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Kim CS, Oh TR, Suh SH, Choi HS, Bae EH, Ma SK, Kim B, Han K, Kim SW. Underweight status and development of end-stage kidney disease: A nationwide population-based study. J Cachexia Sarcopenia Muscle 2023; 14:2184-2195. [PMID: 37503821 PMCID: PMC10570067 DOI: 10.1002/jcsm.13297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/24/2023] [Accepted: 06/16/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Underweight status increases the risk of cardiovascular disease and mortality in the general population. However, whether underweight status is associated with an increased risk of developing end-stage kidney disease is unknown. METHODS A total of 9 845 420 participants aged ≥20 years who underwent health checkups were identified from the Korean National Health Insurance Service database and analysed. Individuals with underweight (body mass index [BMI] < 18.5 kg/m2 ) and obesity (BMI ≥ 25 kg/m2 ) were categorized according to the World Health Organization recommendations for Asian populations. RESULTS During a mean follow-up period of 9.2 ± 1.1 years, 26 406 participants were diagnosed with end-stage kidney disease. After fully adjusting for other potential predictors, the moderate to severe underweight group (<17 kg/m2 ) had a significantly higher risk of end-stage kidney disease than that of the reference (normal) weight group (adjusted hazard ratio, 1.563; 95% confidence interval, 1.337-1.828), and competing risk analysis to address the competing risk of death also showed the similar results (adjusted hazard ratio, 1.228; 95% confidence interval, 1.042-1.448). Compared with that of the reference BMI group (24-25 kg/m2 ), the adjusted hazard ratios for end-stage kidney disease increased as the BMI decreased by 1 kg/m2 . In the sensitivity analysis, sustained underweight status or progression to underweight status over two repeated health checkups, when compared with normal weight status, had a higher hazard ratio for end-stage kidney disease. CONCLUSIONS Underweight status is associated with an increased risk of end-stage kidney disease, and this association gradually strengthens as BMI decreases.
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Affiliation(s)
- Chang Seong Kim
- Department of Internal MedicineChonnam National University Medical SchoolGwangjuSouth Korea
- Department of Internal MedicineChonnam National University HospitalGwangjuSouth Korea
| | - Tae Ryom Oh
- Department of Internal MedicineChonnam National University Medical SchoolGwangjuSouth Korea
- Department of Internal MedicineChonnam National University HospitalGwangjuSouth Korea
| | - Sang Heon Suh
- Department of Internal MedicineChonnam National University Medical SchoolGwangjuSouth Korea
- Department of Internal MedicineChonnam National University HospitalGwangjuSouth Korea
| | - Hong Sang Choi
- Department of Internal MedicineChonnam National University Medical SchoolGwangjuSouth Korea
- Department of Internal MedicineChonnam National University HospitalGwangjuSouth Korea
| | - Eun Hui Bae
- Department of Internal MedicineChonnam National University Medical SchoolGwangjuSouth Korea
- Department of Internal MedicineChonnam National University HospitalGwangjuSouth Korea
| | - Seong Kwon Ma
- Department of Internal MedicineChonnam National University Medical SchoolGwangjuSouth Korea
- Department of Internal MedicineChonnam National University HospitalGwangjuSouth Korea
| | - Bongseong Kim
- Department of Statistics and Actuarial ScienceSoongsil UniversitySeoulSouth Korea
| | - Kyung‐Do Han
- Department of Statistics and Actuarial ScienceSoongsil UniversitySeoulSouth Korea
| | - Soo Wan Kim
- Department of Internal MedicineChonnam National University Medical SchoolGwangjuSouth Korea
- Department of Internal MedicineChonnam National University HospitalGwangjuSouth Korea
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Wagata M, Ishikuro M, Obara T, Nagai M, Mizuno S, Nakaya N, Nakamura T, Hirata T, Tsuchiya N, Metoki H, Ogishima S, Hozawa A, Kinoshita K, Kure S, Yaegashi N, Yamamoto M, Kuriyama S, Sugawara J. Low birth weight and abnormal pre-pregnancy body mass index were at higher risk for hypertensive disorders of pregnancy. Pregnancy Hypertens 2020; 22:119-125. [PMID: 32791355 DOI: 10.1016/j.preghy.2020.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 07/12/2020] [Accepted: 08/03/2020] [Indexed: 12/12/2022]
Abstract
Low birth weight is known to be associated with hypertension, cardiovascular disease and hypertensive disorders of pregnancy (HDP); however, this association might vary by race/ethnicity. This study aimed to clarify the association between women's own birth weight and their subsequent risk for HDP in a Japanese population, in combination with pre-pregnancy body mass index (BMI). We conducted a cohort study as part of the Tohoku Medical Megabank Birth and Three-Generation Cohort Study in Miyagi, Japan. Our study's population included 4810 women. A multivariate logistic regression analysis was performed to calculate the adjusted odds ratio (aOR) and the 95% confidence interval (CI) of the women's own birth weight for HDP, in the combination categories of birth weight and pre-pregnancy BMI. As a result, the group with a low birth weight of <2500 g had a significant association with HDP (the aOR, 1.50; 95% CI, 1.02-2.21). In the subtype analysis, the odds ratio for only preeclampsia was significantly increased in the low birth weight group (aOR, 3.37; 95% CI, 1.84-6.16). In the group with a low birth weight, the prevalence of HDP was higher in both the underweight and overweight groups. In conclusion, there was a significant association between low birth weight and subsequent HDP in Japanese women. Furthermore, a significant association with HDP was found for women born with a low birth weight who were underweight or overweight as adults. Maintaining a normal weight may be effective for preventing HDP even if a woman was born small.
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Affiliation(s)
- Maiko Wagata
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Masato Nagai
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Mizuno
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Naoki Nakaya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomohiro Nakamura
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takumi Hirata
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Naho Tsuchiya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Tohoku Medical Pharmaceutical University, Sendai, Japan
| | - Soichi Ogishima
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Atsushi Hozawa
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kengo Kinoshita
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shigeo Kure
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Nobuo Yaegashi
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Masayuki Yamamoto
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Junichi Sugawara
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan.
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Man REK, Gan ATL, Fenwick EK, Gupta P, Wong MYZ, Wong TY, Tan GSW, Teo BW, Sabanayagam C, Lamoureux EL. The Relationship between Generalized and Abdominal Obesity with Diabetic Kidney Disease in Type 2 Diabetes: A Multiethnic Asian Study and Meta-Analysis. Nutrients 2018; 10:nu10111685. [PMID: 30400648 PMCID: PMC6266073 DOI: 10.3390/nu10111685] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 10/29/2018] [Accepted: 11/01/2018] [Indexed: 12/31/2022] Open
Abstract
This study examined the associations of body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR) and waist-height ratio (WHtR) with diabetic kidney disease (DKD) in a clinical sample of Asian patients with type 2 diabetes (T2DM); substantiated with a meta-analysis of the above associations. We recruited 405 patients with T2DM (mean (standard deviation (SD)) age: 58 (7.5) years; 277 (68.4%) male; 203 (50.1%) with DKD) from a tertiary care centre in Singapore. DKD was defined as urinary albumin-creatinine ratio >3.3 mg/mmoL and/or estimated glomerular filtration rate <60 mL/min/1.73 m2. All exposures were analysed continuously and categorically (World Health Organization cut-points for BMI and WC; median for WHR and WHtR) with DKD using stepwise logistic regression models adjusted for traditional risk factors. Additionally, we synthesized the pooled odds ratio of 18 studies (N = 19,755) in a meta-analysis of the above relationships in T2DM. We found that overweight and obese persons (categorized using BMI) were more likely to have DKD compared to under/normal weight individuals, while no associations were found for abdominal obesity exposures. In meta-analyses however, all obesity parameters were associated with increased odds of DKD. The discordance in our abdominal obesity findings compared to the pooled analyses warrants further validation via longitudinal cohorts.
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Affiliation(s)
- Ryan Eyn Kidd Man
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 169856, Singapore.
- Duke-NUS Medical School, Singapore 169857, Singapore.
| | - Alfred Tau Liang Gan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 169856, Singapore.
| | - Eva Katie Fenwick
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 169856, Singapore.
- Duke-NUS Medical School, Singapore 169857, Singapore.
| | - Preeti Gupta
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 169856, Singapore.
| | - Mark Yu Zheng Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 169856, Singapore.
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 169856, Singapore.
- Duke-NUS Medical School, Singapore 169857, Singapore.
- Singapore National Eye Centre, Singapore 168751, Singapore.
| | | | - Boon Wee Teo
- Department of Nephrology, University Medicine Cluster, National University Health System, Singapore 119074, Singapore.
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 169856, Singapore.
- Duke-NUS Medical School, Singapore 169857, Singapore.
| | - Ecosse Luc Lamoureux
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 169856, Singapore.
- Duke-NUS Medical School, Singapore 169857, Singapore.
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Hyun YY, Kim H, Lee KB. Red cell distribution width predicts incident dipstick albuminuria in Korean adults without chronic kidney disease. Kidney Res Clin Pract 2017; 36:232-239. [PMID: 28904874 PMCID: PMC5592890 DOI: 10.23876/j.krcp.2017.36.3.232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 03/16/2017] [Accepted: 04/01/2017] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Red cell distribution width (RDW) is an emerging marker of inflammation and a predictor of high cardiovascular morbidity and mortality as well as all-cause mortality. A previous cross-sectional study showed that RDW was associated with microalbuminuria, an indicator of target organ damage. However, the longitudinal association of RDW and development of albuminuria is not known. METHODS We analyzed 83,040 participants without chronic kidney disease (CKD) at baseline who underwent two health check-ups at a 4-year interval during 2005 to 2014. Urine albumin was determined by single urine dipstick semi-quantitative analysis, and incident albuminuria was defined as ≥ 1+ dipstick albumin at the second check-up. We used logistic regression analysis to determine the relationship between RDW and incident albuminuria. RESULTS Participants were divided into quartiles according to baseline RDW. After 4 years, 982 cases of incident albuminuria were observed. The cumulative incidences of albuminuria were 0.94, 1.05, 1.18, and 1.62% for the 1st through 4th quartiles of RDW, respectively. Multivariate logistic analysis showed that the odds ratios (95% confidence interval) for incident albuminuria compared to those in the 1st quartile were 1.11 (0.92-1.34), 1.26 (1.04-1.52), and 1.88 (1.58-2.24) for the 2nd, 3rd and 4th quartiles, respectively. CONCLUSION RDW was associated with development of albuminuria in relatively healthy Korean adults without CKD. Further research is needed to verify the role of RDW in the development of albuminuria and renal injury.
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Affiliation(s)
- Young Youl Hyun
- Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Hyang Kim
- Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Kyu-Beck Lee
- Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul,
Korea
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A Cross-sectional Prospective Study of Asymptomatic Urinary Abnormalities, Blood Pressure, and Body Mass Index in Healthy School Children. Kidney Int Rep 2017; 2:1169-1175. [PMID: 29270525 PMCID: PMC5733680 DOI: 10.1016/j.ekir.2017.07.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 07/17/2017] [Accepted: 07/24/2017] [Indexed: 12/13/2022] Open
Abstract
Introduction Screening school children for urinary abnormalities is an inexpensive task but is not commonly undertaken in India. Although debated in western countries, its utility in early diagnosis of kidney disorders has been proved by studies from Asia. We examined the prevalence of asymptomatic urinary abnormalities (AUA), obesity, and hypertension in school children and analyzed data to identify potential risk factors among those detected with such abnormalities. Methods Children and adolescents 8 to 18 years of age of either gender, attending 14 public schools in West Bengal, were screened prospectively from July 2013 to July 2016 for detecting asymptomatic urinary abnormalities by a spot urine test using a dipstick. Sociodemographic profile, medical examination (weight, height, and blood pressure), and questionnaire-based data were recorded. Results A total of 11,000 children were screened. Of these, data from 9306 children were available for AUA, obesity, and hypertension. The prevalence rate was 7.44% (95% confidence interval [CI] = 6.91%−7.97%) for at least 1 AUA. Isolated hematuria was present in 5.2% (95% CI 4.75%−5.65%), whereas isolated proteinuria was present in 1.9% (95% CI = 1.62%−2.18%). The prevalence of prehypertension was 13.43% (95% CI = 12.74%−14.12%) and that of hypertension and abnormal body mass index was 4.05% (95% CI = 6.43%−7.47%) and 38.67 (95% CI = 37.68%−39.66%) respectively. Discussion The prevalence rates of AUA were comparable with those in some Asian countries but higher than in most developed countries. Of children and adolescents 8 to 18 years of age, those 13 to 18 years had significantly more high risk factors such as AUA, hypertension, and obesity.
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Garofalo C, Borrelli S, Minutolo R, Chiodini P, De Nicola L, Conte G. A systematic review and meta-analysis suggests obesity predicts onset of chronic kidney disease in the general population. Kidney Int 2017; 91:1224-1235. [PMID: 28187985 DOI: 10.1016/j.kint.2016.12.013] [Citation(s) in RCA: 185] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Revised: 11/25/2016] [Accepted: 12/01/2016] [Indexed: 01/01/2023]
Abstract
Obesity and chronic kidney disease (CKD) are public health priorities that share core pathophysiological mechanisms. However, whether high body mass index (BMI) increases risk of CKD de novo remains ill-defined. To evaluate the role of BMI in predicting CKD onset in the general adult population, we performed a systematic review and meta-analysis of PubMed and ISI Web of Science databases articles published between January 2000 and August 2016 without language restriction. We selected studies in adult individuals from a general population with normal renal function at baseline that reported the risk of low estimated glomerular filtration (eGFR) (under 60 mL/min/1.73m2) and/or albuminuria (1+ at dipstick or an albumin creatinine ratio of 3.4 mg/mmol or more) as hazard ratio, odds ratio or relative risk related to obesity, overweight, or BMI as continuous value. A total of 39 cohorts covering 630, 677 participants with a mean follow-up of 6.8 years were selected. Obesity increased the relative risk, 95% confidence interval and heterogeneity (I2) of developing low eGFR (1.28, 1.07-1.54, [I2: 95.0%]) and albuminuria (1.51, 1.36-1.67, [I2: 62.7%]). Increase of BMI unit was also associated with higher risk of low eGFR (1.02, 1.01-1.03, [I2: 24.3%]) and albuminuria (1.02, 1.00-1.04, [I2: 0%]). Conversely, overweight did not predict onset of either low eGFR (1.06, 0.94-1.21, [I2: 50.0%]) or albuminuria (1.24, 0.98-1.58, [I2: 49.4%]). Thus, a high BMI predicts onset of albuminuria without kidney failure (CKD stages 1-2) as well as CKD stages 3 and higher, the effect being significant only in obese individuals. Hence, our findings may have implications to improve risk stratification and recommendations on body weight control in the general population.
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Affiliation(s)
- Carlo Garofalo
- Division of Nephrology, Second University of Naples, Naples, Italy
| | - Silvio Borrelli
- Division of Nephrology, Second University of Naples, Naples, Italy
| | - Roberto Minutolo
- Division of Nephrology, Second University of Naples, Naples, Italy
| | - Paolo Chiodini
- Medical Statistics Unit, Second University of Naples, Naples, Italy
| | - Luca De Nicola
- Division of Nephrology, Second University of Naples, Naples, Italy
| | - Giuseppe Conte
- Division of Nephrology, Second University of Naples, Naples, Italy.
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Wakasugi M, Kazama J, Narita I, Iseki K, Fujimoto S, Moriyama T, Yamagata K, Konta T, Tsuruya K, Asahi K, Kondo M, Kurahashi I, Ohashi Y, Kimura K, Watanabe T. Association between Overall Lifestyle Changes and the Incidence of Proteinuria: A Population-based, Cohort Study. Intern Med 2017. [PMID: 28626171 PMCID: PMC5505901 DOI: 10.2169/internalmedicine.56.8006] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objective This study aimed to examine the association between the changes in an overall healthy lifestyle, as quantified by the number of unhealthy lifestyle factors and obesity status, and the incidence of proteinuria in the general Japanese population. Methods A retrospective cohort study was conducted among 99,404 (men, 36.9%) participants aged from 40-74 years of age who underwent two health check-ups with a 1-year interval in Japan between 2008 and 2009. Any participants with chronic kidney disease at baseline were excluded. The smoking status, body mass index, physical activity, alcohol consumption, and healthy eating habits were combined into a simple overall healthy lifestyle score ranging from 0 to 5. The changes in overall healthy lifestyle scores from baseline (range, -5 to +5) and the incidence of proteinuria, defined by a dipstick urinalysis (score ≥1+), were assessed at the second check-up. A logistic regression analysis was used to examine the association between the changes in overall healthy lifestyle scores and the incidence of proteinuria. Results After one year of follow-up, 3.9% of men and 2.4% of women developed proteinuria. Each increase (or decrease) in the changes in overall healthy lifestyle scores was associated with a reduced (or increased) risk of proteinuria in both men (odds ratio (OR) 0.87; 95% confidence interval (CI), 0.81-0.94) and women (OR 0.87; 95%CI, 0.80-0.94) after adjusting for age, baseline lifestyle scores, hypertension, diabetes mellitus, and hypercholesterolemia. Stratified analyses based on age, the presence or absence of hypertension, or diabetes mellitus revealed similar results. Conclusion Overall lifestyle changes, even within a year, were found to influence the incidence of proteinuria.
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Affiliation(s)
- Minako Wakasugi
- Division of Comprehensive Geriatrics in Community, Niigata University Graduate School of Medical and Dental Sciences, Japan
| | - Junichiro Kazama
- Departments of Nephrology and Hypertension, Fukushima Medical University, Japan
| | - Ichiei Narita
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
| | - Kunitoshi Iseki
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
| | - Shouichi Fujimoto
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
| | - Toshiki Moriyama
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
| | - Kunihiro Yamagata
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
| | - Tsuneo Konta
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
| | - Kazuhiko Tsuruya
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
| | - Koichi Asahi
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
| | - Masahide Kondo
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
| | | | - Yasuo Ohashi
- Department of Integrated Science and Engineering for Sustainable Society, Chuo University, Japan
| | - Kenjiro Kimura
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
| | - Tsuyoshi Watanabe
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
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Seo WJ, Lee GM, Hwang JH, Lee MN, Kang HC. Association between Body Mass Index, Waist Circumference and Prevalence of Microalbuminuria in Korean Adults of Age 30 Years and Older without Diabetes, Hypertension, Renal Failure, or Overt Proteinuria: The 2013 Korean National Health and Nutrition Examination Survey. Korean J Fam Med 2016; 37:57-63. [PMID: 26885324 PMCID: PMC4754288 DOI: 10.4082/kjfm.2016.37.1.57] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 08/19/2015] [Accepted: 10/01/2015] [Indexed: 12/03/2022] Open
Abstract
Background Microalbuminuria and obesity markers are known risk factors for cardiovascular or renal disease. This study aimed to evaluate the prevalence of microalbuminuria according to body mass index (BMI) and abdominal obesity criteria. Methods The study subjects included 3,979 individuals aged 30 years or older who did not have diabetes, hypertension, renal failure, or overt proteinuria, from among those who participated in The Korean National Health and Nutrition Examination Survey in 2013, a cross-sectional, nationally representative, stratified survey. Microalbuminuria was defined as a urinary albumin to creatinine ratio of 30 to 300 mg/g. BMI and waist circumference were classified according to the Asia-Pacific criteria. Results The prevalence of microalbuminuria was found to be 5.1%. In the normoalbuminuria group, 3.4%, 41.7%, 24%, 27.6%, and 3.2% of participants were included in the underweight, normal, overweight, obesity 1, and obesity 2 groups, respectively. These percentages in the microalbuminuria group were 7.1%, 34.5%, 19.2%, 28.6%, and 10.6%, respectively (P<0.001). The waist circumference in men was 21.4% in the normoalbuminuria group and 36.5% in the microalbuminuria group (P=0.004). Logistic regression analyses were performed to evaluate the relationship between the presence of microalbuminuria and BMI or waist circumference groups. The risk of microalbuminuria was significant only in the underweight group (odds ratio, 13.22; 95% confidence interval, 2.55–68.63; P=0.002) after adjusting for confounding factors, abdominal obesity was not significantly associated with microalbuminuria. Conclusion The prevalence of microalbuminuria in a general population in Korea was associated with underweight in men and was not associated with waist circumference in either men or women.
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Affiliation(s)
- Woo-Jeong Seo
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Gong-Myung Lee
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ji-Hye Hwang
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Mi-Na Lee
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hee-Cheol Kang
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
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