Association Between Body Mass Index Combined with Albumin: creatinine Ratio and All-cause Mortality in Chinese Population

Jiachuan Xiong,Luxia Zhang,Jinghong Zhao,Jinwei Wang

doi:10.1038/s41598-017-11084-5

Abstract

The association between body mass index (BMI) combined with albumin: creatinine ratio (ACR) and all-cause mortality in the general population has not been established. To address this, we examined a representative sample from the general population of China. The study included 46,854 participants with a follow-up of 4.6 years. Compared to the normal weight with ACR <10 mg/g group (the reference group), the crude hazard ratios (HRs) for all-cause mortality for the underweight with ACR >10 mg/g, normal weight with ACR >10 mg/g, overweight with ACR >10 mg/g, and obese with ACR >10 mg/g groups, were 2.22 (95% CI, 1.41 to 3.49), 1.70 (95% CI, 1.42 to 2.04), 1.52 (95% CI, 1.22 to 1.89), and 2.05 (95% CI, 1.45 to 2.89), respectively. After multivariable adjustments for age, race, comorbidities, and baseline eGFR, the HRs for the underweight with ACR >10 mg/g and normal weight with ACR >10 mg/g groups were 1.85 (95% CI, 1.17 to 2.91) and 1.36 (95% CI, 1.13 to 1.63), respectively. The results indicate that BMI combined with ACR can better predict all-cause mortality than BMI alone in the general Chinese population. Underweight and normal weight people with elevated ACR are at a higher risk of all-cause mortality than those in the same BMI category with ACR <10 mg/g.

Highlights

Obesity is a medical problem in which body fat has accumulated to the extent
We aimed to evaluate the association of body mass index (BMI) combined with Albumin: creatinine ratio (ACR) to predict the risk of all-cause mortality in the Chinese population
Of those study participants with hypertension, 67% were in the highest BMI category (≥30.0 kg/m2), while only 13.8% were in the lowest BMI category (

Summary

Introduction

Obesity is a medical problem in which body fat has accumulated to the extent. Commonly caused by a combination of excessive food energy intake, lack of physical activity, and genetic susceptibility[1], it may have a negative effect on health that can reduce life expectancy and increase health problems[2]. Urinary albumin is a marker of future blood pressure problems and hypertension in the general population, and an independent predictor of future increases in systolic blood pressure[11]. It is an independent risk factor for 5-year mortality in chronic kidney disease (CKD)[12]. A recent meta-analysis of 14 studies involving 105,872 participants found that an ACR ≥1 · 1 mg/mmol (10 mg/g) was an independent predictor of mortality risk in the general population[14]. We aimed to evaluate the association of BMI combined with ACR to predict the risk of all-cause mortality in the Chinese population

Objectives

Results

Conclusion