Prospective Evaluation of Waist Circumference and Visceral Adipose Tissue in Patients with Chronic Kidney Disease

Abstract

Background: Waist circumference (WC), a simple anthropometric measure, is associated with visceral adipose tissue (VAT) in cross-sectional studies, and thus has been used as a surrogate marker for VAT. However, associations between changes over time in WC and VAT have not been studied in chronic kidney disease (CKD) patients. Methods: This prospective study included 87 nondialysis-dependent CKD patients (54 males, 56.2 ± 10.4 years, BMI 27.3 ± 5.1, GFR 35.9 ± 14.6 ml/min/1.73 m²). VAT area was measured by computed tomography (CT) and WC was measured at the umbilicus level at baseline and after 12 months. Results: Changes in WC correlated significantly but weakly with changes in VAT (r = 0.26, p = 0.016), likely due to a substantially smaller change in WC compared to changes in VAT. This was also reflected by a kappa coefficient of 0.26, i.e. indicative of poor agreement between WC and CT measurements in regards to quantification of changes in VAT. Likewise, the receiver operating characteristic curve analysis identified WC as poor predictor of changes in VAT (area under the curve = 0.62). Conclusion: Anthropometric measurement of WC is poorly correlated with changes in VAT measured by CT in nondialysis-dependent CKD patients. Therefore, caution should be taken when using WC as a surrogate marker of VAT changes in this population.