Association Between Obesity and Chronic Kidney Disease, Defined by Both Glomerular Filtration Rate and Albuminuria, in Korean Adults

作者：Kim Yoon Ji; Hwang Seun Deuk; Oh Tae Jung; Kim Kyoung Min; Jang Hak Chul; Kimm Heejin; Kim Hyeon Chang; Jee Sun Ha^*; Lim Soo^*

来源：Metabolic Syndrome and Related Disorders, 2017, 15(8): 416-422.

DOI：10.1089/met.2017.0053

• obesity
• chronic kidney disease
• glomerular filtration rate
• albuminuria

Background: Chronic kidney disease (CKD) has often been defined based on glomerular filtration rate (GFR) alone. The Kidney Disease: Improving Global Outcomes guideline highlights albuminuria in the CKD definition. Thus, we investigated the association between obesity and CKD, as defined by both GFR and albuminuria, in Korean adults.
Methods: We used Korea National Health and Nutrition Examination Survey 2011-2014 data (N=19,331, 19 years old) representing the national Korean population. CKD was classified by (1) estimated GFR (eGFR)<60mL/min/1.73m(2) (CKDGFR); (2) albumin-to-creatinine ratio (ACR) 30mg/gram (CKDACR); and (3) eGFR<60mL/min/1.73m(2) or ACR 30mg/gram (CKDRisk). Associations between obesity and each CKD category were evaluated using multivariate logistic regression analysis.
Results: The prevalence rates of CKDGFR, CKDACR, and CKDRisk were 2.2%, 6.7%, and 8.1%, respectively. Compared with the normal body mass index (BMI; 18.5-22.9kg/m(2)) group, men with BMI25kg/m(2) had 1.88 times greater risk of CKDGFR in the adjusted model [95% confidence interval (CI), 1.26-2.80; P=0.002]; BMI was not significantly associated with CKDGFR in women. In contrast, both men and women with BMI25kg/m(2) had 1.58 and 1.40 times higher risk of CKDACR (95% CI, 1.21-2.07 and 1.08-1.81, respectively, both P<0.01). Obese men and women had 1.65 and 1.38 times higher risk of CKDRisk (95% CI, 1.29-2.12 and 1.09-1.75, respectively, both P<0.01).
Conclusions: Obesity was significantly associated with an increased ACR-based CKD risk. Longitudinal studies are needed to investigate the role of overweight and obesity in the development and progression of CKD.

• 出版日期2017-10