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Liao Z, Yuan G, He K, Li S, Gao M, Liang P, Xu C, Chu Q, Han M, Li Z. Body composition as a potential imaging biomarker for predicting the progression risk of chronic kidney disease. Insights Imaging 2024; 15:247. [PMID: 39400628 PMCID: PMC11473763 DOI: 10.1186/s13244-024-01826-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Accepted: 09/19/2024] [Indexed: 10/15/2024] Open
Abstract
PURPOSE To investigate whether the body composition parameters can be employed as potential biomarkers for predicting the progression risk of chronic kidney disease (CKD). MATERIALS AND METHODS Four hundred sixteen patients diagnosed with CKD were included in this retrospective study. Patients with a greater than 50% decline in estimated glomerular filtration rate or progression to end-stage kidney disease were in the high-risk group, otherwise, they were in a low-risk group. Body composition area, the index, and radiodensities in the Hounsfield unit (HU), which reflect the degree of X-ray absorption, were measured on abdominal CT images. Risk factors in body composition and clinical parameters of CKD were identified by Cox regression and utilized to construct the nomogram. The performance of the nomogram was assessed using time receiver operating characteristics curves, calibration curves, and decision curve analysis. RESULTS There were 254 patients in low-risk group and 162 in high-risk group (268 males, 148 females, mean age: 55.89 years). Urea, diabetes, 24 h-urinary protein, mean arterial pressure, and subcutaneous adipose tissue radiodensity (SATd) were valuable indicators for predicting the high-risk group. The area under curve values for the nomogram of training/validation set at 1 year, 2 years, and 3 years were 0.805/0.753, 0.784/0.783, and 0.846/0.754, respectively. For diabetic CKD patients, extra attention needs to be paid to visceral to subcutaneous fat ratio and renal sinus fat radiodensity. CONCLUSION SATd was the most valuable noninvasive indicator of all body composition parameters for predicting high-risk populations with CKD. The nomogram we constructed has generalization with easily obtainable indicators, good performance, differentiation, and clinical practicability. CRITICAL RELEVANCE STATEMENT Radiodensity rather than an area of adipose tissue can be used as a new biomarker of prognosis for CKD patients, providing new insights into risk assessment, stratified management, and treatment for CKD patients. KEY POINTS Obesity is an independent risk factor for the development and prognosis of CKD. Adipose tissue radiodensity is more valuable than fat area in prognosticating for kidney disease. Parameters that prognosticate in diabetic CKD patients are different from those in other CKD patients.
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Affiliation(s)
- Zhouyan Liao
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guanjie Yuan
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kangwen He
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shichao Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengmeng Gao
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Liang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chuou Xu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qian Chu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Min Han
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhen Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Zhao P, Li Q, Du T, Zhou Q. Association of different obesity indexes with diabetic kidney disease in patients with type 2 diabetes mellitus: a cross-sectional study. Sci Rep 2024; 14:21571. [PMID: 39284924 PMCID: PMC11405409 DOI: 10.1038/s41598-024-73106-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 09/13/2024] [Indexed: 09/22/2024] Open
Abstract
The objective of this study is to investigate the association between diabetic kidney disease (DKD) and various adiposity indexes, including the visceral adiposity index (VAI), lipid accumulation product index (LAPI), visceral fat area (VFA), and subcutaneous fat area (SFA) in type 2 diabetes mellitus (T2DM) patients. 1176 T2DM patients was stratified into normoalbuminuria (NO), microalbuminuria (MI), and macroalbuminuria (MA) groups based on their urinary albumin-creatinine ratio (UACR) levels. To analyse the correlation between DKD and VAI, LAPI, VFA, and SFA. Multiple linear, restricted cubic spline (RCS), subgroup analyses, and multinomial logistic regression were employed. After adjusting for confounding variables, UACR levels were positively associated with VAI, LAPI, and VFA. RCS curves demonstrated a J-shaped dose-response relationship between VAI and LAPI levels with UACR levels, while a linear correlation was observed between UACR levels and VFA. Using the NO and MI as reference groups, the MA group was analysed as the observational group. DKD severity was positively associated with VAI, LAPI and VFA. When evaluating DKD prognostic risk, with the low-risk and medium-risk groups serving as reference categories, a significant positive correlation was identified with prognostic risk and VAI, LAPI, and VFA in the high-risk or very high-risk groups. In patients with T2DM, DKD severity and prognostic risk were positively correlated with VAI, LAPI, and VFA levels.
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Affiliation(s)
- Pingping Zhao
- The First Clinical Medical College, Lanzhou University, Dong gang West Road, 730000, Lanzhou, Gansu, P.R. China.
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
| | - Qing Li
- Yipeng Community Health Service Centre, Hangzhou, Zhejiang, China
| | - Tianqi Du
- The First Clinical Medical College, Lanzhou University, Dong gang West Road, 730000, Lanzhou, Gansu, P.R. China
| | - Qi Zhou
- The First Clinical Medical College, Lanzhou University, Dong gang West Road, 730000, Lanzhou, Gansu, P.R. China
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Yu X, Pu X, Xi Y, Li X, Li H, Zheng D. Association between the lipid accumulation product and chronic kidney disease among adults in the United States. Sci Rep 2024; 14:21423. [PMID: 39271739 PMCID: PMC11399144 DOI: 10.1038/s41598-024-71894-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Accepted: 09/02/2024] [Indexed: 09/15/2024] Open
Abstract
The objective of this research was to explore the potential association between lipid accumulation product (LAP) and chronic kidney disease (CKD) among adult population of United States (US). Using cross-sectional data from the 2013 to 2018 National Health and Nutrition Examination Survey (NHANES), we explored the association of LAP with CKD, low estimated glomerular filtration rate (eGFR), and albuminuria. This analysis encompassed multivariate logistic regression analyses, smoothed curve fitting, subgroup analyses, and interaction tests. We found a significant positive association between higher ln-transformed LAP (LAP was transformed using a natural logarithm) and the prevalence of CKD, low-eGFR and albuminuria. Notably, this association of ln-transformed LAP with CKD and albuminuria was significantly influenced by diabetes status and sex (P for interaction < 0.05), while no significant interaction was observed regarding the association with low-eGFR (P for interaction > 0.05). Additionally, in model 3 (adjusted for all included covariates except eGFR and urinary albumin-creatinine ratio (UACR)), a nonlinear relationship was identified between ln-transformed LAP and the presence of both CKD and albuminuria, with inflection points of 4.57 and 4.49, respectively. This indicates that this correlation is more pronounced on the right of the inflection point. In conclusion, the findings indicate a significant association between LAP and the prevalence of CKD in US adults.
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Affiliation(s)
- Xinxin Yu
- Department of Nephrology, The Affiliated Huai'an Hospital of Xuzhou Medical University and Huai'an Second People's Hospital, Huai'an, China
- Key Laboratory for Chronic Kidney Disease of Xuzhou Medical University, Xuzhou Medical University, Huai'an, China
- Huai'an Key Laboratory of Chronic Kidney Disease, The Affiliated Huai'an Hospital of Xuzhou Medical University and Huai'an Second People's Hospital, Huai'an, China
| | - Xing Pu
- Department of Nephrology, The Affiliated Huai'an Hospital of Xuzhou Medical University and Huai'an Second People's Hospital, Huai'an, China
- Key Laboratory for Chronic Kidney Disease of Xuzhou Medical University, Xuzhou Medical University, Huai'an, China
- Huai'an Key Laboratory of Chronic Kidney Disease, The Affiliated Huai'an Hospital of Xuzhou Medical University and Huai'an Second People's Hospital, Huai'an, China
| | - Yu Xi
- Department of Nephrology, The Affiliated Huai'an Hospital of Xuzhou Medical University and Huai'an Second People's Hospital, Huai'an, China
- Key Laboratory for Chronic Kidney Disease of Xuzhou Medical University, Xuzhou Medical University, Huai'an, China
- Huai'an Key Laboratory of Chronic Kidney Disease, The Affiliated Huai'an Hospital of Xuzhou Medical University and Huai'an Second People's Hospital, Huai'an, China
| | - Xiang Li
- Department of Nephrology, The Affiliated Huai'an Hospital of Xuzhou Medical University and Huai'an Second People's Hospital, Huai'an, China
- Key Laboratory for Chronic Kidney Disease of Xuzhou Medical University, Xuzhou Medical University, Huai'an, China
- Huai'an Key Laboratory of Chronic Kidney Disease, The Affiliated Huai'an Hospital of Xuzhou Medical University and Huai'an Second People's Hospital, Huai'an, China
| | - Hailun Li
- Department of Nephrology, The Affiliated Huai'an Hospital of Xuzhou Medical University and Huai'an Second People's Hospital, Huai'an, China.
- Key Laboratory for Chronic Kidney Disease of Xuzhou Medical University, Xuzhou Medical University, Huai'an, China.
- Huai'an Key Laboratory of Chronic Kidney Disease, The Affiliated Huai'an Hospital of Xuzhou Medical University and Huai'an Second People's Hospital, Huai'an, China.
| | - Donghui Zheng
- Department of Nephrology, The Affiliated Huai'an Hospital of Xuzhou Medical University and Huai'an Second People's Hospital, Huai'an, China.
- Key Laboratory for Chronic Kidney Disease of Xuzhou Medical University, Xuzhou Medical University, Huai'an, China.
- Huai'an Key Laboratory of Chronic Kidney Disease, The Affiliated Huai'an Hospital of Xuzhou Medical University and Huai'an Second People's Hospital, Huai'an, China.
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Li C, Wang G, Zhang J, Jiang W, Wei S, Wang W, Pang S, Pan C, Sun W. Association between visceral adiposity index and incidence of diabetic kidney disease in adults with diabetes in the United States. Sci Rep 2024; 14:17957. [PMID: 39095646 PMCID: PMC11297263 DOI: 10.1038/s41598-024-69034-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 07/31/2024] [Indexed: 08/04/2024] Open
Abstract
Visceral adiposity index (VAI) is a reliable indicator of visceral adiposity. However, no stu-dies have evaluated the association between VAI and DKD in US adults with diabetes. Theref-ore, this study aimed to explore the relationship between them and whether VAI is a good pr-edictor of DKD in US adults with diabetes. Our cross-sectional study included 2508 participan-ts with diabetes who were eligible for the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. Univariate and multivariate logistic regression were used to an-alyze the association between VAI level and DKD. Three models were used to control for pot-ential confounding factors, and subgroup analysis was performed for further verification. A tot-al of 2508 diabetic patients were enrolled, of whom 945 (37.68%) were diagnosed with DKD. Overall, the VAI was 3.36 ± 0.18 in the DKD group and 2.76 ± 0.11 in the control group. VAI was positively correlated with DKD (OR = 1.050, 95% CI 1.049, 1.050) after fully adjusting for co-nfounding factors. Compared with participants in the lowest tertile of VAI, participants in the highest tertile of VAI had a significantly increased risk of DKD by 35.9% (OR = 1.359, 95% CI 1.355, 1.362). Through subgroup analysis, we found that VAI was positively correlated with the occurrence of DKD in all age subgroups, male(OR = 1.043, 95% CI 1.010, 1.080), participants wit-hout cardiovascular disease(OR = 1.038, 95% CI 1.011, 1.069), hypertension (OR = 1.054, 95% CI 1.021, 1.090), unmarried participants (OR = 1.153, 95% CI 1.036, 1.294), PIR < 1.30(OR = 1.049, 95% CI 1.010, 1.094), PIR ≧ 3 (OR = 1.085, 95% CI 1.021, 1.160), BMI ≧ 30 kg/m2 (OR = 1.050, 95% CI 1.016, 1.091), former smokers (OR = 1.060, 95% CI 1.011, 1.117), never exercised (OR = 1.033, 95% CI 1.004, 1.067), non-Hispanic white population (OR = 1.055, 95% CI 1.010, 1.106) and non-Hipanic black population (OR = 1.129, 95% CI 1.033, 1.258). Our results suggest that elevated VAI levels are closely associated with the development of DKD in diabetic patients. VAI may be a simpl-e and cost-effective index to predict the occurrence of DKD. This needs to be verified in furt-her prospective investigations.
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Affiliation(s)
- Chunyao Li
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Gang Wang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Jiale Zhang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Weimin Jiang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Shuwu Wei
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Wenna Wang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Shuyv Pang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Chenyv Pan
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Weiwei Sun
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
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Wu F, Cui C, Wu J, Wang Y. Association between lipid accumulation product index and chronic kidney disease: A systematic review and meta-analysis. Exp Ther Med 2024; 28:308. [PMID: 38873040 PMCID: PMC11170318 DOI: 10.3892/etm.2024.12597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 05/01/2024] [Indexed: 06/15/2024] Open
Abstract
Diabetes mellitus and lipid metabolism disorders are increasingly recognized as key contributors to the development of chronic kidney disease (CKD). The lipid accumulation product (LAP) index, a novel marker of lipid accumulation, has potential implications for CKD risk assessment. The present meta-analysis aimed to assess the association between LAP index and CKD, with an emphasis on varying impacts in diabetic and non-diabetic populations. A comprehensive search for relevant publications was performed using PubMed/MEDLINE, Scopus, Cochrane Library, ScienceDirect and Google Scholar databases, and a meta-analysis of 17 studies was performed to investigate the relationship between LAP index and CKD. The random-effects inverse-variance model employing the DerSimonian-Laird estimator for τ² was utilized to calculate pooled odds ratios (ORs). Diagnostic accuracy was assessed using summary receiver operating characteristic (ROC) curves, with calculations of the area under the ROC curve (AUROC), sensitivity, specificity, likelihood ratios and diagnostic OR. The pooled OR for the association between higher quintiles or tertiles of LAP index and CKD was 1.098 (95% CI: 1.043-1.152), with substantial heterogeneity (I²=91.2%) and evidence of publication bias. Subgroup analysis revealed a stronger association in non-diabetic (OR=2.422, 95% CI: 1.802-3.042) compared with diabetic patients (OR=1.018, 95% CI: 0.993-1.043). The diagnostic accuracy of LAP index for CKD was moderate (AUROC=0.64), with sensitivity and specificity estimates of 0.58 and 0.63, respectively. In conclusion, in the present study, LAP index demonstrated a modest but significant association with CKD, particularly in non-diabetic patients. Despite its moderate diagnostic accuracy, the LAP index could serve as a valuable tool in CKD risk stratification, particularly when integrated with other clinical markers.
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Affiliation(s)
- Feixiang Wu
- Department of Endocrinology and Nephrology, Hangzhou Linping District Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou, Zhejiang 311199, P.R. China
| | - Chenmin Cui
- Department of Internal Medicine, Huzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Huzhou, Zhejiang 313000, P.R. China
| | - Junping Wu
- Department of Endocrinology and Nephrology, Hangzhou Linping District Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou, Zhejiang 311199, P.R. China
| | - Yunqing Wang
- Department of Endocrinology and Nephrology, Hangzhou Linping District Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou, Zhejiang 311199, P.R. China
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Abdi Dezfouli R, Mohammadian Khonsari N, Hosseinpour A, Asadi S, Ejtahed HS, Qorbani M. Waist to height ratio as a simple tool for predicting mortality: a systematic review and meta-analysis. Int J Obes (Lond) 2023; 47:1286-1301. [PMID: 37770574 DOI: 10.1038/s41366-023-01388-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 09/06/2023] [Accepted: 09/21/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND The association of central obesity with higher rates of mortality is not well studied. This study evaluates the association between waist-to-height ratio (WHtR), as a measure of central obesity, with mortality. METHODS Documents were retrieved from PubMed, Web of Science, Scopus, and Google Scholar databases until May 2022. Data were extracted from cohort studies reporting effect size (hazard ratio (HR)) regarding the association between WHtR as a continuous (per 1 SD increment) or categorical (highest/lowest) measure and all-cause and cause-specific mortality. Screening of included studies was performed independently by two authors. Moreover, the quality assessment of included studies was performed based on the Newcastle-Ottawa assessment scale. Finally, random effect meta-analysis was performed to pool the data, and the outcomes' certainty level was assess based on the GRADE criteria. RESULTS Of the 815 initial studies, 20 were included in the meta-analysis. Random effect meta-analysis showed that in the general population, the all-cause mortality HRs for categorical and continuous measurements of WHtR increased significantly by 23% (HR:1.23; 95% CI: 1.04-1.41) and 16% (HR:1.16; 95% CI: 1.07-1.25), respectively. Moreover, the hazard of cardiovascular (CVD) mortality increased significantly for categorical and continuous measurements of WHtR by 39% (HR:1.39; 95% CI: 1.18-1.59) and 19% (HR:1.19; 95% CI: 1.07-1.31). The quality assessment score of all included studies was high. CONCLUSIONS Higher levels of WHtR, indicating central obesity, were associated with an increased hazard of CVD and all-cause mortality. This measure can be used in the clinical setting as a simple tool for predicting mortality.
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Affiliation(s)
- Ramin Abdi Dezfouli
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ali Hosseinpour
- Non-communicable Diseases Research Center, Alborz University of Medicl Sciences, Karaj, Iran
| | - Sasan Asadi
- Social Determinants of Health Research Center, Alborz University of Medicl Sciences, Karaj, Iran
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mostafa Qorbani
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Non-communicable Diseases Research Center, Alborz University of Medicl Sciences, Karaj, Iran.
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Çakır Biçer N, Ermiş AA, Baş D. The Role of Different Methods in Defining Cardiometabolic Risk and Metabolic Syndrome in Women with Polycystic Ovary Syndrome. Life (Basel) 2023; 13:1959. [PMID: 37895341 PMCID: PMC10608420 DOI: 10.3390/life13101959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/31/2023] [Accepted: 09/02/2023] [Indexed: 10/29/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is one of the most frequent endocrine illnesses, often accompanied by visceral adiposity and metabolic syndrome (MetS). Visceral adiposity is an accurate predictor of MetS and cardiometabolic risk. This study aims to evaluate different anthropometric indices that can be used in PCOS and MetS risk assessment. A total of 66 women with PCOS (50%) and 66 controls (50%) were included, and clinical and biochemical parameters were evaluated. The body mass index (BMI), body shape index (ABSI), body roundness index (BRI), dysfunctional adiposity index (DAI), lipid accumulation (LAP) index, and visceral adiposity index (VAI) were calculated. The means of all indices were higher in the PCOS group (p < 0.05). The marker with the lowest discriminatory ability for PCOS and MetS was ABSI (AUC = 0.762 and AUC = 0.714, respectively, p = 0.000). According to the multivariate logistic regression model, the VAI and WC are strong predictors of PCOS (AUC, 98%; accuracy, 92%; sensitivity, 92%; and specificity, 91%), and WC, LAP index, and BRI are strong predictors of MetS (AUC, 0.95%; accuracy, 86%; sensitivity, 83%; and specificity, 88%). The use of different anthropometric indices in the detection of PCOS and MetS may allow for early diagnosis and treatment, and are simple and cost-effective.
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Affiliation(s)
- Nihan Çakır Biçer
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Acıbadem Mehmet Ali Aydınlar University, Icerenkoy Mah., Kayisdagi Cad. No. 32, 34752 Atasehir, Istanbul, Türkiye;
| | - Asime Aleyna Ermiş
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Acıbadem Mehmet Ali Aydınlar University, Icerenkoy Mah., Kayisdagi Cad. No. 32, 34752 Atasehir, Istanbul, Türkiye;
| | - Dilşat Baş
- Department of Nutrition and Dietetics, Faculty of Health Sciences, İstanbul Galata University, Evliya Çelebi Mah., Meşrutiyet Cad. No. 62, Tepebaşı, 34425 Beyoğlu, Istanbul, Türkiye;
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Shao Q, Li J, Wu Y, Liu X, Wang N, Jiang Y, Zhao Q, Zhao G. Enhanced Predictive Value of Lipid Accumulation Product for Identifying Metabolic Syndrome in the General Population of China. Nutrients 2023; 15:3168. [PMID: 37513586 PMCID: PMC10383986 DOI: 10.3390/nu15143168] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/15/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023] Open
Abstract
The purpose of this research was to evaluate the lipid accumulation product (LAP)'s accuracy and predictive value for identifying metabolic syndrome (MS) in the general Chinese population compared with other obesity indicators. Baseline survey information from a population-based cohort study carried out in Shanghai's Songjiang District was used in this research. Odds ratios (OR) and a 95% confidence interval (CI) were obtained by logistic regression. The ability of each variable to detect MS was assessed using the receiver operating characteristic curve (ROC). The optimum cut-off point for each indicator was selected using Youden's index. The survey involved 35,446 participants in total. In both genders, the prevalence of MS rose as the LAP increased (p < 0.001). The LAP's AUC was 0.901 (95%CI: 0.895-0.906) in males and 0.898 (95%CI: 0.893-0.902) in females, making it substantially more predictive of MS than other variables (BMI, WC, WHR, WHtR). The optimal cutoff point of the LAP for men and women was 36.04 (Se: 81.91%, Sp: 81.06%) and 34.95 (Se: 80.93%, Sp: 83.04%). The Youden index of the LAP was 0.64 for both sexes. Our findings imply that the LAP, compared to other obesity markers in China, is a more accurate predictor of MS.
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Affiliation(s)
- Qi Shao
- Key Laboratory of Public Health Safety of Ministry of Education, Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China; (Q.S.); (X.L.); (N.W.); (G.Z.)
| | - Jing Li
- Zhongshan Community Health Center, Shanghai 201613, China;
| | - Yiling Wu
- Songjiang District Center for Disease Control and Prevention, Shanghai 201600, China; (Y.W.); (Y.J.)
| | - Xing Liu
- Key Laboratory of Public Health Safety of Ministry of Education, Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China; (Q.S.); (X.L.); (N.W.); (G.Z.)
| | - Na Wang
- Key Laboratory of Public Health Safety of Ministry of Education, Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China; (Q.S.); (X.L.); (N.W.); (G.Z.)
| | - Yonggen Jiang
- Songjiang District Center for Disease Control and Prevention, Shanghai 201600, China; (Y.W.); (Y.J.)
| | - Qi Zhao
- NHC Key Laboratory of Health Technology Assessment, Department of Social Medicine, School of Public Health, Fudan University, Shanghai 200032, China
| | - Genming Zhao
- Key Laboratory of Public Health Safety of Ministry of Education, Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China; (Q.S.); (X.L.); (N.W.); (G.Z.)
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Nabipoorashrafi SA, Adeli A, Seyedi SA, Rabizadeh S, Arabzadeh Bahri R, Mohammadi F, Yadegar A, Nakhjavani M, Esteghamati A. Comparison of insulin resistance indices in predicting albuminuria among patients with type 2 diabetes. Eur J Med Res 2023; 28:166. [PMID: 37161502 PMCID: PMC10170852 DOI: 10.1186/s40001-023-01134-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/05/2023] [Indexed: 05/11/2023] Open
Abstract
PURPOSE Diabetes is the leading cause of kidney disease. Up to 40% of the population with diabetes experience diabetic kidney disease (DKD). The correlation of DKD with insulin resistance (IR) indices has been shown in previous studies. In this study, the objective was to evaluate surrogate IR indices, including the Triglyceride-Glucose (TyG) index, Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP), and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) to find the most valuable index for the correlation between albuminuria and IR in the type 2 diabetes (T2D) population. Albuminuria is defined as urine albumin excretion of > 30 mg/day. METHODS In this cross-sectional study, 2934 participants were enrolled and evaluated for urinary albumin excretion, and albuminuria was detected in 526 of the entries. The logistic regression models and Receiver Operating Characteristic (ROC) curve analysis were performed to assess the relationship of TyG index, VAI, LAP, and HOMA-IR's with albuminuria in patients with T2D. RESULTS The TyG index had the highest association (OR 1.67) with the presence of albuminuria in patients with T2D, followed by HOMA-IR (OR 1.127), VAI (OR 1.028), and LAP (OR 1.004). These four indices remained independent after adjustment for multiple confounders. Based on the ROC curve, TyG revealed the best area under the curve (AUC) for revealing albuminuria with sufficient accuracy (AUC: 0.62) in comparison with other measured indices. The calculated TyG index cut-off point for the presence of albuminuria was 9.39. CONCLUSION Among the indices, TyG index had the most significant correlation with albuminuria in patients with T2D.
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Affiliation(s)
- Seyed Ali Nabipoorashrafi
- Endocrinology and Metabolism Research Center (EMRC), School of Medicine, Vali-Asr Hospital, P.O.Box 13145784, Tehran, Iran
| | - Azam Adeli
- Endocrinology and Metabolism Research Center (EMRC), School of Medicine, Vali-Asr Hospital, P.O.Box 13145784, Tehran, Iran
| | - Seyed Arsalan Seyedi
- Endocrinology and Metabolism Research Center (EMRC), School of Medicine, Vali-Asr Hospital, P.O.Box 13145784, Tehran, Iran
| | - Soghra Rabizadeh
- Endocrinology and Metabolism Research Center (EMRC), School of Medicine, Vali-Asr Hospital, P.O.Box 13145784, Tehran, Iran
| | - Razman Arabzadeh Bahri
- Endocrinology and Metabolism Research Center (EMRC), School of Medicine, Vali-Asr Hospital, P.O.Box 13145784, Tehran, Iran
| | - Fatemeh Mohammadi
- Endocrinology and Metabolism Research Center (EMRC), School of Medicine, Vali-Asr Hospital, P.O.Box 13145784, Tehran, Iran
| | - Amirhossein Yadegar
- Endocrinology and Metabolism Research Center (EMRC), School of Medicine, Vali-Asr Hospital, P.O.Box 13145784, Tehran, Iran
| | - Manouchehr Nakhjavani
- Endocrinology and Metabolism Research Center (EMRC), School of Medicine, Vali-Asr Hospital, P.O.Box 13145784, Tehran, Iran
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), School of Medicine, Vali-Asr Hospital, P.O.Box 13145784, Tehran, Iran.
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Qin Z, Chen X, Sun J, Jiang L. The association between visceral adiposity index and decreased renal function: A population-based study. Front Nutr 2023; 10:1076301. [PMID: 36969806 PMCID: PMC10036366 DOI: 10.3389/fnut.2023.1076301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 02/27/2023] [Indexed: 03/12/2023] Open
Abstract
AimsWe aimed to investigate the association of visceral adiposity index (VAI) with decreased renal function in US adults.Design and methodsCross-sectional data were analyzed for 35,018 adults in the National Health and Nutrition Examination Survey (NHANES) 2005–2018. VAI was determined using waist circumference, body mass index (BMI), triglycerides (TGs) and high-density lipoprotein-cholesterol. Albuminuria was defined as urinary albumin-to-creatinine ratio (ACR) >30 mg/g. A low estimated-glomerular filtration rate (eGFR) was defined as an eGFR lower than 60 ml/min/1.73 m2. Chronic kidney disease (CKD) was defined as either albuminuria or low-eGFR. A multivariable logistic regression analysis was utilized to explore the relationship of VAI with albuminuria, low-eGFR and CKD. Subgroup analysis and interaction tests were also conducted.ResultsA total of 35,018 participants were enrolled with albuminuria, low-eGFR, and CKD prevalence rates of 5.18, 6.42, and 10.62%, respectively, which increased with the higher VAI tertiles. After full adjustment, a positive association of VAI with albuminuria (OR = 1.03, 95% CI: 1.00, 1.06) and CKD (OR = 1.04, 95% CI: 1.02, 1.06) was observed. Participants in the highest VAI tertile had a significantly 30% increased risk for albuminuria (OR = 1.30, 95% CI: 1.07, 1.58) and a 27% increased risk for CKD (OR = 1.27, 95% CI: 1.08, 1.49) compared with those in the lowest VAI tertile. No statistically significant association between VAI and low-eGFR was detected. Subgroup analysis and the interaction term indicated that there was no significant difference among different stratifications.ConclusionVisceral adiposity accumulation evaluating by VAI was associated with increased likelihood of the decline in renal function.
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Affiliation(s)
- Zheng Qin
- West China School of Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Xinyang Chen
- West China School of Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Jiantong Sun
- West China School of Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Luojia Jiang
- Department of Nephrology, Jiujiang No.1 People’s Hospital, Jiujiang, China
- *Correspondence: Luojia Jiang,
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Amouzegar A, Honarvar M, Masoumi S, Tohidi M, Mehran L, Azizi F. Sex-specific trajectories of insulin resistance markers and reduced renal function during 18 years of follow-up; TLGS. J Clin Endocrinol Metab 2022; 108:e230-e239. [PMID: 36546593 DOI: 10.1210/clinem/dgac735] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/07/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To investigate the association between the dynamic course of insulin resistance and chronic kidney disease (CKD). METHODS In a longitudinal population-based Tehran Lipid and Glucose Study, 3071 eligible participants aged ≥20 years were followed for 18 years at three-year intervals. HOMA-IR and clinical surrogate markers of insulin resistance, including triglyceride-glucose index (TyG), visceral adiposity index (VAI), and lipid accumulation product (LAP), were calculated. Using latent variable mixture modeling, sex-specific trajectories were plotted for each insulin resistance marker. Trajectory group association of the insulin resistance markers with CKD was determined using the multivariate cox proportional hazards regression model. RESULTS For HOMA-IR, two distinct trajectory patterns (stable and increasing), and for TyG, VAI, and LAP, three trajectories (low, moderate, high) were identified. The participants with increasing HOMA-IR trajectory had a significantly increased risk of CKD in men (HR: 1.72, 95%CI: 1.06-2.79) and women (HR: 1.37, 95%CI: 1.00-1.89) after adjusting confounding variables. The high TyG and VAI trajectory classes were associated with a higher risk of CKD than the low TyG and VAI trajectory classes in both men (TyG: HR:1.97, 95%CI: 1.12-3.46; VAI: HR:1.66, 95%CI:1.06-2.62) and women (TyG: HR:1.50, 95%CI:1.06-2.12; VAI: HR:1.66, 95%CI:1.20-2.31). In contrast, the High LAP (HR: 3.38, 95%CI: 2.08-5.48) trajectory was associated with incident CKD only in women. CONCLUSION An increasing trend of HOMA-IR is associated with a higher risk of CKD in men and women. Among clinical insulin resistance surrogate markers, abnormal trajectory patterns of LAP in women and TyG and VAI in both sexes are associated with a higher risk of CKD.
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Affiliation(s)
- Atieh Amouzegar
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, I.R.Iran
| | - Mohammadjavad Honarvar
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, I.R.Iran
| | - Safdar Masoumi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, I.R.Iran
| | - Maryam Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, I.R.Iran
| | - Ladan Mehran
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, I.R.Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, I.R.Iran
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Bullen AL, Katz R, Kumar U, Gutierrez OM, Sarnak MJ, Kramer HJ, Shlipak MG, Ix JH, Judd SE, Cushman M, Garimella PS. Lipid accumulation product, visceral adiposity index and risk of chronic kidney disease. BMC Nephrol 2022; 23:401. [PMID: 36522626 PMCID: PMC9753382 DOI: 10.1186/s12882-022-03026-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/30/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Lipid accumulation product (LAP) and visceral adiposity index (VAI) are novel, non-imaging markers of visceral adiposity that are calculated by using body mass index (BMI), waist circumference (WC) and serum lipid concentrations. We hypothesized that LAP and VAI are more strongly associated with adverse kidney outcomes than BMI and WC. METHODS Using data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, we used multivariable logistic regression to evaluate associations of LAP, VAI, BMI and WC with incident chronic kidney disease (CKD), (incident eGFR < 60 ml/min/1.73m2 and > 25% decline). RESULTS Among the overall cohort of 27,550 participants, the mean baseline age was 65 years; 54% were women; and 41% were African American. After a median of 9.4 years (IQR 8.6, 9.9) of follow-up, a total of 1127 cases of incident CKD were observed. Each two-fold higher value of VAI (OR 1.12, 95% CI 1.04, 1.20), LAP (OR 1.21, 95% CI 1.13, 1.29), WC (OR 2.10, 95% CI 1.60, 2.76) and BMI (OR: 2.66, 95% CI 1.88, 3.77), was associated with greater odds of incident CKD. CONCLUSIONS LAP and VAI as measures of visceral adiposity are associated with higher odds of incident CKD but may not provide information beyond WC and BMI.
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Affiliation(s)
- Alexander L Bullen
- Nephrology Section, Veterans Affairs San Diego Healthcare System, La Jolla, CA, USA.
- Division of Nephrology & Hypertension, University of California San Diego, 200 W Arbor Dr.. M/C 8409 MPF L030, San Diego, CA, 92103, USA.
| | - Ronit Katz
- Division of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - Ujjala Kumar
- Division of Nephrology & Hypertension, University of California San Diego, 200 W Arbor Dr.. M/C 8409 MPF L030, San Diego, CA, 92103, USA
| | - Orlando M Gutierrez
- Division of Nephrology, UAB Heersink School of Medicine, Birmingham, AL, USA
| | - Mark J Sarnak
- Division of Nephrology, Tufts Medical Center, Boston, MA, USA
| | - Holly J Kramer
- Division of Nephrology and Hypertension, Loyola University Medical Center, Maywood, IL, USA
| | - Michael G Shlipak
- Kidney Health Research Collaborative, Department of Medicine, University of California, San Francisco, CA, USA
- Department of Medicine, San Francisco VA Medical Center, San Francisco, CA, USA
| | - Joachim H Ix
- Nephrology Section, Veterans Affairs San Diego Healthcare System, La Jolla, CA, USA
- Division of Nephrology & Hypertension, University of California San Diego, 200 W Arbor Dr.. M/C 8409 MPF L030, San Diego, CA, 92103, USA
| | - Suzanne E Judd
- Department of Biostatistics, UAB School of Public Health, Birmingham, AL, USA
| | - Mary Cushman
- Division of Hematology and Oncology, University of Vermont, Colchester, VT, USA
| | - Pranav S Garimella
- Division of Nephrology & Hypertension, University of California San Diego, 200 W Arbor Dr.. M/C 8409 MPF L030, San Diego, CA, 92103, USA
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Shu L, Zhao Y, Shen Y, Jia L, Zhang J. Interaction analysis of lipid accumulation product and family history of diabetes on impaired fasting glucose and diabetes risk in population with normotension in Eastern China: a community-based cross-sectional survey. Arch Public Health 2022; 80:217. [PMID: 36183132 PMCID: PMC9526958 DOI: 10.1186/s13690-022-00972-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 09/23/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Lipid accumulation product (LAP) is considered to be a new convenient useful indicator to assess the visceral fat. Therefore, we aimed to evaluate the risk factors of impaired fasting glucose (IFG) and diabetes, and explore the possible interacting influences of LAP with other factors on the risk of IFG and diabetes among Chinese normotension adults. METHODS A multistage stratified cluster sampling method was conducted to select urban residents in Bengbu, China. For each eligible participant, data on questionnaire survey, anthropometric measurements and laboratory tests were obtained. The effects of body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR) and LAP for predicting IFG and diabetes were performed by multiple logistic regressions and receiver operating characteristic (ROC) analyses. The interaction effects were evaluated by relative excess risk of interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI). RESULTS Six thousand, four hundred sixty-seven normotension subjects (2695 men and 3772 women) were enrolled in our study, the prevalence of IFG and diabetes were 9.37% and 14.33%, respectively. When assessed using ROC curve analysis, LAP exhibited higher diagnostic accuracy for identifying IFG and diabetes than BMI, the area under the AUC curve was 0.650 (95% CI: 0.637 to 0.662). After adjustment for age, sex, educational level and other confounding factors, multivariate logistic regression analyses indicated that subjects with the fourth quartile of LAP were more likely to develop IFG (adjusted OR: 2.735, 95% CI: 1.794-4.170) and diabetes (adjusted OR: 1.815, 95% CI: 1.297-2.541) than those with the first quartile. A significant interaction between LAP and family history of diabetes was observed in participants (RERI = 1.538, 95%CI: 0.167 to 3.612; AP = 0.375, 95%CI: 0.118 to 0.631; SI = 1.980, 95%CI: 1.206 to 3.251). However, a significant interaction between LAP and abdominal obesity was indicated by the value of RERI (1.492, 95%CI: 0.087 to 3.723) and AP (0.413, 95%CI: 0.014 to 0.756), but not the value of SI (1.824, 95%CI: 0.873 to 3.526). CONCLUSION Our results demonstrated that there might be synergistic effect between LAP and family history of diabetes on the risk of IFG and diabetes.
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Affiliation(s)
- Li Shu
- grid.252957.e0000 0001 1484 5512School of Public Health, Bengbu Medical College, Bengbu, Anhui Province China
| | | | - Yanqi Shen
- grid.252957.e0000 0001 1484 5512School of Public Health, Bengbu Medical College, Bengbu, Anhui Province China
| | - Linlin Jia
- grid.252957.e0000 0001 1484 5512School of Public Health, Bengbu Medical College, Bengbu, Anhui Province China
| | - Jiaye Zhang
- grid.252957.e0000 0001 1484 5512School of Public Health, Bengbu Medical College, Bengbu, Anhui Province China
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Kuma A, Kato A. Lifestyle-Related Risk Factors for the Incidence and Progression of Chronic Kidney Disease in the Healthy Young and Middle-Aged Population. Nutrients 2022; 14:nu14183787. [PMID: 36145162 PMCID: PMC9506421 DOI: 10.3390/nu14183787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/10/2022] [Accepted: 09/11/2022] [Indexed: 11/16/2022] Open
Abstract
The prevalence of chronic kidney disease (CKD) increased by 88% from 1990 to 2016. Age of onset of lifestyle-related diseases (such as hypertension, diabetes mellitus, obesity, dyslipidemia, and hyperuricemia), which are risk factors for incident CKD, is lower now compared with the past. Thus, we aimed to evaluate the risk factors for the incidence and progression of CKD in the young and middle-aged population. There are differences in the risk for CKD among the young, middle-aged, and elderly populations. We aimed to assess obesity (which is basic component of metabolic syndrome), waist circumference, and abdominal adiposity, which are predictive factors of CKD in the younger population. Furthermore, we described the management and clinical evidence of hypertension, diabetes mellitus, dyslipidemia, and hyperuricemia for young and middle-aged patients, along with diet management and nutrients associated with kidney function. Kidney function in the young and middle-aged population is mostly normal, and they are considered a low-risk group for incident CKD. Thus, we expect this review to be useful in reducing the prevalence of CKD.
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Affiliation(s)
- Akihiro Kuma
- Kidney Center, Hospital of the University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8556, Fukuoka, Japan
| | - Akihiko Kato
- Blood Purification Unit, Hamamatsu University Hospital, 1-20-1 Handayama, Higashi-ku, Hamamatsu 431-3125, Shizuoka, Japan
- Correspondence:
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do Nascimento RA, Vieira MCA, Fernandes J, Azevedo IG, Moreira MA, Costa JV, da Câmara SMA, Maciel ÁCC. Exploring the relationships between anthropometric indices of adiposity and physical performance in middle-aged and older Brazilian women: a canonical correlation analysis. Epidemiol Health 2022; 44:e2022074. [PMID: 36108670 PMCID: PMC9943635 DOI: 10.4178/epih.e2022074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 09/13/2022] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES This study analyzed the influence of anthropometric indices of adiposity on the physical performance of middle-aged and older women. METHODS A cross-sectional study was conducted among 368 women from 50 years to 80 years old. Anthropometric and biochemical characteristics were analyzed, and physical performance was evaluated. The statistical analysis used measures of central tendency and dispersion for descriptive data, Pearson correlations to demonstrate the initial associations between the variables, and canonical correlation (CC) to evaluate the relationship between the set of anthropometric adiposity indices and performance-related variables. RESULTS The participants had a mean age of 58.57±8.21 years, a visceral adiposity index of 7.09±4.23, a body mass index of 29.20±4.94 kg/m2, and a conicity index of 1.33±0.07. The average handgrip strength was 25.06±4.89 kgf, gait speed was 1.07±0.23 m/s, and the mean Short Physical Performance Battery (SPPB) score was 10.83±1.36. The first canonical function presented the highest shared variance, CC, and redundancy index (cumulative percentage of variance, 82.52; Wilks' lambda, 0.66; CC, 0.532; p<0.001). From the analysis of this canonical function, the conicity index (-0.59) displayed inverse correlations with handgrip strength (0.84) and the SPPB (0.68), as well as a direct correlation with gait speed (-0.43). CONCLUSIONS In middle-aged and older women, there was an inverse relationship between the conicity index and muscle strength and power, while a direct relationship was found between the same index and gait speed.
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Affiliation(s)
| | | | - Juliana Fernandes
- Physiotherapy and Collective Health Laboratory, Physiotherapy Department, Federal University of Pernambuco, Recife, Brazil
| | - Ingrid Guerra Azevedo
- Departamento de Procesos Terapeuticos, Universidad Católica de Temuco, Temuco, Brazil,Correspondence: Ingrid Guerra Azevedo Departamento de Procesos Terapeuticos, Universidad Católica de Temuco, Manuel Montt 56 Campus San Francisco, Temuco 4813302, Chile E-mail:
| | | | - José Vilton Costa
- Department of Demography and Actuarial Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
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Choumessi AT, Saha BUF, Navti LK, Tibi AS, Njeck AT, Nantia EA. Assessment of visceral adiposity index and lipid accumulation product index as markers of chronic kidney disease among diabetic and hypertensive patients at the Bamenda Regional Hospital, Cameroon: a cross-sectional study. Pan Afr Med J 2022; 42:228. [PMID: 36845245 PMCID: PMC9949295 DOI: 10.11604/pamj.2022.42.228.33499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 07/10/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction very limited studies have emphasized the importance of visceral adiposity index (VAI) and lipid accumulation product index (LAPI) in the prevention and management of chronic kidney disease (CKD) especially in diabetic and hypertension patients in developing countries including Cameroon. This study aimed at assessing whether VAI and LAPI are markers of CKD among diabetic and hypertensive patients at the Bamenda Regional Hospital, Cameroon. Methods this analytical cross-sectional study was conducted at Bamenda Regional Hospital and involved 200 diabetic and/or hypertensive patients, including 77 males and 123 females. The participant´s anthropometric indices, biochemical parameters, VAI, LAPI, and glomerular filtration rate were investigated. A structured questionnaire was used to assess some risk factors of CKD and participant lifestyle. Results the overweight (41%) and obesity (34%) statuses were prevalent in the population. A considerable proportion of subjects had elevated total cholesterol (46%), low-density lipoprotein (LDL) cholesterol (37.50%), triglycerides (24.5%), urea (40.5%) and creatinine (53.5%) levels. Stage 1 to 3 CKD was largely present in the elderly (>54-year-old) affecting the majority of patients (57.5%). Low education level and lack of physical activity were significantly associated with the prevalence of CKD (p < 0.001). On the contrary to creatinine (unadjusted OR = 1.36; 95% CI: 1.13-1.62), urea (unadjusted OR = 1.02; 95% CI: 1.01-1.03), HDL (unadjusted OR = 0.87; 95% CI: 0.78-0.97), total cholesterol/HDL ratio (unadjusted OR = 1.38; 95% CI; 1.12-1.71), VAI (unadjusted OR = 1.13; 95% CI: 1.05-1.22) and LAPI (unadjusted OR = 1.00; 95% CI: 1.00-1.00) were significantly associated with CKD status of the patients while HDL was negatively associated (unadjusted OR = 0.87; 95% CI: 0.78-0.97). The 9.905 and 5679 cut-offs of VAI and LAPI respectively for CKD discrimination obtained high sensitivity (75.0%) and specificity (≥79.6%). Conclusion visceral adiposity index and LAPI were associated with CKD among diabetic and hypertensive patients. Visceral adiposity index and LAPI could be user-friendly tools for the early diagnosis of CKD among these categories of patients in Cameroon.
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Affiliation(s)
| | | | - Lifoter Kenneth Navti
- Department of Biochemistry, Faculty of Science, University of Bamenda, Bambili, Cameroon
| | - Ateh Sheron Tibi
- Department of Biochemistry, Faculty of Science, University of Bamenda, Bambili, Cameroon
| | - Anweck Thecla Njeck
- Department of Biochemistry, Faculty of Science, University of Bamenda, Bambili, Cameroon
| | - Edouard Akono Nantia
- Department of Biochemistry, Faculty of Science, University of Bamenda, Bambili, Cameroon,Corresponding author: Edouard Akono Nantia, Department of Biochemistry, Faculty of Science, University of Bamenda, Bambili, Cameroon.
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Zheng X, Han L, Shen S, Wu W. Association between visceral adiposity index and chronic kidney disease: Evidence from the China Health and Retirement Longitudinal Study. Nutr Metab Cardiovasc Dis 2022; 32:1437-1444. [PMID: 35422360 DOI: 10.1016/j.numecd.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/26/2022] [Accepted: 03/09/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS The association between visceral adiposity index (VAI) and chronic kidney disease (CKD) remains debatable. We aimed to prospectively investigate the relationship between VAI and CKD. METHODS AND RESULTS A total of 8808 participants from the China Health and Retirement Longitudinal Study were included. Males and females were divided into four groups according to gender-specific quartiles of VAI scores. CKD was based on self-reported physicians' diagnosis or personal eGFR level. A logistic regression model was established to analyze the correlation between VAI and CKD. A meta-analysis was conducted to incorporate the results of the current study and previous studies on the association of VAI with CKD. During 7 years of follow-up, a total of 826 participants (9.38%) experienced CKD. In multivariable-adjusted analyses, the adjusted odds ratios (95% confidence intervals) for the highest versus lowest quartile of VAI was 1.33 (1.03-1.77) for male, and 1.10 (0.81-1.48) for female, respectively. The meta-analysis found the significant associations between VAI and CKD in total, male and female participants (pooled relative risk for highest vs lowest VAI quartile were 2.24(1.70-2.95), 2.36(1.54-3.61) and 2.57 (1.57-4.22), respectively). CONCLUSIONS Higher VAI score was associated with increased risk of CKD, independently of established risk factors. The VAI may be a predictor of incident CKD, but only among male participants based on present study.
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Affiliation(s)
- Xiaowei Zheng
- Department of Public Health and Preventive Medicine, Wuxi School of Medicine Jiangnan University, Wuxi, Jiangsu, 214122, China.
| | - Longyang Han
- Department of Public Health and Preventive Medicine, Wuxi School of Medicine Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Suwen Shen
- Wuxi Municipal Center for Disease Control and Prevention, Wuxi, Jiangsu, 214023, China
| | - Wenyan Wu
- Institutes of Biology and Medical Sciences, Soochow University, Suzhou, Jiangsu, 215000, China
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Lei L, Dai L, Zhang Q, Lu J, Tang Y, Xiao M, Li G, Yan S, Li X, Chen Y, Chen Y, Li Y, An S, Xiu J. The Association Between Visceral Adiposity Index and Worsening Renal Function in the Elderly. Front Nutr 2022; 9:861801. [PMID: 35399655 PMCID: PMC8987107 DOI: 10.3389/fnut.2022.861801] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 02/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background Visceral adiposity index (VAI) is an indicator of visceral fat accumulation and dysfunction. However, little is known about whether VAI is associated with worsening renal function (WRF) in the elderly. Therefore, our study aimed to explore the association between VAI and WRF among the elderly population. Methods In total, 5,583 elderly participants (aged ≥ 65 years) who participated in the annual health checkups at least twice between January 2017 and July 2021 were enrolled and divided into four groups according to the VAI quartiles. The primary endpoint was incident chronic kidney disease (CKD), defined as incident estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2. The secondary endpoint was rapid kidney function decline (RKFD), defined as decline in eGFR of 40%. To evaluate the association between VAI and WRF, three Cox regression models were conducted, where VAI was treated as a continuous variable and a categorical variable (Q1 as reference), respectively. Subgroup analysis in participants with different baseline characteristics was also performed. Results During a median of 2.46 year follow-up, 931 (16.68%) participants developed CKD. After fully adjusting for confounding factors, VAI was significantly associated with incident CKD (HR, 1.052; 95% CI: 1.029–1.076, p < 0.001), and RKFD (HR, 1.077; 95% CI: 1.041–1.114, p < 0.001). Moreover, compared to those with the lowest VAI quartiles, subjects with the highest quartiles had a higher risk of incident CKD (HR, 1.286; 95% CI: 1.033–1.601, p = 0.024), and RKFD (HR, 1.895; 95% CI: 1.086–3.307, p = 0.025). The risk of incident CKD also tended to increase with elevated VAI quartiles (all p-values for trend <0.05). This positive association remained consistent among participants with different genders, baseline weights, or kidney functions. Conclusion In our study, elevated VAI was associated with increased risk of incident CKD and RKFD in the elderly population.
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Affiliation(s)
- Li Lei
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Lei Dai
- Department of Cardiology, Zengcheng Branch of Nanfang Hospital, Guangzhou, China
| | - Qiuxia Zhang
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Junyan Lu
- Department of Cardiology, Zengcheng Branch of Nanfang Hospital, Guangzhou, China
| | - Yongzhen Tang
- Department of Cardiology, Zengcheng Branch of Nanfang Hospital, Guangzhou, China
| | - Min Xiao
- Department of Cardiology, Zengcheng Branch of Nanfang Hospital, Guangzhou, China
| | - Guodong Li
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shaohua Yan
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaobo Li
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yejia Chen
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yaode Chen
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yun Li
- Department of Public Health Management, Zengcheng Xintang Hospital, Guangzhou, China
| | - Shengli An
- Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Jiancheng Xiu
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Department of Cardiology, Zengcheng Branch of Nanfang Hospital, Guangzhou, China
- *Correspondence: Jiancheng Xiu,
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Li H, Wang Q, Ke J, Lin W, Luo Y, Yao J, Zhang W, Zhang L, Duan S, Dong Z, Chen X. Optimal Obesity- and Lipid-Related Indices for Predicting Metabolic Syndrome in Chronic Kidney Disease Patients with and without Type 2 Diabetes Mellitus in China. Nutrients 2022; 14:nu14071334. [PMID: 35405947 PMCID: PMC9002364 DOI: 10.3390/nu14071334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/16/2022] [Accepted: 03/20/2022] [Indexed: 12/10/2022] Open
Abstract
Existing obesity- and lipid-related indices are inconsistent with metabolic syndrome (MetS) in chronic kidney disease (CKD) patients. We compared seven indicators, including waist circumference (WC), body mass index (BMI), visceral fat area (VFA), subcutaneous fat area (SFA), visceral adiposity index (VAI), Chinese VAI and lipid accumulation product (LAP), to evaluate their ability to predict MetS in CKD patients with and without Type 2 diabetes mellitus (T2DM) under various criteria. Multivariate logistic regression analysis was used to investigate the independent associations between the indices and metabolic syndrome among 547 non-dialysis CKD patients, aged ≥18 years. The predictive power of these indices was assessed using receiver operating characteristic (ROC) curve analysis. After adjusting for potential confounders, the correlation between VAI and MetS was strongest based on the optimal cut-off value of 1.51 (sensitivity 86.84%, specificity 91.18%) and 2.35 (sensitivity 83.54%, specificity 86.08%), with OR values of 40.585 (8.683–189.695) and 5.076 (1.247–20.657) for males and females with CKD and T2DM. In CKD patients without T2DM, based on the optimal cut-off values of 1.806 (sensitivity 98.11%, specificity 72.73%) and 3.11 (sensitivity 84.62%, specificity 83.82%), the OR values were 7.514 (3.757–15.027) and 3.008 (1.789–5.056) for males and females, respectively. The area under ROC curve (AUC) and Youden index of VAI were the highest among the seven indexes, indicating its superiority in predicting MetS in both male and female CKD patients, especially those with T2DM.
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Affiliation(s)
- Hangtian Li
- National Clinical Research Center for Kidney Diseases, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People’s Liberation Army, Beijing 100853, China; (H.L.); (Q.W.); (J.K.); (W.L.); (Y.L.); (J.Y.); (W.Z.); (L.Z.); (S.D.)
- School of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Qian Wang
- National Clinical Research Center for Kidney Diseases, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People’s Liberation Army, Beijing 100853, China; (H.L.); (Q.W.); (J.K.); (W.L.); (Y.L.); (J.Y.); (W.Z.); (L.Z.); (S.D.)
| | - Jianghua Ke
- National Clinical Research Center for Kidney Diseases, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People’s Liberation Army, Beijing 100853, China; (H.L.); (Q.W.); (J.K.); (W.L.); (Y.L.); (J.Y.); (W.Z.); (L.Z.); (S.D.)
- School of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Wenwen Lin
- National Clinical Research Center for Kidney Diseases, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People’s Liberation Army, Beijing 100853, China; (H.L.); (Q.W.); (J.K.); (W.L.); (Y.L.); (J.Y.); (W.Z.); (L.Z.); (S.D.)
- School of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Yayong Luo
- National Clinical Research Center for Kidney Diseases, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People’s Liberation Army, Beijing 100853, China; (H.L.); (Q.W.); (J.K.); (W.L.); (Y.L.); (J.Y.); (W.Z.); (L.Z.); (S.D.)
- School of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Jin Yao
- National Clinical Research Center for Kidney Diseases, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People’s Liberation Army, Beijing 100853, China; (H.L.); (Q.W.); (J.K.); (W.L.); (Y.L.); (J.Y.); (W.Z.); (L.Z.); (S.D.)
- School of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Weiguang Zhang
- National Clinical Research Center for Kidney Diseases, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People’s Liberation Army, Beijing 100853, China; (H.L.); (Q.W.); (J.K.); (W.L.); (Y.L.); (J.Y.); (W.Z.); (L.Z.); (S.D.)
| | - Li Zhang
- National Clinical Research Center for Kidney Diseases, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People’s Liberation Army, Beijing 100853, China; (H.L.); (Q.W.); (J.K.); (W.L.); (Y.L.); (J.Y.); (W.Z.); (L.Z.); (S.D.)
| | - Shuwei Duan
- National Clinical Research Center for Kidney Diseases, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People’s Liberation Army, Beijing 100853, China; (H.L.); (Q.W.); (J.K.); (W.L.); (Y.L.); (J.Y.); (W.Z.); (L.Z.); (S.D.)
| | - Zheyi Dong
- National Clinical Research Center for Kidney Diseases, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People’s Liberation Army, Beijing 100853, China; (H.L.); (Q.W.); (J.K.); (W.L.); (Y.L.); (J.Y.); (W.Z.); (L.Z.); (S.D.)
- Correspondence: (Z.D.); (X.C.)
| | - Xiangmei Chen
- National Clinical Research Center for Kidney Diseases, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People’s Liberation Army, Beijing 100853, China; (H.L.); (Q.W.); (J.K.); (W.L.); (Y.L.); (J.Y.); (W.Z.); (L.Z.); (S.D.)
- School of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
- Correspondence: (Z.D.); (X.C.)
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20
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Shi Y, Hu L, Li M, Zhou W, Wang T, Zhu L, Bao H, Cheng X, Li P. Association Between the Surrogate Markers of Insulin Resistance and Chronic Kidney Disease in Chinese Hypertensive Patients. Front Med (Lausanne) 2022; 9:831648. [PMID: 35198578 PMCID: PMC8859105 DOI: 10.3389/fmed.2022.831648] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 01/05/2022] [Indexed: 12/21/2022] Open
Abstract
BackgroundWe aim to evaluate the four surrogate markers of insulin resistance (IR), including triglyceride-glucose index (TyG), lipid accumulation product index (LAP), visceral adiposity index (VAI), triglycerides to high-density lipoprotein cholesterol ratio (TG/HDL), on prevalence of chronic kidney disease (CKD) and to examine any possible effect modifiers in Chinese hypertensive patients.MethodsA total of 13,055 hypertensive participants were included in this cross-sectional study. In addition, average age of the study population was 63.81 ± 9.46 years, and 47.66% of them are men. The primary outcome was CKD, defined as eGFR <60 ml/min/1.73 m2. Multivariate logistic regression analysis and the generalized additive model and a fitted smoothing curve (penalized spline method) were used to examine the association between the surrogate markers of IR and CKD.ResultsFour surrogate markers of IR were independently and positively associated with CKD in a dose-response fashion. The association between four surrogate markers of IR and the prevalence of CKD was examined as a continuous variable per one unit increment and also as a categorical variable using tertiles with the tertiles (T1) as the reference group. In the fully adjusted model, multivariate logistic analyses showed that the per one unit increments of the TyG, LAP, VAI, and TG/HDL ratios were all significantly associated with 42, 31, 67, and 78% higher risk for CKD, respectively. Consistently, the adjusted ORs (95% CI) for CKD were 1.48 (1.21, 1.81), 1.34 (1.06, 1.69), 1.26 (1.03, 1.53), 1.35 (1.12, 1.63) when comparing the highest tertile to the lowest tertile of the TyG, LAP, VAI, and TG/HDL ratios, respectively. The stratification analysis showed that a significant positive correlation between TyG, VAI, and TG/HDL and CKD in patients over 65 years old.ConclusionFour surrogate markers of IR were independently and positively correlated with CKD, and LAP was better than the other surrogate markers of IR for predicting CKD. Only among participants aged over 65 years were higher levels of TyG, VAI and TG/HDL found to be closely related to the increased prevalence of CKD.
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Affiliation(s)
- Yumeng Shi
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China
| | - Lihua Hu
- Department of Cardiovascular Medicine, Peking University First Hospital, Beijing, China
| | - Minghui Li
- Department of Cardiovascular Medicine, Inner Mongolia People's Hospital, Hohhot, China
| | - Wei Zhou
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Tao Wang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Lingjuan Zhu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Xiaoshu Cheng
| | - Ping Li
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Ping Li
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Yu P, Meng X, Kan R, Wang Z, Yu X. Association between metabolic scores for visceral fat and chronic kidney disease: A cross-sectional study. Front Endocrinol (Lausanne) 2022; 13:1052736. [PMID: 36545336 PMCID: PMC9762045 DOI: 10.3389/fendo.2022.1052736] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 11/09/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Central obesity is closely linked to the risk of chronic kidney disease (CKD). This study aimed to evaluate the association between the novel central obesity index- metabolic score for visceral fat (METS-VF) and the risk of CKD in a Chinese population, and to compare its ability to predict CKD with other central obesity indices including waist circumference (WC), waist-to-height ratio (WHtR), lipid accumulation product (LAP), visceral adiposity index (VAI), a body shape index (ABSI), body roundness index (BRI), and cardiometabolic index (CMI). METHODS This cross-sectional study included 8866 individuals from China. Demographic information, lifestyle data, and medical history data were collected, and physical examinations, anthropometric measurements and laboratory tests were performed for each participant. CKD was defined as an estimated GFR< 60 ml/min/1.73m2. Multivariate logistic regression models were used to evaluate the association between the METS-VF and the prevalence of CKD. Receiver operating characteristic (ROC) analyses were performed to assess and compare the predictive abilities of the central obesity indices and determine the optimal cut-off points. RESULTS A graded increase in the prevalence of CKD was observed with increasing METS-VF tertiles. Moreover, the METS-VF was independently associated with the risk of CKD after adjustment for current smoking, current drinking, physical activity level, diabetes, hypertension, CVD history and BMI. Compared with participants with a METS-VF in the lowest tertile, the multivariate-adjusted ORs and 95% CIs for participants with a METS-VF in the highest tertile were 3.943 (2.435-6.385) in the overall population, 3.585 (1.585-8.109) for men and 4.627 (2.485-8.616) for women. Significant interactions were found between the METS-VF and the risk of CKD by age (P value for interaction = 0.023). In ROC analysis, the METS-VF had a higher AUC value than other indices for predicting CKD in men and had comparable or higher AUC than other indices for women. For predicting CKD, the optimal cut-off value of the METS-VF was 6.891 for men and 6.744 for women. The METS-VF yielded the greatest Youden index among all indices for both sexes. CONCLUSION A higher METS-VF was independently associated with a greater risk of CKD. The METS-VF can be a useful clinical indicator for identifying CKD, as it had superior predictive power for CKD when compared with other central obesity indices.
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Affiliation(s)
- Peng Yu
- Department of Endocrinology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, Hubei, China
| | - Xiaoyu Meng
- Department of Endocrinology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, Hubei, China
| | - Ranran Kan
- Department of Endocrinology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, Hubei, China
| | - Zhihan Wang
- Department of Endocrinology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, Hubei, China
| | - Xuefeng Yu
- Department of Endocrinology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, Hubei, China
- *Correspondence: Xuefeng Yu,
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22
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Lin M, Li N, Heizhati M, Gan L, Zhu Q, Yao L, Li M, Yang W. Chinese Visceral Adiposity Index Is Associated With Incident Renal Damage in Patients With Hypertension and Abnormal Glucose Metabolism: A Longitudinal Study. Front Endocrinol (Lausanne) 2022; 13:910329. [PMID: 35909550 PMCID: PMC9329673 DOI: 10.3389/fendo.2022.910329] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate the association between Chinese visceral adiposity index (CVAI) and incident renal damage and compared its predictive power with that of other visceral obesity indices in patients with hypertension and abnormal glucose metabolism (AGM). METHODS This retrospective cohort consecutively included patients with hypertension and AGM who did not have renal damage at baseline. Renal damage was defined using the estimated glomerular filtration rate (eGFR) and urine protein. Multivariable Cox regression analysis was used to evaluate the association between CVAI and incident renal damage. Restricted cubic splines were used to determine the shape of the association. The predictive power of the CVAI was examined and directly compared with other indices, including the VAI, body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR), using the area under the receiver operating characteristic curve (AUC) and C-index. RESULTS In total, 2,033 patients with hypertension and AGM were included. During a median follow-up of 2.6 years, the incidence of renal damage was 31.5, 48.9, 56.8, and 67.5/1,000 person-years across the quartiles of CVAI. Compared with the first quartile, the risk of renal damage was higher in the second (hazard ratio (HR) = 1.36 [95% CI: 0.93-1.97]), third (HR = 1.57 [95% CI: 1.09-2.27]), and fourth (HR = 1.65 [95% CI: 1.11-2.44]) quartiles (p for trend = 0.011). A linear dose-response association was observed. Sensitivity and subgroup analyses confirmed the robustness and consistency of the results. In terms of predictive power, the CVAI had the highest AUC and C-index values. CONCLUSIONS CVAI is positively associated with renal damage risk in a linear dose-response pattern and has the best performance in predicting incident renal damage in patients with hypertension and AGM. The CVAI may serve as a reliable indicator for identifying patients at a high risk of renal damage.
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Zhao S, Ren Z, Yu S, Chi C, Tang J, Maimaitiaili R, Teliewubai J, Li J, Xu Y, Zhang Y. Association Between Lipid Accumulation Product and Target Organ Damage in Elderly Population: The Northern Shanghai Study. Clin Interv Aging 2021; 16:1769-1776. [PMID: 34629868 PMCID: PMC8495140 DOI: 10.2147/cia.s330313] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/19/2021] [Indexed: 12/13/2022] Open
Abstract
Introduction Lipid accumulation product (LAP), calculated from waist circumference (WC) and triglycerides (TG), is a novel index that correlates cardiovascular disease. We aimed to investigate the relationship between LAP and target organ damage (TOD) in elderly Chinese community-dwelling individuals. Materials and Methods We enrolled 3363 participants whose age was ≥65 years old. TOD, including left ventricular hypertrophy (LVH), arterial stiffness (AS), lower extremity atherosclerotic (LEA), micro-albuminuria (MAU) and chronic kidney disease (CKD), was measured using standard methods. LAP was calculated as (WC–65) × TG in men and (WC–58) × TG in women. Both quartiles and continuation of LAP were analyzed. Results Age-sex adjusted partial correlation analysis showed that LAP was significantly associated with CVD risk factors. With the first quartile (Q1) as a reference, in univariate logistic regression, the fourth quartile (Q4) of LAP was associated with all TOD. In multivariate model, Q4 of LAP was only associated with an increased risk of AS (odds ratio (OR) = 1.88, 95% confidence interval (CI): 1.37–2.58, Pfor trend< 0.001), MAU (OR = 1.33, 95% CI: 1.01–1.75, Pfor trend= 0.02) and CKD (OR = 2.39, 95% CI: 1.39–4.12, Pfor trend< 0.001). But, Q4 of LAP was not associated with an increased risk of LVH (OR = 1.19, 95% CI: 0.85–1.65, Pfor trend= 0.25) or LEA (OR = 0.87, 95% CI: 0.58–1.29, Pfor trend= 0.96). Similar associations were found when analyzed continuously. Conclusion The novel metabolic parameter LAP is significantly and independently associated with an increased risk of arterial stiffness, chronic kidney disease and micro-albuminuria in Chinese community-dwelling elderly individuals.
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Affiliation(s)
- Song Zhao
- Department of Cardiology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, People's Republic of China
| | - Zhongyuan Ren
- Department of Cardiology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, People's Republic of China
| | - Shikai Yu
- Department of Cardiology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, People's Republic of China
| | - Chen Chi
- Department of Cardiology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, People's Republic of China
| | - Jiamin Tang
- Department of Cardiology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, People's Republic of China
| | - Rusitanmujiang Maimaitiaili
- Department of Cardiology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, People's Republic of China
| | - Jiadela Teliewubai
- Department of Cardiology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, People's Republic of China
| | - Jiaxin Li
- Department of Cardiology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, People's Republic of China
| | - Yawei Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, People's Republic of China
| | - Yi Zhang
- Department of Cardiology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, People's Republic of China
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Yan P, Xu Y, Miao Y, Tang Q, Wu Y, Bai X, Zhang Z, Li Q, Wan Q. Association of lipid accumulation product with chronic kidney disease in Chinese community adults: a report from the REACTION study. Lipids Health Dis 2021; 20:131. [PMID: 34627270 PMCID: PMC8502407 DOI: 10.1186/s12944-021-01569-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/26/2021] [Indexed: 02/06/2023] Open
Abstract
Background Limited studies regarding the correlation of lipid accumulation product (LAP) with a decreased estimated glomerular filtration rate (eGFR) have yielded conflicting findings, and no report has demonstrated the relationship of LAP with chronic kidney disease (CKD), defined as the presence of albuminuria and/or a decreased eGFR. The purpose of this study was to estimate the possible correlation of LAP with CKD prevalence in Chinese community adults. Method In this cross-sectional study, LAP level of 7202 participants (age ≥ 40 years) was determined, and its possible association with CKD was evaluated by a multiple logistic regression model. Results Compared with subjects with non-CKD, non-albuminuria, and high eGFR, LAP levels significantly increased in female not male subjects with CKD, albuminuria, and low eGFR, respectively (all P < 0.001). The univariate logistic regression analysis revealed that LAP level of female not male subjects were significantly and positively associated with the prevalence of CKD (P < 0.001). The multivariate logistic regression analysis showed that the risk of CKD prevalence in female not male subjects progressively increased across LAP quartiles (P for trend < 0.01), and the risk of CKD prevalence of subjects in Q4 significantly increased compared to those in Q1 after adjustment for potential confounding factors in Models 4 (odds ratio [OR]: 1.382, 95% confidence intervals [CI] 1.002–1.906, P < 0.05). Stratified analysis revealed positive associations of LAP quartiles with risk of CKD prevalence in people with the following characteristics: women, older, overweight, with hypertension, normal glucose tolerance, appropriate low-density lipoprotein cholesterol, nonsmokers, nondrinkers, and no cardiovascular disease events. Conclusions High LAP levels might be significantly associated with risk of CKD prevalence in community-dwelling Chinese female adults, which may inform both public health recommendations and clinical practice.
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Affiliation(s)
- Pijun Yan
- Department of Endocrinology, the Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Yong Xu
- Department of Endocrinology, the Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Ying Miao
- Department of Endocrinology, the Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Qian Tang
- Department of Endocrinology, the Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Yuru Wu
- Department of Endocrinology, the Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Xue Bai
- Department of Endocrinology, the Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Zhihong Zhang
- Department of General Medicine, the Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Qian Li
- Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Qin Wan
- Department of Endocrinology, the Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
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25
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Memarian E, Nilsson PM, Zia I, Christensson A, Engström G. The risk of chronic kidney disease in relation to anthropometric measures of obesity: A Swedish cohort study. BMC Nephrol 2021; 22:330. [PMID: 34610818 PMCID: PMC8491415 DOI: 10.1186/s12882-021-02531-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 09/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It has been shown that individuals with obesity have a higher risk for chronic kidney disease (CKD). However, it is unclear which measure of obesity is most useful for prediction of CKD in the general population. The aim of this large prospective study was to explore the association between several anthropometric measures of obesity, i. e., body mass index (BMI), waist circumference (WC), waist circumference to height ratio (WHtR), waist-to-hip ratio (WHR), percentage of body fat (BF%), weight, height and incidence of hospitalizations due to CKD, in a population-based cohort study. METHODS The 'Malmö Diet and Cancer Study (MDCS)' cohort in Sweden was examined during 1991 to 1996. A total of 28,449 subjects underwent measurement of anthropometric measures and blood pressure and filled out a questionnaire. Incidence of in- and outpatient hospital visits for CKD was monitored from the baseline examination over a mean follow-up of 18 years. Cox proportional hazards regression was used to explore the association between anthropometric measures and incidence of CKD, with adjustments for risk factors. RESULTS The final study population included 26,723 subjects, 45-73 years old at baseline. Higher values of BMI, WC, WHR, WHtR and weight were associated with an increased risk of developing CKD in both men and women. Only in women, higher values of BF% was associated with higher risk of CKD. Comparing the 4th vs 1st quartile of the obesity measure, the highest hazard ratio (HR) for CKD in men was observed for BMI, HR 1.51 (95% CI: 1.18-1.94) and weight (HR 1.52 (95% CI: 1.19-1.94). For women the highest HR for CKD was observed for BF%, HR 2.01 (95% CI: 1.45-2.78). CONCLUSIONS In this large prospective study, all anthropometric measures of obesity were associated with a substantially increased incidence of CKD, except for BF% in men. Some measures were slightly more predictive for the risk of CKD than others such as BMI and weight in men and BF% in women. In clinical daily practice use of all anthropometric measures of obesity might be equally useful to assess the risk of developing CKD. This study supports the strong evidence for an association between obesity and CKD.
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Affiliation(s)
- Ensieh Memarian
- Department of Clinical Sciences in Malmö, Lund University, Internal Medicine - Epidemiology Research Group, Jan Waldenströms gata 15, 5th floor, Malmo, Sweden.
| | - Peter M Nilsson
- Department of Clinical Sciences in Malmö, Lund University, Internal Medicine - Epidemiology Research Group, Jan Waldenströms gata 15, 5th floor, Malmo, Sweden
| | - Isac Zia
- Department of Clinical Sciences in Malmö, Lund University, Internal Medicine - Epidemiology Research Group, Jan Waldenströms gata 15, 5th floor, Malmo, Sweden
| | - Anders Christensson
- Department of Nephrology, Skåne University Hospital, Lund University, S-20502, Malmo, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences in Malmö, Lund University, Internal Medicine - Epidemiology Research Group, Jan Waldenströms gata 15, 5th floor, Malmo, Sweden
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Ou YL, Lee MY, Lin IT, Wen WL, Hsu WH, Chen SC. Obesity-related indices are associated with albuminuria and advanced kidney disease in type 2 diabetes mellitus. Ren Fail 2021; 43:1250-1258. [PMID: 34461808 PMCID: PMC8409948 DOI: 10.1080/0886022x.2021.1969247] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Obesity is an important risk factor for the development of diseases including diabetes, hypertension, and cardiovascular disease. However, few reports have investigated the relationships between these obesity-related indices and diabetic nephropathy. The aim of this study was to evaluate associations between obesity-related markers with albuminuria and advanced kidney disease in patients with type 2 diabetes mellitus (DM). Obesity-related indices including body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body roundness index (BRI), conicity index (CI), lipid accumulation product (LAP), visceral adiposity index (VAI), body adiposity index (BAI), abdominal volume index (AVI), body shape index (BSI), and triglyceride glucose (TyG) index were measured. Albuminuria was defined as a urine albumin/creatinine ratio of ≥30 mg/g. Advanced kidney disease was defined as an estimated glomerular filtration rate (eGFR) <30 ml/min/1.73 m2. A total of 1872 patients with type 2 DM (mean age 64.0 ± 11.3 years, 809 males and 1063 females) were enrolled. In multivariable analysis, 11 high obesity-related indices (BMI, WHR, WHtR, LAP, BRI, CI, VAI, BAI, AVI, ABSI, and TyG index) were significantly associated with albuminuria. In addition, high BMI, WHR, WHtR, LAP, BRI, CI, VAI, and AVI were significantly associated with eGFR <30 ml/min/1.73 m2. The results of this study showed that various obesity-related indices were significantly associated with albuminuria and advanced kidney disease in patients with type 2 DM. Screening may be considered in public health programs to recognize and take appropriate steps to prevent subsequent complications.
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Affiliation(s)
- Yu-Lun Ou
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Mei-Yueh Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - I-Ting Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wei-Lun Wen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wei-Hao Hsu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Szu-Chia Chen
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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Bermúdez V, Salazar J, Fuenmayor J, Nava M, Ortega Á, Duran P, Rojas M, Añez R, Rivas-Montenegro A, Angarita L, Chacín M, Cano C, Velasco M, Rojas J. Lipid Accumulation Product Is More Related to Insulin Resistance than the Visceral Adiposity Index in the Maracaibo City Population, Venezuela. J Obes 2021; 2021:5514901. [PMID: 34194826 PMCID: PMC8203405 DOI: 10.1155/2021/5514901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 05/30/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Visceral adiposity is related to insulin resistance (IR), a metabolic state considered as a risk factor for other cardiometabolic diseases. In that matter, mathematical indexes such as the visceral adiposity index (VAI) and the lipid accumulation product (LAP) could indirectly assess IR based on visceral adiposity. OBJECTIVE To evaluate the association and diagnostic accuracy of VAI and LAP to diagnose IR in the adult population of Maracaibo city. METHODS This is a cross-sectional descriptive study with multistage sampling. Receiver operating characteristic (ROC) curves were built to determine VAI and LAP cutoff points to predict IR. A set of logistic regression models was constructed according to sociodemographic, psychobiologic, and metabolic variables. RESULTS 1818 subjects were evaluated (51.4% women). The area under the curve (AUC) values for LAP and VAI were 0.689 (0.665-0.714) and 0.645 (0.619-0.670), respectively. Both indexes showed a higher IR risk in the upper tertile in bivariate analysis. However, in the logistic regression analysis for the IR risk, only the 2nd (OR: 1.91; 95% CI: 1.37-2.65; p < 0.01) and 3rd (OR: 5.40; 95% CI: 3.48-8.39; p < 0.01) LAP tertiles showed a significant increase. This behaviour was also observed after adjusting for hs-C-reactive protein (hs-CPR). CONCLUSION Although both indexes show a low predictive capacity in individuals with IR in the Maracaibo city population, the LAP index was more strongly associated with IR.
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Affiliation(s)
- Valmore Bermúdez
- Universidad Simón Bolívar, Facultad de Ciencias de La Salud, Barranquilla, Colombia
| | - Juan Salazar
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Jorge Fuenmayor
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Manuel Nava
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Ángel Ortega
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Pablo Duran
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Milagros Rojas
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Roberto Añez
- Department of Endocrine and Nutrition, Gregorio Marañón General University Hospital, Madrid, Spain
| | | | - Lissé Angarita
- Universidad Andres Bello, Carrera de Nutrición, Concepción, Chile
| | - Maricarmen Chacín
- Universidad Simón Bolívar, Facultad de Ciencias de La Salud, Barranquilla, Colombia
| | - Clímaco Cano
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Manuel Velasco
- Universidad Central de Venezuela, Escuela de Medicina José María Vargas, Caracas, Venezuela
| | - Joselyn Rojas
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
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Li M, Hu L, Hu L, Huang X, Liu X, Zhou W, Wang T, Zhu L, Bao H, Cheng X. Visceral Adiposity Index Is Inversely Associated with Renal Function in Normal-Weight Adults with Hypertension: The China H-Type Hypertension Registry Study. J Nutr 2021; 151:1394-1400. [PMID: 33693869 DOI: 10.1093/jn/nxab022] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/15/2020] [Accepted: 01/21/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Risk of chronic kidney disease (CKD) is higher in normal-weight metabolically unhealthy people, especially when combined with hypertension. In this context, whether the visceral adiposity index (VAI), which reflects body fat distribution and metabolism, can be used to identify the risk of CKD among normal-weight hypertensive patients is unclear. OBJECTIVES This study aimed to evaluate the association between VAI and renal function in normal-weight hypertensive patients. METHODS In this cross-sectional study, 8591 hypertensive patients with normal BMI from the China H-type Hypertension Registry Study were analyzed. The VAI was calculated with serum triglycerides, serum HDL cholesterol, waist circumference, and BMI. VAI was ln-transformed for analysis on account of the skewed distribution. Estimated glomerular filtration rate (eGFR) was calculated using the CKD-Epidemiology Collaboration equation. CKD was defined as an eGFR <60 mL · min-1 · 1.73 m-2. Multivariable linear and multivariable logistic regression analyses were performed to evaluate the association of VAI with eGFR and CKD. RESULTS The prevalence rate of CKD was 10.1%. Multivariable linear regression analyses showed that an elevated lnVAI reduced eGFR by 2.63 mL · min-1 · 1.73 m-2 (95% CI: -3.54, -1.72 mL · min-1 · 1.73 m-2). Multivariable logistic regression analysis showed that an elevated lnVAI was independently associated with the prevalence of CKD (OR: 1.59; 95% CI: 1.31, 1.93). As possible confounding factors were removed the association became greater. The higher the VAI was, the greater the decrease in eGFR and the higher the risk of CKD. No significant interactions were found in any of the subgroups (age, sex, physical activity, current smoking, current drinking, fasting glucose, LDL cholesterol, blood pressure, and antihypertensive drugs). CONCLUSIONS VAI, as a simple surrogate measure of visceral fat accumulation, is independently and inversely associated with renal function in normal-weight Chinese hypertensive adults.This trial was registered at chictr.org.cn as ChiCTR1800017274.
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Affiliation(s)
- Minghui Li
- Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
| | - Longlong Hu
- Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
| | - Lihua Hu
- Department of Cardiovascular Medicine, Peking University First Hospital, Beijing, China
| | - Xiao Huang
- Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
| | - Xi Liu
- Cardiovascular Center, Inner Mongolia People's Hospital, Hohhot, Inner Mongolia, China
| | - Wei Zhou
- Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
| | - Tao Wang
- Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
| | - Lingjuan Zhu
- Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
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The Cross-Link between Ferroptosis and Kidney Diseases. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:6654887. [PMID: 34007403 PMCID: PMC8110383 DOI: 10.1155/2021/6654887] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 03/31/2021] [Accepted: 04/15/2021] [Indexed: 02/08/2023]
Abstract
Acute and chronic kidney injuries result from structural dysfunction and metabolic disorders of the kidney in various etiologies, which significantly affect human survival and social wealth. Nephropathies are often accompanied by various forms of cell death and complex microenvironments. In recent decades, the study of kidney diseases and the traditional forms of cell death have improved. Nontraditional forms of cell death, represented by ferroptosis and necroptosis, have been discovered in the field of kidney diseases, which have reshuffled the role of traditional cell death in nephropathies. Although interactions between ferroptosis and acute kidney injury (AKI) have been continuously explored, studies on ferroptosis and chronic kidney disease (CKD) remain limited. Here, we have reviewed the therapeutic significance of ferroptosis in AKI and anticipated the curative potential of ferroptosis for CKD in the hope of providing insights into ferroptosis and CKD.
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Abstract
BACKGROUND Hypertension and obesity often coexist. There are sex differences in the mechanisms of obesity-related hypertension but the reasons for these differences are still not fully understood. OBJECTIVE The aim of this study was to investigate sex differences in the development of hypertension associated with obesity. METHODS A total of 866 men and 1022 women were selected for the study. Anthropometric measurements, including arterial pressure measurements, were performed. The plasma lipid levels were measured using an enzymatic method with commercially available kits. RESULTS In both overweight and obesity, hypertensive women had more atherogenic lipid profiles and higher values of lipid accumulation product (LAP) than normotensive women. In overweight and obese men, no significant differences in lipid levels or LAP were noted between the normotensive and hypertensive groups. CONCLUSION The pathogenesis of obesity-related hypertension in women differs from that in men and tends to be associated with metabolic disorders.
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Affiliation(s)
- Anastasiya M Kaneva
- Institute of Physiology of Коmi Science Centre of the Ural Branch of the Russian Academy of Sciences, FRC Komi SC UB RAS, Syktyvkar, Russia
| | - Evgeny R Bojko
- Institute of Physiology of Коmi Science Centre of the Ural Branch of the Russian Academy of Sciences, FRC Komi SC UB RAS, Syktyvkar, Russia
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Gender difference in the association of chronic kidney disease with visceral adiposity index and lipid accumulation product index in Korean adults: Korean National Health and Nutrition Examination Survey. Int Urol Nephrol 2021; 53:1417-1425. [PMID: 33389514 DOI: 10.1007/s11255-020-02735-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 12/02/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND This study was conducted to assess gender difference in the association of chronic kidney disease (CKD) with visceral adiposity index (VAI) and lipid accumulation product index (LAP) in Korean adults. MATERIALS AND METHODS The study was performed using data from the 2015 Korean National Health and Nutrition Examination Survey and included 4947 adults aged 20 years or older. RESULTS There were several key findings in the present study. First, overall, after adjusting for related variables (including age), CKD (estimated glomerular filtration rate < 60 ml/min/1.73 m2) was positively associated with the quartiles of VAI and LAP. Second, when analyzed separately for gender, the results in men and women were different. After adjusting for the related variables (except age), CKD was positively associated with the quartiles of VAI and LAP in both men and women. After further adjustment for age, CKD was still positively associated with the quartiles of VAI and LAP in men. However, in women, the relationships between CKD and the quartiles of VAI and LAP were no longer significant. CONCLUSIONS The VAI and LAP index were positively associated with CKD in Korean men but not in women.
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Liu Y, Wang Y, Wang J, Chen K, Jin L, Wang W, Gao Z, Tang X, Yan L, Wan Q, Luo Z, Qin G, Chen L, Mu Y. Lipid Accumulation Product is Associated with Urinary Albumin-creatinine Ratio in Chinese Prediabitic Population: A Report from the REACTION Study. Diabetes Metab Syndr Obes 2021; 14:2415-2425. [PMID: 34093028 PMCID: PMC8168967 DOI: 10.2147/dmso.s310751] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 04/30/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Lipid accumulation product (LAP) as a powerful marker of visceral obesity is an independent risk factor of chronic kidney disease. The present study attempted to explore the association between LAP and albuminuria in prediabetic individuals. METHODS We conducted a cross-sectional study and enrolled 26,529 participants with prediabetes over 40 years old with prediabetes from seven provinces in China. LAP was calculated from waist circumference and fasting triglycerides. Elevated albuminuria was defined by urinary albumin-creatinine ratio (uACR) ≥30 mg/g. Propensity score matching was applied to reduce bias, comparison between LAP and other traditional visceral obesity indices was performed and multiple logistic regression models were conducted to assess the association between LAP and albuminuria in the prediabetic population. RESULTS Individuals with uACR ≥30 mg/g were older and had higher BP, BMI, WC, TG, fasting insulin, glycohemoglobin and LAP, as well as lower eGFR and HDL level. Multiple logistic regression analysis showed elevated LAP was associated with increased odds of albuminuria (OR [95%CI]Q2 vs Q1 1.09 [0.94, 1.27], OR [95%CI]Q3 vs Q1 1.13 [0.97, 1.31], OR [95%CI]Q4 vs Q1 1.42 [1.21, 1.67], P for trend=0.018), and superior over waist-to-hip ratio or waist-to-height ratio. Stratification indicated that the prediabetic population with higher LAP level and characterized by female gender, middle age, being overweight, and rise in blood pressure were more likely to have increased uACR. CONCLUSION Elevated level of LAP was associated with increased albuminuria in the prediabetic population in China.
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Affiliation(s)
- Yang Liu
- Graduate School, Chinese PLA General Hospital, Beijing, People’s Republic of China
- Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Yun Wang
- Graduate School, Chinese PLA General Hospital, Beijing, People’s Republic of China
- Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Jie Wang
- Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Kang Chen
- Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Lingzi Jin
- Department of International Medical Services, Peking Union Medical College Hospital (Xidan Campus), Beijing, People’s Republic of China
| | - Weiqing Wang
- Shanghai National Research Centre for Endocrine and Metabolic Diseases, State Key Laboratory of Medical Genomics, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China
| | - Zhengnan Gao
- Department of Endocrinology, Dalian Central Hospital, Dalian, Liaoning, People’s Republic of China
| | - Xulei Tang
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou, Gansu, People’s Republic of China
| | - Li Yan
- Department of Endocrinology, Zhongshan University Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong, People’s Republic of China
| | - Qin Wan
- Department of Endocrinology, Southwest Medical University Affiliated Hospital, Luzhou, Sichuan, People’s Republic of China
| | - Zuojie Luo
- Department of Endocrinology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Guijun Qin
- Department of Endocrinology, First Affiliated Hospital of Zhengzhou University, Zhenzhou, Henan, People’s Republic of China
| | - Lulu Chen
- Department of Endocrinology, Wuhan Union Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
| | - Yiming Mu
- Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China
- Correspondence: Yiming Mu Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, People’s Republic of ChinaTel +86-10-5549 9001 Email
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Chen IJ, Hsu LT, Lu MC, Chen YJ, Tsou MT, Chen JY. Gender Differences in the Association Between Obesity Indices and Chronic Kidney Disease Among Middle-Aged and Elderly Taiwanese Population: A Community-Based Cross-Sectional Study. Front Endocrinol (Lausanne) 2021; 12:737586. [PMID: 34966356 PMCID: PMC8710780 DOI: 10.3389/fendo.2021.737586] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 11/17/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Traditional risk factors for chronic kidney disease (CKD) include diabetes mellitus (DM), hypertension (HTN), and metabolic syndrome, which are health conditions related to obesity. We aimed to investigate which of the three obesity indices has the strongest association with CKD and to explore whether there are gender differences in these relationships in the middle-aged and elderly Taiwanese population. METHODS This was a cross-sectional, community-based study. It included 400 residents (141 males and 259 females, age 50-90 years) residing in a community in northern Taiwan. Each participant was asked to fill a questionnaire that collected personal information, medical history, medication use, and anthropometric measurements. The laboratory data were obtained by testing the blood and urine samples. The baseline characteristics were compared, and the obesity indices included body mass index (BMI), waist circumference (WC), and visceral adiposity index (VAI). CKD was defined as the presence of renal dysfunction (urine albumin-creatinine ratio ≥ 30 mg/g) or estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2. We used a multiple logistic regression model to evaluate the association between each obesity index and CKD for both genders. Further, we used the area under the receiver operating characteristic (ROC) curve (AUC) to examine the best obesity indices to predict CKD in different genders. RESULTS The average age of the subjects was 64.47 ± 8.45 years, and men were significantly older. CKD was found in 31 (22.0%) males and 50 (19.3%) females. In men, there was no significant difference between the CKD and non-CKD groups among the three obesity indices. However, in women, only VAI was significantly higher in subjects with CKD (1.9 [1.1, 3.4]) than in subjects without CKD (1.5 [1.0, 2.2]) (p-value = 0.03). The multivariate logistic regression revealed that even after adjusting for possible confounding factors, VAI was found to be an independent risk factor for CKD in women (OR: 1.32, 95% CI: 1.04-1.69, p = 0.02), but not in men (OR: 1.20, 95% CI: 0.85-1.69, p = 0.30). The AUC of VAI had a significant ability to predict CKD in women but not in men. CONCLUSION Our results showed that among the three obesity indices, VAI had the strongest association with CKD compared to BMI and WC in women. In addition, VAI in women should be given more importance in the screening for CKD among the middle-aged and elderly Taiwanese population.
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Affiliation(s)
- I-Ju Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Le-Tien Hsu
- Department of Gynecology and Obstetrics, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Mei-Chun Lu
- Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Ying-Jen Chen
- Division of General Internal Medicine and Geriatrics, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Meng-Ting Tsou
- Department of Family Medicine and Occupation Medicine, MacKay Memorial Hospital, Taipei City, Taiwan
- Department of Nursing, and Management, MacKay Junior College of Medicine, New Taipei City, Taiwan
| | - Jau-Yuan Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
- *Correspondence: Jau-Yuan Chen,
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Zhou C, Zhan L, Yuan J, Tong X, Peng Y, Zha Y. Comparison of visceral, general and central obesity indices in the prediction of metabolic syndrome in maintenance hemodialysis patients. Eat Weight Disord 2020; 25:727-734. [PMID: 30968371 DOI: 10.1007/s40519-019-00678-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 03/15/2019] [Indexed: 01/10/2023] Open
Abstract
PURPOSE We aimed to compare the predictive ability of the anthropometric indices reflecting general, central and visceral obesity for identification of metabolic syndrome (MetS) in maintenance hemodialysis (MHD) patients. METHODS A multicenter, cross-sectional study that consisted of 1603 adult MHD patients (54.6 ± 16 years) was conducted in Guizhou Province, Southwest China. Eight anthropometric obesity indexes including body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), conicity index (Ci) and visceral adiposity index (VAI), lipid accumulation product (LAP), a body shape index (ABSI) and body roundness index (BRI) were recorded. MetS was defined based on the criteria of the International Diabetes Federation. Participants were categorized into four groups according to quartiles of different obesity indices. Binary logistic regression analyses were used to evaluate the associations between the eight obesity parameters and MetS. Receiver operator curve (ROC) analyses were used to identify the best predictor of MetS. RESULTS The eight anthropometric obesity indexes were independently associated with MetS risk, even after adjustment for age, sex, educational status and history of smoking. The ROC analysis revealed that all the eight obesity indices included in the study were able to discriminate MetS [all area under the ROC curves (AUCs) > 0.6, P < 0.05]. LAP showed the highest AUC and according to the maximum Youden indexes, the cut off values for men and women were 27.29 and 36.45, respectively. The AUCs of LAP, VAI, ABSI, BRI, WC, WHtR, Ci and BMI were 0.88, 0.87, 0.60, 0.78, 0.79, 0.78, 0.69 and 0.76 for men, and 0.87, 0.85, 0.65, 0.79, 0.81, 0.79, 0.73 and 0.76 for women, respectively. There was no significant difference in the AUC value between LAP and VAI, BRI/WHtR and BMI in men and between BRI/WHtR and BMI in women. The AUC value for WHtR was equal to that for BRI in identifying MetS. CONCLUSIONS Visceral obesity marker LAP followed by VAI was the most effective predictor of MetS while ABSI followed by CI was the weakest indicator for the screening of MetS in MHD patients. BRI could be an alternative obesity measure to WHtR in assessment of MetS. LAP may be a simple and useful screening tool to identify individuals at high risk of MetS particularly in middle-aged and elderly Chinese MHD patients. LEVEL OF EVIDENCE Level V, descriptive study.
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Affiliation(s)
- Chaomin Zhou
- Renal Division, Department of Medicine, Guizhou Provincial People' s Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, 550002, Guizhou, China
| | - Lin Zhan
- Blood Center of Guizhou Province, Guiyang, China
| | - Jing Yuan
- Renal Division, Department of Medicine, Guizhou Provincial People' s Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, 550002, Guizhou, China
| | - Xiaoya Tong
- Renal Division, Department of Medicine, Guizhou Provincial People' s Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, 550002, Guizhou, China
| | - Yanzhe Peng
- Renal Division, Department of Medicine, Guizhou Provincial People' s Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, 550002, Guizhou, China
| | - Yan Zha
- Renal Division, Department of Medicine, Guizhou Provincial People' s Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, 550002, Guizhou, China.
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Su W, Wang J, Mu Y. Association Between Hypertriglyceridemic Waist Phenotype and Increased Urinary Albumin-Creatinine Ratio in Chinese Adults: The REACTION Study. Diabetes Metab Syndr Obes 2020; 13:2965-2974. [PMID: 32904657 PMCID: PMC7457398 DOI: 10.2147/dmso.s257736] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 08/03/2020] [Indexed: 12/28/2022] Open
Abstract
PURPOSE The hypertriglyceridemic waist (HTGW) phenotype can predict cardiovascular disease (CVD) risk. Additionally, strong evidence indicates that elevated urinary albumin-creatinine ratio (UACR) is associated with increased prevalence of CVD. However, few studies have explored the association between the HTGW phenotype and UACR. PATIENTS AND METHODS In this cross-sectional descriptive study, a total of 40,674 subjects (28,562 women and 12,112 men older than 40 years) were recruited from seven different geographic regional centres. The HTGW phenotype was defined as increased triglyceride levels (triglyceride ≥ 1.5 mmol/L for female and ≥2.0 mmol/L for male) and waist circumference (WC; WC ≥ 85 for female and WC ≥ 90 cm for male). Logistic regression analyses were performed to assess the relationship between UACR and the HTGW phenotype. RESULTS Subjects with the HTGW phenotype showed a more significant trend towards increased excretion of UACR [among all subjects, odds ratio (OR) = 1.303, 95% CI: 1.132-1.499, P < 0.001; among men, OR = 1.406, 95% CI: 1.057-1.870, P = 0.019; among women, OR = 1.268, 95% CI: 1.074-1.496, P = 0.005]. Furthermore, the stratified analysis showed that the OR for high-risk significantly increased in individuals in the HTGW group aged below 65 years, with 5.6 ≤ fasting blood glucose < 7.0 or 7.8 ≤ post-load blood glucose <11.1 mmol/L, 120 ≤ systolic blood pressure < 140 or 80 ≤ diastolic blood pressure < 90, 24 ≤ body mass index < 28 kg/m2, and estimated globular filtration rate > 90 mL/min per 1.73 m2. CONCLUSION This study has advanced the understanding of visceral obesity and our results supported the fact that the HTGW phenotype is associated with elevated UACR excretion among general Chinese adults.
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Affiliation(s)
- Wanlu Su
- Medicine School of Nankai University, No. 94 Weijin Road, Tianjin300071, People’s Republic of China
- Department of Endocrinology, Chinese People’s Liberation Army General Hospital, Beijing100853, People’s Republic of China
| | - Jie Wang
- Medicine School of Nankai University, No. 94 Weijin Road, Tianjin300071, People’s Republic of China
- Department of Endocrinology, Chinese People’s Liberation Army General Hospital, Beijing100853, People’s Republic of China
| | - Yiming Mu
- Medicine School of Nankai University, No. 94 Weijin Road, Tianjin300071, People’s Republic of China
- Department of Endocrinology, Chinese People’s Liberation Army General Hospital, Beijing100853, People’s Republic of China
- Correspondence: Yiming Mu Department of Endocrinology, Chinese People’s Liberation Army General Hospital, No. 28 Fuxing Road, Beijing100853, People’s Republic of China Email
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Chen T, Wang X, Wang X, Chen H, Xiao H, Tang H, Feng L, Xiang Z, Zou H, Shao X. Comparison of Novel Metabolic Indices in Estimation of Chronic Kidney Diseases in a Southern Chinese Population. Diabetes Metab Syndr Obes 2020; 13:4919-4927. [PMID: 33328750 PMCID: PMC7735784 DOI: 10.2147/dmso.s286565] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/26/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND To determine the optimal cut-off values and evaluate the associations of product of triacylglycerol and glucose (TyG), lipid accumulation product (LAPI), visceral adiposity index (VAI) with chronic kidney diseases (CKD) stratified by sex. METHODS From January to April 2018, our team had conducted a large-scale cross-sectional survey that contained 2720 individuals on the southern coast of China. Logistic regression analysis and receiver operating characteristic (ROC) analyses were used to evaluate the optimal cut-off and value of TyG, LAPI, VAI for predicting CKD. RESULTS A multivariate logistic regression analysis found that the TyG had the better value of prediction for the presence of CKD for the highest quartile vs the lowest quartile in both males (OR: 3.65; 95% CI, 2.04-6.52; p<0.001) and females (OR: 3.50; 95% CI, 2.20-5.56; p<0.001), followed by LAPI and VAI, when further adjusted for cofounder factors, LAPI and VAI both lost their independence, and only TyG remains its significant association with CKD in both males (OR: 2.81; 95% CI, 1.25-6.30; p<0.001) and females (OR: 3.22; 95% CI, 1.56-6.61; p<0.001). ROC curve showed that TyG had the highest AUC for predicting CKD in males (AUC: 0.618). TyG (AUC: 0.670) and LAPI (AUC: 0.670) both had the highest AUC in females. United predicted models which contain TyG were conducted for predicting CKD in males (AUC: 758) and females (AUC: 0.773) and results indicated that multivariate analysis of TyG and other traditional factors can impressively improve the accuracy of predictive probability for CKD. CONCLUSION TyG is a priority to the other two novel indices and may become valuable makers and have strong predictive power for predicting CKD, especially in females.
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Affiliation(s)
- Tong Chen
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Xuan Wang
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Xin Wang
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Haishan Chen
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Hua Xiao
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Hongjuan Tang
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Ling Feng
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Zhicong Xiang
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Hequn Zou
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
- Department of Nephrology, Pinghu Hospital, Health Science Center, Shenzhen University, Shenzhen518116, People’s Republic of China
- Hequn Zou No. 1, Fuxin Road, Pinghu Street, Longgang District, Shenzhen518116, People’s Republic of China Email
| | - Xiaofei Shao
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
- Correspondence: Xiaofei Shao Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China Email
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Liu L, Wang Y, Zhang W, Chang W, Jin Y, Yao Y. Waist height ratio predicts chronic kidney disease: a systematic review and meta-analysis, 1998-2019. Arch Public Health 2019; 77:55. [PMID: 31867106 PMCID: PMC6918668 DOI: 10.1186/s13690-019-0379-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 11/18/2019] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The incidence of chronic kidney disease (CKD) increases each year, and obesity is an important risk factor for CKD. The main anthropometric indicators currently reflecting obesity are body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), but the rationality and merits of various indicators vary. This article aims to find whether the WHtR is a more suitable physical measurement that can predict CKD. METHODS Pubmed, embase, the cochrane library, and web of science were systematically searched for articles published between 1998 and 2019 screening CKD through physical indicators. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and evaluated the quality of the methodology included in the study. Meta-analysis used the Stata 12.0 software. RESULTS Nine studies were included, with a total of 202,283 subjects. Meta-analysis showed that according to the analysis of different genders in 6 studies, regardless of sex, WHtR was the area with the largest area under the curve (AUC). Except WHtR and visceral fat index (VFI) in women which showed no statistical difference, WHtR and other indicators were statistically different. In three studies without gender-based stratification, the area under the curve AUC for WHtR remained the largest, but only the difference between WHtR and BMI was statistically significant. When the Chinese population was considered as a subgroup, the area under the curve AUC for WHtR was the largest. Except for WHtR and VFI which showed no statistical difference in women, there was a statistically significant difference between WHtR and other indicators in men and women. CONCLUSION WHtR could be better prediction for CKD relative to other physical measurements. It also requires higher-quality prospective studies to verify the clinical application of WHtR.
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Affiliation(s)
- Ling Liu
- School of Public Health,Wannan Medical College, Wenchang West Road 22, Wuhu, China
| | - Yanqiu Wang
- School of Public Health,Wannan Medical College, Wenchang West Road 22, Wuhu, China
| | - Wanjun Zhang
- School of Public Health,Wannan Medical College, Wenchang West Road 22, Wuhu, China
| | - Weiwei Chang
- School of Public Health,Wannan Medical College, Wenchang West Road 22, Wuhu, China
| | - Yuelong Jin
- School of Public Health,Wannan Medical College, Wenchang West Road 22, Wuhu, China
| | - Yingshui Yao
- School of Public Health,Wannan Medical College, Wenchang West Road 22, Wuhu, China
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Mousapour P, Barzin M, Valizadeh M, Mahdavi M, Azizi F, Hosseinpanah F. Predictive performance of lipid accumulation product and visceral adiposity index for renal function decline in non-diabetic adults, an 8.6-year follow-up. Clin Exp Nephrol 2019; 24:225-234. [PMID: 31734819 DOI: 10.1007/s10157-019-01813-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 10/28/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Lipid accumulation product (LAP) and visceral adiposity index (VAI) are surrogates for visceral adiposity dysfunction. Our aim was to evaluate potential association of these two indices with the incidence of renal function decline. METHODS We included 6693 non-diabetic adults age ≥ 18 years, with estimated glomerular filtration rate (eGFR) ≥ 60 ml/min/1.73 m2, from the Tehran Lipid and Glucose Study 2002-2005 survey. Natural logarithmic transformation (Ln) was applied for LAP and VAI measures. The incidence of renal function decline, defined as eGFR < 60 ml/min/1.73 m2, was evaluated for each gender, across tertiles of Ln LAP, Ln VAI, body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR) and waist to hip ratio (WHR), using Cox-proportional hazard models. RESULTS Over a median 8.6 years of follow-up, 1670 new cases of renal function decline were identified (incidence rate 3.2%). After multivariable adjustment, the hazard ratios (HRs) with 95% CI across second and third tertiles of Ln LAP were 1.14 (0.86-1.50) and 1.33 (1.00-1.78) in men (P trend = 0.132); and 1.16 (0.90-1.50) and 1.24 (0.96-1.61) in women (P trend = 0.263), respectively. Multivariable adjusted HRs across second and third tertiles of Ln VAI were 1.40 (1.08-1.83) and 1.35 (1.02-1.78) in men (P trend = 0.031); and 0.93 (0.75-1.15) and 1.15 (0.93-1.41) in women (P trend = 0.072), respectively. HRs across tertiles of BMI, WC, WHtR and WHR were not significant for renal function decline among both genders in any adjustment models. CONCLUSION Among the adiposity indices assessed in this study, VAI seems to be an independent predictor of renal function decline only in males.
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Affiliation(s)
- Pouria Mousapour
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Barzin
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Mahdavi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Nusrianto R, Ayundini G, Kristanti M, Astrella C, Amalina N, Riyadina W, Tahapary DL, Soewondo P. Visceral adiposity index and lipid accumulation product as a predictor of type 2 diabetes mellitus: The Bogor cohort study of non-communicable diseases risk factors. Diabetes Res Clin Pract 2019; 155:107798. [PMID: 31330161 DOI: 10.1016/j.diabres.2019.107798] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 06/12/2019] [Accepted: 07/17/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Lipid accumulation product (LAP) index and Visceral Adiposity Index (VAI) are simple calculations to measure fat accumulation and visceral fat respectively. We aim to study the use of LAP index and VAI as diagnostic parameter and predictor of T2DM. METHODS We analysed the baseline and longitudinal data from the Indonesian Ministry of Health Cohort Study of Non-communicable Diseases Risk Factors in West Java, comprising 846 men and 2437 women aged 25-65 years. At baseline, the odds ratio for the diagnosis of prediabetes and T2DM among subjects with high LAP Index and VAI was analysed using logistic regression analysis. In the longitudinal analysis, LAP index and VAI as predictor of prediabetes and T2DM was analysed with cox regression analysis. RESULT Worsening glycemia status was associated with an increased LAP index and VAI (p < 0.001). Subjects with high VAI had an increased OR of having T2DM in both men [OR, 95%CI, 2.29(1.15-4.56), p = 0.018] and women [1.95(1.49-2.54), p < 0.001)]. Association of high LAP with T2DM was found only in women [OR, 95%CI, 2.11(1.16-1.52), p < 0.001]. In terms of T2DM prediction, only women [RR, 95% CI, 2.59 (1.05-6.39), p = 0.038)], with high VAI had an increased risk of T2DM in the future. High LAP index was not associated with an in increased risk of T2DM in the future in both sexes. CONCLUSION High LAP index was associated with an increased risk of T2DM diagnosis in women but it could not predict the development of T2DM. High VAI was associated with an increased risk of T2DM diagnosis in both sexes, however, it could only predict the development of T2DM in women.
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Affiliation(s)
- Randy Nusrianto
- Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine Universitas Indonesia, Jl. Diponegoro No. 71, Central Jakarta 10430, Indonesia
| | - Gratcia Ayundini
- Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine Universitas Indonesia, Jl. Diponegoro No. 71, Central Jakarta 10430, Indonesia
| | - Melly Kristanti
- Division of Endocrinology, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine Universitas Indonesia, Jl. Diponegoro No. 71, Central Jakarta 10430, Indonesia
| | - Cindy Astrella
- Metabolic, Cardiovascular and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jl. Salemba Raya No VI, Central Jakarta 10430, Indonesia
| | - Nida Amalina
- Division of Endocrinology, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine Universitas Indonesia, Jl. Diponegoro No. 71, Central Jakarta 10430, Indonesia
| | - Woro Riyadina
- National Institute of Health Research and Development, Ministry of Health Republic of Indonesia, Jl. Percetakan Negara No. 29, Central Jakarta 10560, Indonesia
| | - Dicky L Tahapary
- Division of Endocrinology, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine Universitas Indonesia, Jl. Diponegoro No. 71, Central Jakarta 10430, Indonesia; Metabolic, Cardiovascular and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jl. Salemba Raya No VI, Central Jakarta 10430, Indonesia.
| | - Pradana Soewondo
- Division of Endocrinology, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine Universitas Indonesia, Jl. Diponegoro No. 71, Central Jakarta 10430, Indonesia; Metabolic, Cardiovascular and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jl. Salemba Raya No VI, Central Jakarta 10430, Indonesia.
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Yang S, Li M, Chen Y, Zhao X, Chen X, Wang H, Tian Y, Liu C, Shen C. Comparison of the Correlates Between Body Mass Index, Waist Circumference, Waist-to-Height Ratio, and Chronic Kidney Disease in a Rural Chinese Adult Population. J Ren Nutr 2019; 29:302-309.e1. [DOI: 10.1053/j.jrn.2018.10.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 09/14/2018] [Accepted: 10/10/2018] [Indexed: 12/25/2022] Open
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A Systematic Review on the Association between Lipid Accumulation Product Index and Type 2 Diabetes Mellitus. J ASEAN Fed Endocr Soc 2019; 34:16-20. [PMID: 33442132 PMCID: PMC7784243 DOI: 10.15605/jafes.034.01.04] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 04/02/2019] [Indexed: 01/22/2023] Open
Abstract
Introduction Excess fat accumulation contributes to the development of type 2 diabetes mellitus (T2DM). Lipid accumulation product (LAP) is an index computed from waist circumference and triglycerides, which represents increased lipotoxicity. We aim to study the relationship of LAP index and T2DM and its utility as a predictor for T2DM development. Methodology A literature search in PubMed and Cochrane database was performed to retrieve and review studies reporting the association between LAP and T2DM. Results Two cross-sectional studies from Japan and the United States, and one cohort study from Iran were obtained. A high LAP was associated with a higher risk of T2DM [odds ratio (OR) 19.1, 95% confidence interval (CI) (6.6-55.5) for women; and OR 7.4, 95% CI (5.1-10.8) for men]. Conclusion LAP was strongly associated with T2DM. Its utility in predicting the development of T2DM needs to be confirmed.
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Lipid Accumulation and Chronic Kidney Disease. Nutrients 2019; 11:nu11040722. [PMID: 30925738 PMCID: PMC6520701 DOI: 10.3390/nu11040722] [Citation(s) in RCA: 211] [Impact Index Per Article: 42.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/25/2019] [Accepted: 03/26/2019] [Indexed: 12/12/2022] Open
Abstract
Obesity and hyperlipidemia are the most prevalent independent risk factors of chronic kidney disease (CKD), suggesting that lipid accumulation in the renal parenchyma is detrimental to renal function. Non-esterified fatty acids (also known as free fatty acids, FFA) are especially harmful to the kidneys. A concerted, increased FFA uptake due to high fat diets, overexpression of fatty acid uptake systems such as the CD36 scavenger receptor and the fatty acid transport proteins, and a reduced β-oxidation rate underlie the intracellular lipid accumulation in non-adipose tissues. FFAs in excess can damage podocytes, proximal tubular epithelial cells and the tubulointerstitial tissue through various mechanisms, in particular by boosting the production of reactive oxygen species (ROS) and lipid peroxidation, promoting mitochondrial damage and tissue inflammation, which result in glomerular and tubular lesions. Not all lipids are bad for the kidneys: polyunsaturated fatty acids (PUFA) such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) seem to help lag the progression of chronic kidney disease (CKD). Lifestyle interventions, especially dietary adjustments, and lipid-lowering drugs can contribute to improve the clinical outcome of patients with CKD.
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Dereziński T, Zozulińska-Ziółkiewicz D, Uruska A, Dąbrowski M. Visceral adiposity index as a useful tool for the assessment of cardiometabolic disease risk in women aged 65 to 74. Diabetes Metab Res Rev 2018; 34:e3052. [PMID: 30064156 DOI: 10.1002/dmrr.3052] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 07/12/2018] [Accepted: 07/20/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND The visceral adiposity index (VAI) is considered to be a reliable indicator of adipose tissue dysfunction and cardiometabolic disease risk. The aim of this study was to evaluate its usefulness in assessing cardiometabolic risk in a sample of elderly women living in a rural-urban community in central Poland. METHODS A total of 365 women aged 65 to 74 years were included in this cross-sectional study. All patients were interviewed to obtain their history of diabetes mellitus, myocardial infarction, stroke, and revascularization. For all participants, anthropometric measurements were performed, then body mass index (BMI) and waist/hip ratio were calculated. Blood pressure was measured on the arm and on both ankles, and the ankle/brachial index was calculated. Blood samples were collected for the assessment of glycemia, lipid profile, and creatinine level. In patients with elevated fasting glucose, the test was repeated, or an oral glucose tolerance test was performed where appropriate. Finally, carotid intima-media thickness was measured in all women. RESULTS The VAI of participants was significantly correlated with a history of myocardial infarction, higher carotid intima-media thickness, diabetes, prediabetes, and impaired kidney function. Furthermore, VAI demonstrated a better correlation with these endpoints than BMI or waist circumference. CONCLUSIONS The VAI can be considered a useful tool for the assessment of cardiometabolic disease risk in elderly women, with a score of ≥2.71 representing the cut-off point for identifying females at high risk. In such patients, screening for cardiovascular disease, abnormal glucose metabolism, and impaired kidney function should be routine practice.
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Affiliation(s)
| | | | - Aleksandra Uruska
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznań, Poland
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Wang HY, Shi WR, Yi X, Wang SZ, Luan SY, Sun YX. Value of reduced glomerular filtration rate assessment with cardiometabolic index: insights from a population-based Chinese cohort. BMC Nephrol 2018; 19:294. [PMID: 30359237 PMCID: PMC6202850 DOI: 10.1186/s12882-018-1098-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 10/12/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Recent studies have suggested that cardiometabolic index (CMI), a novel estimate of visceral adipose tissue, could be of use in the evaluation of cardiovascular risk factors. However, the potential utility and clinical significance of CMI in the detection of reduced estimated glomerular filtration rate (eGFR) remains uncertain. The purpose of this study was to investigate the usefulness of CMI in assessing reduced eGFR in the general Chinese population. METHODS This cross-sectional analysis included 11,578 participants (mean age: 53.8 years, 53.7% females) from Northeast China Rural Cardiovascular Health Study (NCRCHS) of general Chinese population (data collected from January 2013 to August 2013). CMI was calculated by triglyceride to high density lipoprotein cholesterol ratio multiply waist-to-height ratio. Reduced eGFR was defined as eGFR< 60 ml/min per 1.73m2. Multivariate regressions were performed to determine CMI's association with eGFR value and eGFR reduction, ROC analyses were employed to investigate CMI's discriminating ability for decreased eGFR. RESULTS The prevalence of reduced eGFR was 1.7% in males and 2.5% in females. CMI was notably more adverse in reduced eGFR groups, regardless of genders. In fully adjusted multivariate linear models, each 1 SD increment of CMI caused 3.150 ml/min per 1.73m2 and 2.411 ml/min per 1.73m2 loss of eGFR before CMI reached 1.210 and 1.520 in males and females, respectively. In logistic regression analyses, per 1 SD increase of CMI brought 51.6% additional risk of reduced eGFR in males while caused 1.347 times of risk in females. After divided into quartiles, people in the top quartile of CMI had higher adjusted ORs of having reduced eGFR, with ORs of 4.227 (1.681, 10.627) and 3.442 (1.685-7.031) for males and females respectively. AUC of CMI was revealed to be 0.633 (0.620-0.646) in males and 0.684 (0.672-0.695) in females. CONCLUSIONS Higher CMI was independently associated with greater burden of reduced eGFR, highlighting VAT distribution and dysfunction as a potential mechanism underlying the association of obesity with kidney damage and adverse cardiovascular outcomes. The findings from this study provided important insights regarding the potential usefulness and clinical relevance of CMI in the detection of reduced eGFR among general Chinese population.
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Affiliation(s)
- Hao-Yu Wang
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001 China
| | - Wen-Rui Shi
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001 China
| | - Xin Yi
- Department of Cardiovascular Medicine, Beijing Moslem Hospital, Beijing, 100054 China
| | - Shu-Ze Wang
- Department of Computational Medicine and Bioinformatics, University of Michigan, 100 Washtenaw Avenue, Ann Arbor, MI 48109 USA
| | - Si-Yuan Luan
- West China School of Medicine, Sichuan University, #37 Guoxue Alley, Chengdu, 610041 China
| | - Ying-Xian Sun
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001 China
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Song J, Chen X, Zhao Y, Mi J, Wu X, Gao H. Risk factors for prehypertension and their interactive effect: a cross- sectional survey in China. BMC Cardiovasc Disord 2018; 18:182. [PMID: 30219041 PMCID: PMC6139180 DOI: 10.1186/s12872-018-0917-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 09/06/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Individuals with prehypertension are at higher risk of developing hypertension and cardiovascular diseases, while the interaction between factors may aggravate prehypertension risk. Therefore, this study aimed to evaluate the risk factors for prehypertension in Chinese middle-aged and elderly adults, and explore the potentially interactive effect of evaluated factors. METHODS All the participants that came from a community based cross-sectional survey were investigated in Bengbu, China, by being interviewed with a questionnaire. Body mass index (BMI), Waist circumference (WC) and lipid accumulation product (LAP) that reflect participants' obesity were also calculated. In addition, logistic regression model was applied to explore the risk factors of prehypertension, followed by the assessment of the interactive effects between risk factors on prehypertension by the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI). RESULTS A total of 1777 participants were enrolled in this study, among which the prevalence of normtension, prehypertension and hypertension were 41.70%, 33.93% and 24.37% respectively. According to the multivariate logistic regression analysis, age (OR: 1.01, 95%CI: 1.00-1.02), smoking (OR: 1.67, 95%CI: 1.22-2.29), family history of cardiovascular diseases (OR: 1.52, 95%CI: 1.14-2.02), general obesity (OR: 1.51, 95%CI: 1.15-1.97) and LAP (OR: 2.58, 95%CI: 1.76-3.80) were all defined as the major factors that significantly related with the risk of prehypertension. When identifying prehypertension risk, the receiver-operating characteristics (ROC) curves (AUC) analysis indicated that LAP performed better than BMI in males (Z = 2.05, P = 0.03) and females (Z = 2.12, P = 0.03), but was superior to WC only in females (Z = 2.43, P = 0.01). What is more, there were significant interactive effects of LAP with family history of cardiovascular diseases (RERI: 1.88, 95%CI: 0.25-3.51; AP: 0.44, 95%CI: 0.20-0.69; SI: 2.37, 95%CI: 1.22-4.60) and smoking (RERI: 1.99, 95%CI: 0.04-3.93; AP: 0.42, 95%CI: 0.17-0.67; SI: 2.16, 95%CI: 1.68-4.00) on prehypertension risk. The value of AP (0.40, 95%CI: 0.03-0.77) also indicated a significant interaction between family history of cardiovascular diseases and smoking on prehypertension. CONCLUSION Prehypertension is currently prevalent in Chinese adults. This study indicated that age, family history of cardiovascular diseases, smoking, general obesity and LAP were significantly related with prehypertension risk. Furthermore, interactive effects on risk of prehypertension had been demonstrated in this study as well, which would help researchers to build strategy against prehypertension more comprehensively and scientifically.
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Affiliation(s)
- Jian Song
- School of public health, Bengbu medical college, 2600 Donghai Road, Bengbu, 233000 Anhui Province China
| | - Xue Chen
- School of public health, Bengbu medical college, 2600 Donghai Road, Bengbu, 233000 Anhui Province China
| | - Yingying Zhao
- Bengbu health board, 568 Nanhu Road, Bengbu, 233000 Anhui Province China
| | - Jing Mi
- School of public health, Bengbu medical college, 2600 Donghai Road, Bengbu, 233000 Anhui Province China
| | - Xuesen Wu
- School of public health, Bengbu medical college, 2600 Donghai Road, Bengbu, 233000 Anhui Province China
| | - Huaiquan Gao
- School of public health, Bengbu medical college, 2600 Donghai Road, Bengbu, 233000 Anhui Province China
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Zhou C, Peng H, Yuan J, Lin X, Zha Y, Chen H. Visceral, general, abdominal adiposity and atherogenic index of plasma in relatively lean hemodialysis patients. BMC Nephrol 2018; 19:206. [PMID: 30115010 PMCID: PMC6097306 DOI: 10.1186/s12882-018-0996-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 07/31/2018] [Indexed: 01/08/2023] Open
Abstract
Background Obesity is a well-established risk factor for atherosclerosis. However, it is unknown which measure of adiposity best relates to atherosclerosis in relatively lean maintenance hemodialysis (MHD) patients. We aimed to explore and compare the associations between different adiposity indices reflecting general, abdominal, visceral adiposity and arteriosclerosis risk with atherogenic index of plasma(AIP) in relatively lean MHD patients. Methods We conducted a multicenter, cross-sectional study in Guizhou Province, Southwest China. General/abdominal adiposity indices like body mass index (BMI), waist circumference(WC), waist-height ratio(WHtR), conicity index (Ci) and visceral obesity indices including visceral adiposity index (VAI), lipid accumulation product (LAP) and the hypertriglyceridemic waist phenotype (HW phenotype) were recorded. Univariate and multivariate linear regression models were used. Results All adiposity indices correlated positively with AIP in univariate analysis both in men and women except for Ci. After adjustment for age and traditional atherosclerosis risk factors, BMI, WC, WHtR, VAI and LAP still had associations with AIP both in men (β = 0.265, 0.153, 0.16, 0.788 and 0.74, respectively, all P < 0.001) and women (β = 0.34,0.199, 0.21, 0.83 and 0.74, respectively, all P < 0.001). After further adjustment for BMI, associations between AIP and VAI, LAP remained significant, but associations between WC, WHtR and AIP disappeared. Conclusions The HW phenotype, VAI, and LAP, validated and convenient markers of visceral obesity, were superior to classical anthropometric general/ abdominal adiposity indices for atherosclerosis risk assessment, especially in relatively lean MHD patients aged 40 years or older.
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Affiliation(s)
- Chaomin Zhou
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, 550002, Guizhou, China
| | - Hongying Peng
- Renal Division, Department of Medicine, Baiyun Hospital Affiliated to Guizhou Medical University, Guiyang, 550002, Guizhou, China
| | - Jing Yuan
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, 550002, Guizhou, China
| | - Xin Lin
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, 550002, Guizhou, China
| | - Yan Zha
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, 550002, Guizhou, China.
| | - Hui Chen
- The ministry of science and education, Guizhou Provincial People's Hospital, Guiyang, 550002, Guizhou, China.
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Cantero I, Abete I, Del Bas JM, Caimari A, Arola L, Zulet MA, Martinez JA. Changes in lysophospholipids and liver status after weight loss: the RESMENA study. Nutr Metab (Lond) 2018; 15:51. [PMID: 30026784 PMCID: PMC6050739 DOI: 10.1186/s12986-018-0288-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 07/09/2018] [Indexed: 12/15/2022] Open
Abstract
Background Obesity and comorbidities such as non-alcoholic fatty liver disease (NAFLD) are major public health burdens. Alterations in lipid metabolism are involved in hepatic diseases. The objective of this study was to assess the influence of weight loss on lysophospholipid (LP) metabolism and liver status in obese subjects as well as to provide new evidence regarding the interaction of LP metabolism as a key factor in the onset and management of obesity-related diseases such as liver damage. Methods Thirty-three subjects from the RESMENA (Reduction of Metabolic Syndrome in Navarra, NCT01087086) study were selected based on their Fatty Liver Index (FLI). Plasma lipid species (lysophosphatidilcholine: LPC, lysophosphatidilethanolamines: LPE and lysophosphatidylinositols: LPI specifically) were determined by LC-MS, while waist circumference (WC) and other non-invasive liver markers such as, FLI and BAAT scores as well as dietary records, anthropometrical measurements, body composition by DXA and other metabolic determinants were analyzed before and after a six-month hypocaloric nutritional intervention. Results Computed Z-scores of total LP (LPC, LPE, and LPI) were significantly decreased after 6-months of following a hypocaloric diet. Specifically, LPC14:0, LPC15:0, LPC16:1, LPC18:4, LPC20:4, showed clear relationships with weight loss. Changes in FLI score, WC and BAAT score revealed associations with general changes in LPC score. Interestingly the BAAT score was statistically associated with the LPC score after adjustment for weight loss. Conclusion The lipidomic LPC profile analysis revealed a generalized decrease in circulating lysophospholipids after weight loss. The involvement of particular LP in liver metabolism and obesity merit further attention, as some of these specific non-invasive liver markers were reduced independently of weight loss. Trial registration NCT01087086. Registered 15 March 2010, retrospectively registry.
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Affiliation(s)
- Irene Cantero
- 1Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain.,2Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
| | - Itziar Abete
- 1Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain.,2Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain.,3CIBERobn, Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain
| | - Josep Maria Del Bas
- Technological Unit of Nutrition and Health, EURECAT-Technological Center of Catalonia, Reus, Spain
| | - Antoni Caimari
- Technological Unit of Nutrition and Health, EURECAT-Technological Center of Catalonia, Reus, Spain
| | - Lluís Arola
- Technological Unit of Nutrition and Health, EURECAT-Technological Center of Catalonia, Reus, Spain
| | - M Angeles Zulet
- 1Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain.,2Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain.,3CIBERobn, Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - J Alfredo Martinez
- 1Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain.,2Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain.,3CIBERobn, Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,6IMDEA Food, Madrid, Spain
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Kuma A, Uchino B, Ochiai Y, Kawashima M, Enta K, Tamura M, Otsuji Y, Kato A. Relationship between abdominal adiposity and incident chronic kidney disease in young- to middle-aged working men: a retrospective cohort study. Clin Exp Nephrol 2018; 23:76-84. [DOI: 10.1007/s10157-018-1606-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 06/19/2018] [Indexed: 11/28/2022]
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Song J, Zhao Y, Nie S, Chen X, Wu X, Mi J. The effect of lipid accumulation product and its interaction with other factors on hypertension risk in Chinese Han population: A cross-sectional study. PLoS One 2018; 13:e0198105. [PMID: 29874254 PMCID: PMC5991403 DOI: 10.1371/journal.pone.0198105] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 05/14/2018] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Lipid accumulation product (LAP) is a simple and effective indicator that reflects visceral obesity. This study aimed to compare the significance of LAP in predicting hypertension risk with other obesity indices, and to evaluate the interactive effects of LAP and smoking, family history of hypertension on hypertension risk in Chinese Han adults. METHODS A community based cross-sectional study was performed in Bengbu, China. Participants received face-to-face questionnaire survey, anthropometric tests and laboratory examinations. Relevant indicators that reflect obesity including BMI (body mass index), waist-to-height ratio (WHtR) and LAP were calculated. Multivariate logistic regression analysis was applied to explore the association between LAP and hypertension risk. The area under the receiver-operating characteristics curves (AUC) of LAP, BMI, and WHtR were calculated and then compared. Interactive effect was evaluated by relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI). RESULTS A total of 1777 participants were enrolled, and the prevalence of hypertension was 24.4% (n = 433). There was a significant increase in hypertension risk with LAP levels in the fourth quartile as compared with the bottom quartile (OR: 3.31, 95%CI: 1.76-6.25). The AUC of LAP was significantly different than that of BMI in males (Z = 2.158, p = 0.0309) and females (Z = 3.570, p = 0.0004), while only performed better in females as compared with that of WHtR (Z = 2.166, p = 0.0303). LAP was significantly interacted with family history of hypertension on hypertension risk both in males (RERI: 1.07, 95%CI: 0.09-2.05; AP: 0.33, 95%CI: 0.23-0.44; SI: 1.92, 95%CI: 1.53-2.41) and females (RERI: 0.80, 95%CI: 0.07-1.53; AP: 0.25, 95%CI: 0.11-0.39; SI: 1.59, 95%CI: 1.16-2.19). However, a significant interaction between LAP and smoking was only observed in males (RERI: 1.32, 95%CI: 0.15-2.75; AP: 0.40, 95% CI: 0.14-0.73). CONCLUSION Increased LAP was significantly associated with a higher risk of hypertension in Chinese Han adults. Moreover, the effect of LAP on predicting hypertension risk was better than that of other obesity indices. Our results also demonstrated interactive effects of LAP with smoking, family history of hypertension on hypertension risk.
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Affiliation(s)
- Jian Song
- School of public health, Bengbu medical college, Bengbu, Anhui Province, China
| | | | - Sumei Nie
- Bengbu health board, Bengbu, Anhui Province, China
| | - Xue Chen
- School of public health, Bengbu medical college, Bengbu, Anhui Province, China
| | - Xuesen Wu
- School of public health, Bengbu medical college, Bengbu, Anhui Province, China
| | - Jing Mi
- School of public health, Bengbu medical college, Bengbu, Anhui Province, China
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Dong Y, Wang Z, Chen Z, Wang X, Zhang L, Nie J, Zheng C, Wang J, Shao L, Tian Y, Gao R. Comparison of visceral, body fat indices and anthropometric measures in relation to chronic kidney disease among Chinese adults from a large scale cross-sectional study. BMC Nephrol 2018; 19:40. [PMID: 29454330 PMCID: PMC5816526 DOI: 10.1186/s12882-018-0837-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 02/07/2018] [Indexed: 04/12/2023] Open
Abstract
Background The aim of the study was to assess the association between chronic kidney disease (CKD) and obesity in predicting CKD among Chinese adults, distinguishing between 5 different adiposity indices: visceral fat index (VFI), percentage body fat (PBF), body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR). Methods A total of 29,516 participants aged 35 years or above were selected using a stratified multistage random sampling method across China during 2012–2015. CKD was defined as an estimated glomerular filtration (eGFR) < 60 ml/min/1.72m2. Results The overall weighted prevalence of CKD was 3.94% (3.62% in males and 4.25% in females). All five adiposity indices had significant negative correlations to eGFR (P < 0.05). The area under the ROC (receiver operating characteristic) curves (AUC) for PBF was almost significantly larger than the other adiposity indices (P < 0.001). In addition, PBF yielded the highest Youden index in identifying CKD (male: 0.15; female: 0.20). In the logistic analysis, PBF had the highest crude odds ratios (ORs) in both males (OR: 1.819, 95% CI 1.559–2.123) and females (OR: 2.268, 95% CI 1.980–2.597). After adjusted for age, smoking status, alcohol use, education level, marital status, rural vs. urban area, geographic regions, and diagnosis of hypertension, diabetes mellitus, myocardial infarction and stroke, the ORs on PBF remained significant for both genders (P < 0.05). Conclusions Obesity is associated with an increased risk of CKD. Furthermore, PBF was a better predictor for identifying CKD than other adiposity indices (BMI, WC, WHtR, and VFI). Electronic supplementary material The online version of this article (10.1186/s12882-018-0837-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ying Dong
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Pecking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 102308, China
| | - Zengwu Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Pecking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 102308, China.
| | - Zuo Chen
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Pecking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 102308, China
| | - Xin Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Pecking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 102308, China
| | - Linfeng Zhang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Pecking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 102308, China
| | - Jingyu Nie
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Pecking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 102308, China
| | - Congyi Zheng
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Pecking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 102308, China
| | - Jiali Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Pecking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 102308, China
| | - Lan Shao
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Pecking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 102308, China
| | - Ye Tian
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Pecking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 102308, China
| | - Runlin Gao
- Fuwai Hospital, Pecking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 100037, China
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