U-shaped association between central body fat and the urinary albumin-to-creatinine ratio and microalbuminuria

Abstract

BackgroundThe prevalence of obese and overweight patients has increased dramatically worldwide. Both are common risk factors for chronic kidney disease (CKD) as indicated by a diminished estimated glomerular filtration rate (eGFR) or microalbuminuria. This study aimed to investigate whether anthropometric parameters [waist circumference (WC), waist-to-height ratio (WHtR) and body mass index (BMI)] are associated with renal function in a population-based study of Caucasian subjects.MethodsData from 3749 subjects (1825 women) aged 20 to 81 years from the Study of Health in Pomerania (SHIP) were analysed. Renal indices, including the urinary albumin-to-creatinine ratio (uACR), microalbuminuria, eGFR and CKD, were studied. Parameters of anthropometry (WC, WHtR and BMI) were categorised into sex-specific quintiles.ResultsAnalysis of variance (ANOVA) models, adjusting for age, sex, type 2 diabetes mellitus and hypertension, revealed that a high and low WC or WHtR and low BMI were independently related to a higher uACR. Logistic regression models confirmed these results with respect to uACR and showed that subjects with a high or low WC or a high WHtR had increased odds of microalbuminuria. The ANOVA models revealed no relations of the investigated anthropometric parameters with eGFR. However, subjects with high values for these parameters had increased odds of CKD.ConclusionsOur results demonstrate U-shaped associations between markers of central fat distribution and uACR or microalbuminuria in the general population, suggesting that both obese and very thin subjects have a higher risk of renal impairment.

Lower body mass index is not of more benefit for diabetic complications

“…have reported that increasing BMI is associated with a risk of albumin‐to‐creatinine ratio progression. A study with 3,749 participants (BMI 22.8–30.2 kg/m 2 ) from the Study of Health in Pomerania showed that low BMI is positively correlated with the urinary albumin‐to‐creatinine ratio. Yet, in the present study, it was determined that a higher BMI was positively correlated with DKD.…”

“…The major strength of the present study was the comprehensively discussed relationship between BMI and diabetic macrovascular and microvascular complications. We demonstrated that BMI showed a U‐shaped association with DPN and PAD, whereas the results of the aforementioned studies showed a linear relationship. The observed differences could result from methodological differences, differences in the definitions of vascular complications, inadequate clinical sample sizes and differences in study participants (e.g., some studies did not include the lean population, some studies only examined the elderly population).…”

“…have recently proposed the opposite concept; that is, that a low BMI might be a potential risk factor for DPN. Furthermore, most studies have suggested that a high BMI is a risk factor for DKD; however, one study suggested that a low BMI is positively associated with the albumin‐to‐creatinine ratio. Additionally, conflicting results have been reported about a possible relationship between a higher BMI and increased risk of DR.…”

Impact of body composition on estimated glomerular filtration rate in relatively healthy adults in Taiwan

“…18 A recent study evaluating the associations between WC, WHtR, BMI and renal function also demonstrated that both obese and very thin subjects have a higher risk of renal impairment. 19 BMI and WC were found to be associated with reduced estimated GFR (eGFR) in Japanese cohort studies. 20,21 Central obesity was positively related to WC in some cross-sectional studies, including Asian populations.…”

Chronic Kidney Disease аs a Common Medical Problem

“…Показано наличие U-образной связи между маркерами центрального ожирения и соотношени-ем альбумин/креатинин в моче, а также микроаль-буминурией в общей популяции, что свидетельст-вует о том, что как люди с ожирением, так и очень худые люди имеют повышенный риск почечной недостаточности [58]. У здоровых людей среднего возраста снижение чувствительности к инсулину и гиперинсулинемия также являются факторами рис-ка альбуминурии [61].…”