Visceral adiposity index is closely associated with urinary albumin‐creatinine ratio in the Chinese population with prediabetes

Abstract

Aims: Visceral obesity is a major health issue and is a risk factor for an atherogenic state. Visceral obesity has been reported to be a crucial link between albuminuria and cardiovascular diseases (CVD). This study attempted to explore the association between visceral obesity and albuminuria in prediabetic individuals. Methods: This cross-sectional study included 24871 prediabetic participants over 40 years of age from seven centres across China (REACTION study). The visceral adiposity index (VAI) was determined based on the measurements of anthropometric indices and lipid parameters. Increased albuminuria was defined as a urinary albumin-creatinine ratio (UACR) ≥30 mg/g, indicating kidney damage. Propensity score matching was used to reduce bias, and a multiple logistic regression model was performed to evaluate the association between visceral obesity and albuminuria in the population with prediabetes.

Association of Lipid Accumulation Product With Chronic Kidney Disease in Chinese Community Adults: A Report From the REACTION Study

“…It is well known that estrogens could regulate adipose deposition and function [9], and estrogen exerts renoprotective effects [22]. Therefore, postmenopausal females tended to deposit more abdominal visceral adipose tissue and lost estrogen renal protection partly due to the rapid decline in estrogens [5,9]. On the other hand, males tended to be physically active and consumed more tea, especially green tea, both of which may make males have a lower distribution of abdominal fat compared to females of the same ages who were less active and consumed less tea [23,24,25].…”

“…It has been well established that adiposity is an important risk factor for renal function decline and albuminuria [6]. Compared with subcutaneous adipose tissue, visceral adipose tissue is more strongly associated with cardiometabolic risks [5]. Visceral adipose tissue secretes several proinfammatory cytokines such as C-reactive protein (CRP), interleukine-6 (IL-6), and distinct atherogenic lipoprotein pro les, contributes to the change in adipocytokines such as adiponectin, leptin, resistin, and omentin-1, which lead to subclinical in ammation, oxidative stress, insulin resistance (IR), and endothelial dysfunction, and subsequently, induces kidney structure and function changes such as glomerular sclerosis and increased albuminuria, and ultimately result in renal dysfunction [5,7,8,9].…”

“…Compared with subcutaneous adipose tissue, visceral adipose tissue is more strongly associated with cardiometabolic risks [5]. Visceral adipose tissue secretes several proinfammatory cytokines such as C-reactive protein (CRP), interleukine-6 (IL-6), and distinct atherogenic lipoprotein pro les, contributes to the change in adipocytokines such as adiponectin, leptin, resistin, and omentin-1, which lead to subclinical in ammation, oxidative stress, insulin resistance (IR), and endothelial dysfunction, and subsequently, induces kidney structure and function changes such as glomerular sclerosis and increased albuminuria, and ultimately result in renal dysfunction [5,7,8,9]. Body mass index (BMI) is the most frequently used index in the assessment of adiposity in clinical practice, but lacks discriminatory power between lean vs. adipose tissue, or between subcutaneous and visceral fat, and also lacks the ability to track over time changes in the lipid compartment [10].…”

“…Compelling data indicate that obesity plays an important role in the onset and development of CKD [3,5,6,7], but the underlying mechanisms by which obesity, especially visceral obesity, affects CKD are multifactorial and are not fully understood. It has been well established that adiposity is an important risk factor for renal function decline and albuminuria [6].…”

“…Body mass index (BMI) is the most frequently used index in the assessment of adiposity in clinical practice, but lacks discriminatory power between lean vs. adipose tissue, or between subcutaneous and visceral fat, and also lacks the ability to track over time changes in the lipid compartment [10]. Waist circumference (WC), a practical athropometric parameter to identify central obesity, is also unable to distinguish between visceral adipose tissue and subcutaneous adipose tissue [5,7]. In recent years, lipid accumulation product (LAP), a novel surrogate marker of visceral adiposity and an alternative continuous index of central lipid accumulation proposed by Kahn in 2005, is based on a combination of WC and fasting triglyceride (TG) levels, and re ects the anatomic and physiologic changes associated with obesity among adults [9,10].…”