增加（风险比 = 1.69，p值 < 0.0001）。
研究结果表明，腰围显著影响男性肾脏损害的进展。然而，该研究也再次确认BMI是肾脏损害的可靠预测指标。它强调了维持BMI和腰围正常范围以降低肾脏损害进展风险的重要性。
