The Visceral Adiposity Index Is a Predictor of Incident Chronic Kidney Disease: A Population-Based Longitudinal Study

Abstract

Background and Aims: Visceral adiposity index (VAI), calculated with body mass index, high density lipoprotein-cholesterol, triglycerides and waist circumference, has been proposed as a marker of visceral fat accumulation and dysfunction in adipose tissue. Methods: The impact of VAI on incident chronic kidney disease (CKD) in a historical cohort study of 15,159 (8,260 men and 6,899 women) participants was investigated. CKD was defined when estimated glomerular filtration rate was < 60 mL/min/1.73 m 2 or proteinuria (positive: ≥1+). We divided the participants into 2 groups according to sex and into quartiles according to VAI (Q1-4). We performed Cox proportional hazard models, adjusting for age, smoking status, exercise, alcohol consumption, systolic blood pressure, hemoglobin A1c, uric acid, and creatinine. Results: During the median 3.3-year follow-up for men and 3.2-year follow-up for women, 1,078 participants (629 men and 449 women) developed CKD. The 4,000 days cumulative incidence rate of CKD for men and women were 3.7 and 3.9% in Q1, 5.2 and 5.9% in Q2, 6.5 and 7.0% in Q3, and 8.4 and 9.3% in Q4 respectively. Compared to Q1, the hazard ratios of incident CKD in Q2, Q3 and Q4 for men and women were 1.23 (95% CI 0.91-1.66, p = 0.184) and 1.30 (0.87-1.96, p = 0.203), 1.42 (1.06-1.90, p = 0.018) and 1.38 (0.94-2.05, p = 0.105), and 1.51 (1.12-2.02, p = 0.006) and 1.65 (1.12-2.46, p = 0.013) respectively. Additionally, the area under the curve of VAI for incidence of CKD was superior to that of VAI in men (0.595 vs. 0.552, p < 0.001) and equal to in women (0.597 vs. 0.591, p = 0.708). Conclusions: The VAI can be a predictor of incident CKD.blood after an overnight fast. We used the Japanese Society of Nephrology equation for calculating each patient's estimated GFR (eGFR): eGFR (mL/min/1.73 m 2 ) = 194 × serum creatinine -1.094 × age -0.287 (× 0.739 for women) [14]. Spot morning urine sample was measured.

Association of visceral adiposity index with incident nephropathy and retinopathy: a cohort study in the diabetic population

“…First, VAI is a representative marker to assess visceral adiposity which is strongly related with insulin resistance [ 34 ], and insulin resistance may lead to hypo-inflammation [ 35 ], endothelium dysfunction [ 36 ], and oxidative stress [ 37 ], contributing to the development of microangiopathy. Podocytes are insulin sensitive renal cells, and thus the insulin resistance is more likely to cause kidney damage [ 38 ]. Second, VAI is a valuable indicator of visceral adipose function [ 10 ].…”

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

“…During the median follow-up period of 2.46 years, the occurrence rate of incident CKD in our study was 16.68% ( n = 931). Another longitudinal study conducted by Bamba et al ( 16 ) enrolled 15,159 general population without baseline medication or CKD. During the median 3.3-year follow-up for men and 3.2-year follow-up for women, the occurrence rate of incident CKD in their cohort was 7.62% and 6.51%, respectively ( 16 ).…”

“…Another longitudinal study conducted by Bamba et al ( 16 ) enrolled 15,159 general population without baseline medication or CKD. During the median 3.3-year follow-up for men and 3.2-year follow-up for women, the occurrence rate of incident CKD in their cohort was 7.62% and 6.51%, respectively ( 16 ). Comparing with the previous result, the occurrence rate of incident CKD in our cohort was higher.…”

Obesity-related indices are associated with albuminuria and advanced kidney disease in type 2 diabetes mellitus

“…These effects can then result in the ectopic accumulation of lipids and increases in renal sinus fat, glomerular hypertension, and increased permeability of the glomeruli through glomerular filtration barrier injury related to hyperfiltration, and consequently glomerulomegaly and focal or segmental glomerulosclerosis [44,45]. This mechanism could also explain that the higher VAI was associated with incident CKD, and many previous studies had also proved the same result [46,47]. In previous meta-analyses and systemic reviews, WHtR was shown to have the best discriminatory ability for the risk of hypertension, diabetes, and dyslipidemia [48,49].…”