Sex Differences in Associations Among Obesity, Metabolic Abnormalities, and Chronic Kidney Disease in Japanese Men and Women.

Masaru Sakurai,Shin-Ya Nagasawa,Hiroshi Mabuchi,Hideaki Nakagawa,Yasuo Takeda,Junji Kobayashi,Junji Moriya,Junichi Yamakawa

doi:10.2188/jea.je20150208

Abstract

AimsThe present study aimed to investigate relationships among abdominal obesity, metabolic abnormalities, and the prevalence of chronic kidney disease (CKD) in relatively lean Japanese men and women.Participants and methodsThe participants included 8133 men and 15 934 women between 40 and 75 years of age recruited from the government health check-up center in Kanazawa City, Japan. The prevalence of abdominal obesity, high blood pressure, dyslipidemia, and high fasting plasma glucose levels were assessed according to the Japanese criteria for metabolic syndrome. The estimated glomerular filtration rate (eGFR) was calculated using the modified Modification of Diet in Renal Disease equation for the Japanese population, and participants with an eGFR <60 mL/min/1.73 m2 and/or proteinuria were diagnosed with CKD.ResultsOverall, 23% of males and 14% of females met criteria for CKD. Having more numerous complicated metabolic abnormalities was significantly associated with a higher odds ratio (OR) of CKD for men and women, irrespective of abdominal obesity. However, there was a sex difference in the OR of CKD for obese participants without metabolic abnormalities, such that abdominal obesity without metabolic abnormalities was significantly associated with a higher OR for men (multivariate-adjusted OR 1.63; 95% confidence interval [CI], 1.16–2.28) but not for women (OR 1.01; 95% CI, 0.71–1.44).ConclusionsThe present findings demonstrated that obesity without metabolic abnormalities was associated with a higher risk of CKD in men but not women in a relatively lean Japanese population.

Highlights

The increasing number of patients with end-stage renal disease (ESRD) has been recognized as a major global public health problem.[1]
Abdominal obesity was associated with low estimated glomerular filtration rate (eGFR), proteinuria, and chronic kidney disease (CKD) independent of other metabolic abnormalities among men and women
High plasma glucose was associated with proteinuria, but not with low eGFR, after adjusting for other metabolic abnormalities, and it was not associated with CKD in men

Summary

Introduction

The increasing number of patients with end-stage renal disease (ESRD) has been recognized as a major global public health problem.[1]. Obesity is a representative risk factor of CKD5–7 because the hemodynamic and hormonal changes caused by excess weight and the accumulation of abdominal fat may increase the risk for CKD.[8,9,10] It has been shown that obesityrelated metabolic abnormalities, such as hypertension,[11,12] dyslipidemia,[13,14] and diabetes mellitus,[13,15] affect the progression of CKD. The prevalence of obesity among Asian individuals is relatively low,[16] and it is not clear whether obesity itself or the metabolic abnormalities caused by obesity have a stronger effect on the progression of CKD

Methods

Results

Conclusion