A central body fat distribution is related to renal function impairment, even in lean subjects

Pinto‐Sietsma, Sara‐Joan; Navis, Gerjan; Janssen, Wmt; Zeeuw, Dick de; Gans, Reinhold O.B; Jong, Paul E. de

doi:10.1016/s0272-6386(03)00020-9

Cited by 322 publications

(252 citation statements)

References 18 publications

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“…Similarly, several studies have suggested a differential effect according to body morphology. [15][16][17][18][19][20] The prevalence of MA among the study subjects was lower than that reported for a study of the general population. [5][6][7] This is expected following the selection criteria for the study.…”

Section: Discussionmentioning

confidence: 99%

“…[9][10][11] Studies of glucose-tolerant subjects suggested that IR is not always associated with MA. [12][13][14] Some studies suggested that abdominal obesity is independently associated with MA, [15][16][17][18][19][20] whereas others showed that abdominal obesity is not related to the albuminuria level. 12,13 The latter studies may have been biased by factors such as a small sample size and the former studies did not exclude subjects with high-normal blood pressure or hypertension.…”

Section: Introductionmentioning

confidence: 99%

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Abdominal obesity, systolic blood pressure, and microalbuminuria in normotensive and euglycemic Korean men

et al. 2006

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Objectives: To evaluate the relationship between abdominal obesity and microalbuminuria (MA) in normotensive, euglycemic Korean men. Design: A cross-sectional study at a health screening center. Subjects: A total of 1321 healthy, normotensive Korean men, aged 20-78 years, with a fasting plasma glucose level o100 mg/dl. Measurements: Height, weight, and waist; systolic blood pressure (SBP); diastolic blood pressures (DBP); urinary albumin to creatinine ratio (ACR); fasting glucose, insulin, lipids, C-reactive protein (CRP), and white blood cell count. Waist circumference (WC) was used to indicate abdominal obesity and a single measurement of ACR was used to estimate MA. We also calculated body mass index (BMI) based on weight and height. Results: Mean BMI, WC, and SBP were significantly higher in subjects with MA than in those without (24.874.1 vs 23.872.7 kg/m 2 , 8679 vs 8378 cm, and 11575 vs 11277 mmHg, respectively). Multiple logistic regression analyses showed that only WC and SBP were independent predictors of MA. Conclusion: WC and SBP were positively associated with MA in normotensive and euglycemic Korean men.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Abdominal obesity, systolic blood pressure, and microalbuminuria in normotensive and euglycemic Korean men

et al. 2006

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“…Numerous studies have determined that the development of CKD is associated with obesity-related metabolic syndrome 4 and central fat has been linked to renal abnormalities in obese and lean subjects. 5 Considering that elevated FFA-induced lipotoxicity may result in worsening CKD, 6 our studies showing that cinacalcet decreases lipolysis 3 suggest that sPTH treatment in patients with renal disease may have this added beneficial effect.…”

Section: Introductionmentioning

confidence: 95%

Antilipolytic effect of calcimimetics depends on the allelic variant of calcium-sensing receptor gene polymorphism rs1042636 (Arg990Gly)

et al. 2011

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Calcium-sensing receptor polymorphism rs1042636 (Arg990Gly) affects the response to the calcimimetic cinacalcet, used to treat hypercalcemia in secondary hyperparathyroidism (sHPT) or parathyroid carcinoma. Carriers of the Arg allelle, show less parathyroid hormone secretion suppression in response to the drug. This effect was reproducible in transfected cultured human embryonic kidney cells, supporting a causal relationship on the protein level. We previously established that cinacalcet has an antilipolytic effect in isolated human adipocytes; however, there were a number of samples that did not respond to the treatment. The present work aimed to investigate whether the variable antilipolytic response to cinacalcet in adipocytes was consistent with the effect reported for the rs1042636 polymorphism. Lipolysis was assessed by measuring glycerol release after exposure to cinacalcet (10 lM) or vehicle in adipocytes isolated from 38 donors. Responsiveness was defined as lipolysis suppression (cinacalcet vs vehicle control) greater than 20%. Genotype analysis showed that 23 adipocyte donors were homozygous for Arg at position 990, 14 heterozygous and 1 homozygous Gly-Gly. Among the Arg homozygotes, one was responsive to cinacalcet, whereas five Gly carriers responded to the calcimimetic. In all, 83% of adipocytes showing response to cinacalcet carried the glycine allele, whereas in 96% of Arg-Arg individuals adipocytes did not respond to the calcimimetic (P¼0.027, Fisher's exact test). Confirming sHPT observations, adipocytes from rs1042636 Gly-allele carriers show higher sensitivity to the antilipolytic action of cinacalcet. The potential benefit of cinacalcet as a suppressor of basal lipolysis and free fatty acid release in uremic patients needs to consider the rs1042636 single-nucleotide polymorphism.

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“…Consequently, we believe a correction factor for the MDRD equation may be needed in order that it has greater utility as a clinical tool for estimating GFR in Asians. [10,13,14,16,25].…”

Section: Discussionmentioning

confidence: 99%

“…The applicability of these equations in Asians, who generally have a smaller body habitus and consequently, different creatinine metabolism than other ethnic groups is unclear [13][14][15][16]. In addition, the utility of the MDRD equation in individuals with normal renal function, diabetic nephropathy or who may vary in glucose tolerance status is still controversial [12,17,18].…”

Section: Introductionmentioning

confidence: 99%

Superiority of the Modification of Diet in Renal Disease equation over the Cockcroft–Gault equation in screening for impaired kidney function in Japanese Americans

Gerchman

Tong

Utzschneider

et al. 2007

Diabetes Research and Clinical Practice

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The Cockcroft-Gault and the Modification of Diet in Renal Disease (MDRD) Study equations have not been validated in Asian Americans with varying degrees of glucose tolerance. We compared both equations to 24 hour urinary creatinine clearance, the latter as a standard measurement of glomerular filtration rate (GFR), in 398 Japanese Americans (62.1±5.8y, mean±SD) who had normal glucose tolerance (n=138), impaired glucose tolerance (n=136) and diabetes (n=124). Although both the Cockcroft-Gault (r=0.65, P<0.001) and the MDRD (r=0.74, P<0.001) equations correlated well with creatinine clearance, the latter was significantly superior (P=0.013 between r values). ROC curve analysis showed that the area under the curve (AUC) for the MDRD equation was significantly greater than for the Cockcroft-Gault equation (AUC 0.86 vs. 0.80, P=0.015) in classifying subjects as having mildly reduced GFR (<90 ml/min per 1.73 m 2 ). However, both equations overestimated the number of individuals with decreased GFR. We conclude therefore that while the MDRD equation more accurately identifies Asians who are in the early stages of kidney disease, as for other groups, a correction term appears necessary in order to reduce the number of Asian subjects being falsely diagnosed with CKD.

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A central body fat distribution is related to renal function impairment, even in lean subjects

Cited by 322 publications

References 18 publications

Abdominal obesity, systolic blood pressure, and microalbuminuria in normotensive and euglycemic Korean men

Abdominal obesity, systolic blood pressure, and microalbuminuria in normotensive and euglycemic Korean men

Antilipolytic effect of calcimimetics depends on the allelic variant of calcium-sensing receptor gene polymorphism rs1042636 (Arg990Gly)

Superiority of the Modification of Diet in Renal Disease equation over the Cockcroft–Gault equation in screening for impaired kidney function in Japanese Americans

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