Impact of visceral fat area in patients with chronic kidney disease

Manabe, Shun; Kataoka, Hiroshi; Mochizuki, Toshio; Iwadoh, Kazuhiro; Ushio, Yusuke; Kawachi, Keiko; Watanabe, Kentaro; Watanabe, Saki; Akihisa, Taro; Makabe, Shiho; Sato, Masayo; Iwasa, Naomi; Yoshida, Rie; Sawara, Yukako; Hanafusa, Norio; Tsuchiya, Ken; Nitta, Kosaku

doi:10.1007/s10157-021-02029-4

Cited by 13 publications

(12 citation statements)

References 52 publications

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“…Another cohort including 10,699 hypertensive participants from the renal substudy of the China Stroke Primary Prevention Trial (CSPPT) reported that compared to those in the 1st quartile, patients in the 4th VAI quartile tended to have a higher risk of new-onset proteinuria (OR, 1.86; 95% CI: 1.12–3.11, p = 0.017), and progression of proteinuria (OR, 1.45; 95% CI: 1.08–1.95, p = 0.014), during a median follow-up period of 4.4 years ( 14 ). Similar results were also observed by Manabe et al ( 20 ) among patients with CKD ( 20 ).…”

Section: Discussionsupporting

confidence: 90%

The Association Between Visceral Adiposity Index and Worsening Renal Function in the Elderly

Dai

Zhang

et al. 2022

Front. Nutr.

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BackgroundVisceral adiposity index (VAI) is an indicator of visceral fat accumulation and dysfunction. However, little is known about whether VAI is associated with worsening renal function (WRF) in the elderly. Therefore, our study aimed to explore the association between VAI and WRF among the elderly population.MethodsIn total, 5,583 elderly participants (aged ≥ 65 years) who participated in the annual health checkups at least twice between January 2017 and July 2021 were enrolled and divided into four groups according to the VAI quartiles. The primary endpoint was incident chronic kidney disease (CKD), defined as incident estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2. The secondary endpoint was rapid kidney function decline (RKFD), defined as decline in eGFR of 40%. To evaluate the association between VAI and WRF, three Cox regression models were conducted, where VAI was treated as a continuous variable and a categorical variable (Q1 as reference), respectively. Subgroup analysis in participants with different baseline characteristics was also performed.ResultsDuring a median of 2.46 year follow-up, 931 (16.68%) participants developed CKD. After fully adjusting for confounding factors, VAI was significantly associated with incident CKD (HR, 1.052; 95% CI: 1.029–1.076, p < 0.001), and RKFD (HR, 1.077; 95% CI: 1.041–1.114, p < 0.001). Moreover, compared to those with the lowest VAI quartiles, subjects with the highest quartiles had a higher risk of incident CKD (HR, 1.286; 95% CI: 1.033–1.601, p = 0.024), and RKFD (HR, 1.895; 95% CI: 1.086–3.307, p = 0.025). The risk of incident CKD also tended to increase with elevated VAI quartiles (all p-values for trend <0.05). This positive association remained consistent among participants with different genders, baseline weights, or kidney functions.ConclusionIn our study, elevated VAI was associated with increased risk of incident CKD and RKFD in the elderly population.

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Section: Discussionsupporting

confidence: 90%

The Association Between Visceral Adiposity Index and Worsening Renal Function in the Elderly

Dai

Zhang

et al. 2022

Front. Nutr.

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“…One of these studies, from the cohort reported by Madero et al (148), confirmed the association between VFA measured on CT and kidney function decline, defined as a decrease in eGFR of >30% during a median follow-up of 8.9 years; their recruited patients were limited to individuals aged 70-79 years (Table 1, upper line). The other two reports were from our cohort (115,119). Manabe et al (115) found that VFA was significantly associated with CKD progression in a cohort with a wide age range (mean age, 59.2 years).…”

Section: Challenges For Attribute-based Medicine For Obesity-related ...mentioning

confidence: 76%

“…Before devising personalized medicine approaches in patients with CKD, high-quality databases must be created and risk factors for the acceleration of the CKD progression must be identified (113,115,118,119,(124)(125)(126)(127)(128)(129), paying attention to attributes such as sex differences or ages (130,131). Indeed, it has been reported that even data used in AI should be divided according to sex and attribute, which makes collecting data disaggregated by age and sex essential if AI is to fulfill its promise of improving outcomes for everyone (132)(133)(134)(135).…”

Section: Attribute-based Medicine For Patients With Obesity and Ckdmentioning

confidence: 99%

“…In patients with CKD, the risk factors and pathophysiological conditions generally differ regarding patient attributes ( 113 ). In patients with obesity and CKD, multiple attributes, including age ( 114 , 115 ), sex ( 116 – 119 ), race/ethnicity ( 17 , 120 ), fat distribution ( 119 , 121 ), the amount of VAT ( 119 , 121 , 122 ), and CKD stage ( 115 ), are known to more intricately influence the pathophysiology of fat accumulation and cardiorenal metabolic disease ( 51 , 80 ). Such complex interactions of chronic diseases with obesity raise the difficulty of interpretation of pathophysiology, prognosis prediction, and validation in a clinical setting.…”

Section: Literature Reviewmentioning

confidence: 99%

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Visceral fat and attribute-based medicine in chronic kidney disease

Kataoka

Nitta²,

Hoshino³

2023

Front. Endocrinol.

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Visceral adipose tissue plays a central role in obesity and metabolic syndrome and is an independent risk factor for both cardiovascular and metabolic disorders. Increased visceral adipose tissue promotes adipokine dysregulation and insulin resistance, leading to several health issues, including systemic inflammation, oxidative stress, and activation of the renin-angiotensin-aldosterone system. Moreover, an increase in adipose tissue directly and indirectly affects the kidneys by increasing renal sodium reabsorption, causing glomerular hyperfiltration and hypertrophy, which leads to increased proteinuria and kidney fibrosis/dysfunction. Although the interest in the adverse effects of obesity on renal diseases has grown exponentially in recent years, the relationship between obesity and renal prognosis remains controversial. This may be attributed to the long clinical course of obesity, numerous obesity-related metabolic complications, and patients’ attributes. Multiple individual attributes influencing the pathophysiology of fat accumulation make it difficult to understand obesity. In such cases, it may be effective to elucidate the pathophysiology by conducting research tailored to individual attributes from the perspective of attribute-based medicine/personalized medicine. We consider the appropriate use of clinical indicators necessary, according to attributes such as chronic kidney disease stage, level of visceral adipose tissue accumulation, age, and sex. Selecting treatments and clinical indicators based on individual attributes will allow for advancements in the clinical management of patients with obesity and chronic kidney disease. In the clinical setting of obesity-related nephropathy, it is first necessary to accumulate attribute-based studies resulting from the accurate evaluation of visceral fat accumulation to establish evidence for promoting personalized medicine.

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“…VFA ≥ 100 cm 2 was VFA obesity. BFP>25% for males or>35% for females was defined as BFP obesity [11,13]. WC ≥ 90 cm for males or ≥ 80 cm for females was defined as WC obesity [14].…”

Section: Discussionmentioning

confidence: 99%

Visceral fat area and body fat percentage measured by bioelectrical impedance analysis correlate with glycometabolism

Ding

et al. 2022

BMC Endocr Disord

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Background: Adiposity evaluated by body mass index (BMI) is associated with glycometabolism. The aim of the investigation was to explore the correlation of visceral fat area (VFA), body fat percentage (BFP), BMI and waist circumference (WC) with type 2 diabetes mellitus (T2DM) and pre-diabetes.Methods: A total of 18,458 participates underwent physical examination in Nanjing Drum Tower Hospital from January 2018 to April 2022 was included in this study. Data were collected retrospectively. Regression analysis was used to evaluate the relationship of VFA, BFP, WC and BMI with diabetes status, fasting blood glucose (FBG) and glycohemoglobin (HbA1c).Results: After fully adjusted for multiple covariates, VFA, BFP, WC and BMI in T2DM and pre-diabetes group exceeded compared with normal group. FBG was positively correlated with VFA, BFP, WC and BMI with βs of 2.221,0.306,0.606 and 0.175(p < 0.001). HbA1c was also positively correlated with the four indexes with βs of 2.645, 0.328, 0.685 and 0.255(p < 0.001). Subgroup analysis shown that FBG and HbA1c were positively correlated with VFA, BFP, BMI and WC in normal and pre-diabetes group (p < 0.001). FBG was negatively correlated with BMI in T2DM group (p = 0.023). In T2DM, there were non-linear relationships of HbA1c with VFA, BFP, WC and BMI with the inflection points for about 7%. Before the inflection point, HbA1c was positively correlated with obesity-related indicators, and it was reversed after the inflection point. In the individuals with excessive VFA and normal BMI, the risk for glycometabolism disorder exceed compared with normal VFA and normal BMI. Every per-standard deviation increasing in VFA, BFP, WC and BMI, the corresponding risk increasing of glycometabolism disorder was 16.4, 14.6, 22.6 and 22.2%. Conclusion:The study demonstrated that in adults with T2DM or prediabetes, the VFA, BFP, WC and BMI were higher than with normal glycometabolism. In pre-diabetes and normal population, there were positive correlations of HbA1c and FBG with obesity-related indicators. In T2DM with poor glycemic control (HbA1c > 7%), there might be a trend of fat loss. VFA could negatively affect glycometabolism independently from BMI. The optimum to evaluate the risk of glycometabolism disorder was WC.

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Impact of visceral fat area in patients with chronic kidney disease

Cited by 13 publications

References 52 publications

The Association Between Visceral Adiposity Index and Worsening Renal Function in the Elderly

The Association Between Visceral Adiposity Index and Worsening Renal Function in the Elderly

Visceral fat and attribute-based medicine in chronic kidney disease

Visceral fat area and body fat percentage measured by bioelectrical impedance analysis correlate with glycometabolism

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