Abstract
ObjectiveKidney dysfunction in obesity may be independent of and may precede the development of hypertension and/or diabetes mellitus. We aimed to examine if abdominal obesity is associated with early markers of CKD in a young healthy population and whether these associations differ by race and/or ethnicity.MethodsWe analyzed data from the NHANES 1999–2010 for 6918 young adults ages 20–40 years. Abdominal obesity was defined by gender criteria of waist circumference. CKD markers included estimated glomerular filtration rate and albuminuria ≥30 mg/g. Race stratified analyses were done overall and in subgroups with normal blood pressures, normoglycemia and normal insulin sensitivity. Awareness of CKD was assessed in participants with albuminuria.ResultsAbdominal obesity was present in over one-third of all young adults and was more prevalent among non-Hispanic blacks (45.4%) versus Mexican-Americans (40.6%) or non-Hispanic whites (37.4%) (P-value = 0.004). Mexican-American young adults with abdominal obesity had a higher odds of albuminuria even among those with normal blood pressure, normal glucose, and normal insulin sensitivity [adjusted odds ratio 4.5; 95% confidence interval (1.6–12.2), p = 0.004]. Less than 5% of young adults with albuminuria of all races and ethnicities had been told they had kidney disease.ConclusionAbdominal obesity in young adults, especially in Mexican-Americans, is independently associated with albuminuria even with normal blood pressures, normoglycemia and normal insulin levels. Greater awareness of CKD is needed to protect this young population from long-standing exposure to abdominal obesity and early progressive renal disease.
Highlights
The obesity epidemic affects more than a third of adults (body mass index (BMI) 30 kg/m2) in the United States, according to data from the National Health and Nutrition Examination Survey (NHANES) 2011–2012 survey cycle[1]
Mexican-American young adults with abdominal obesity had a higher odds of albuminuria even among those with normal blood pressure, normal glucose, and normal insulin sensitivity [adjusted odds ratio 4.5; 95% confidence interval (1.6–12.2), p = 0.004]
We examined the distribution of chronic kidney disease (CKD) risk factors in NHANES participants with missing data on one or more variables of interest
Summary
The obesity epidemic affects more than a third of adults (body mass index (BMI) 30 kg/m2) in the United States, according to data from the National Health and Nutrition Examination Survey (NHANES) 2011–2012 survey cycle[1]. Obesity is closely linked to the development of hypertension, dyslipidemia and diabetes mellitus that together constitute the metabolic syndrome. Together, they are well established independent risk factors for cardiovascular disease (CVD) and chronic kidney disease (CKD) [2]. The CARDIA Study in healthy white and black young adults showed a rapid decline in estimated GFR (eGFR) with higher BMI [10]. They did not assess albuminuria or include Hispanics, the largest racial/ ethnic minority in the US. The young adult population is at a high risk of obesity-related future kidney disease and provides opportunities for preventive interventions [11]
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