U-shaped association between central body fat and the urinary albumin-to-creatinine ratio and microalbuminuria

Kathleen Dittmann,Sylvia Stracke,Nele Friedrich,Anke Hannemann,Matthias Nauck,Henri Wallaschofski,Henry Völzke,Rainer Rettig

doi:10.1186/1471-2369-14-87

Kathleen Dittmann, Sylvia Stracke + Show 6 more

Open Access

https://doi.org/10.1186/1471-2369-14-87

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Journal: BMC Nephrology	Publication Date: Apr 17, 2013
Citations: 53	License type: CC BY 2.0

Affiliation: University of Greifswald

Abstract

BackgroundThe prevalence of obese and overweight patients has increased dramatically worldwide. Both are common risk factors for chronic kidney disease (CKD) as indicated by a diminished estimated glomerular filtration rate (eGFR) or microalbuminuria. This study aimed to investigate whether anthropometric parameters [waist circumference (WC), waist-to-height ratio (WHtR) and body mass index (BMI)] are associated with renal function in a population-based study of Caucasian subjects.MethodsData from 3749 subjects (1825 women) aged 20 to 81 years from the Study of Health in Pomerania (SHIP) were analysed. Renal indices, including the urinary albumin-to-creatinine ratio (uACR), microalbuminuria, eGFR and CKD, were studied. Parameters of anthropometry (WC, WHtR and BMI) were categorised into sex-specific quintiles.ResultsAnalysis of variance (ANOVA) models, adjusting for age, sex, type 2 diabetes mellitus and hypertension, revealed that a high and low WC or WHtR and low BMI were independently related to a higher uACR. Logistic regression models confirmed these results with respect to uACR and showed that subjects with a high or low WC or a high WHtR had increased odds of microalbuminuria. The ANOVA models revealed no relations of the investigated anthropometric parameters with eGFR. However, subjects with high values for these parameters had increased odds of CKD.ConclusionsOur results demonstrate U-shaped associations between markers of central fat distribution and uACR or microalbuminuria in the general population, suggesting that both obese and very thin subjects have a higher risk of renal impairment.

Highlights

The prevalence of obese and overweight patients has increased dramatically worldwide
This study aimed to identify possible associations between waist circumference (WC), waist-to-height ratio (WHtR) or body mass index (BMI) and renal dysfunction based on the urinary albumin-to-creatinine ratio, microalbuminuria, estimated glomerular filtration rate (GFR) and chronic kidney disease (CKD) in an adult Caucasian population
Multivariable ANOVA models confirmed these U-shaped relationships between WC or WHtR and urinary albumin-to-creatinine ratio (uACR) (Figure 1, upper right panel)

Summary

Introduction

The prevalence of obese and overweight patients has increased dramatically worldwide. Both are common risk factors for chronic kidney disease (CKD) as indicated by a diminished estimated glomerular filtration rate (eGFR) or microalbuminuria. Waist circumference (WC) and waist-to-hip ratio (WHR) as indices of visceral obesity have been reported to be even more sensitive predictors of late-stage renal disease than BMI [6]. Renal and Vascular End-Stage Disease (PREVEND) study [9] revealed that obese subjects with a central fat distribution had a higher risk of microalbuminuria than lean subjects with a peripheral fat distribution. That study [9] showed that overweight and obese subjects and lean subjects with central fat distribution were at a higher risk of a diminished GFR

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