Obesity, Albuminuria, and Urinalysis Findings in US Young Adults from the Add Health Wave III Study

Abstract

Background and objectives: Obesity has been associated with kidney disease in adults. This study was designed to evaluate the association of obesity with an early marker of kidney disease, albuminuria, among young adults.Design, setting, participants, & measurements: Urinalysis (n ‫؍‬ 9371), albumin-to-creatinine ratio (n ‫؍‬ 4463), and body mass index (kg/m 2 ) were measured in the Add Health Wave III cohort (2001 to 2002), a multiethnic sample of young adults followed for approximately 6 yr. Multivariate logistic regression modeled the association of sex-specific albuminuria with body mass index, adjusted for sample weights, sex, race, ethnicity, and glycosuria.Results: Urinalysis revealed that 0.8% had proteinuria, 4.6% had hematuria, 0.2% had combined hematuria and proteinuria, and 1.5% had glycosuria. Albuminuria prevalence was 4.4%. Mean body mass index was higher among those with albuminuria compared with those without. There were no associations between body mass index categories of 25 to <30 or 30 to <35 kg/m

Early markers of obesity-related renal injury in childhood

“…Ferris et al demonstrated that microalbuminuria was strongly related to the severity of obesity in adults. In addition, these authors reported that a change in BMI over the 6 years of the study, but not the baseline BMI itself, was associated with microalbuminuria, indicating that the growth in body mass may occur faster than the kidneys can adapt [13]. Microalbuminuria was not found to be different between obese children and healthy controls in the study of Goknar et al [11].…”

Risk factors associated with urinary albumin excretion in African Americans

“…5 In another large study of young adults, the median UAE was 2.3 mg per g CR. 6 Although microalbuminuria defines a clinically significant threshold for UAE, the association of UAE with cardiovascular risk may be linear and become manifest below 30 mg per g CR. Data from several clinical trials have identified an increase in adverse cardiovascular outcomes at levels of UAE below 30 mg per g CR.…”

Correlation between Body Mass Index (BMI) and Waist Circumference (W.C) With Urine Albumin Excretion in NonDiabetic Obese Subjects - A Cross Sectional Study

“…Emerging evidence indicates that obesity per se, specifically targets the kidney and contributes significantly to the development and progression of CKD [4,5,6,7]. The Framingham Offspring data reported obesity as a major risk factor for the development of kidney disease.…”

“…. Studies have reported that weight gain, even within the normal range of body mass index, may increase the risk of CKD [12] Central obesity has received more attention as a potential risk factor for renal Disease [13,14,15,16]. It is reported that central body fat distribution is directly associated with renal hemodynamic alterations even independent of overall weight excess leading to progressive renal damage [17,18].…”

“…A post-hoc analysis of the Add Health Wave III cohort of young adults revealed an association between a body mass index over 35 kg/m2 and proteinuria [7]. Conversely, weight loss has been shown to reduce proteinuria in non-diabetic nephropathies making renal disease in obesity accessible for prevention programs [26,27,28].…”