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Obesity (Silver Spring). 2018 Apr;26(4):762-768. doi: 10.1002/oby.22134. Epub 2018 Mar 2.

Metabolically Healthy Obesity and Risk of Kidney Function Decline.

Author information

1
Kidney Health Research Institute, Geisinger Health, Danville, Pennsylvania, USA.
2
Department of Epidemiology and Health Services Research, Geisinger Health, Danville, Pennsylvania, USA.
3
Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA.
4
Biomedical and Translational Informatics Institute, Geisinger Health, Danville, Pennsylvania, USA.
5
Division of Nephrology, Loyola University Medical Center, Maywood, Illinois, USA.
6
Department of Molecular and Functional Genomics, Geisinger Health, Danville, Pennsylvania, USA.
7
Divison of Nephrology, Johns Hopkins University, Baltimore, Maryland, USA.

Abstract

OBJECTIVE:

The aim of this study was to examine the association between BMI categories, stratified by metabolic health status, and the risk of kidney function decline (KFD).

METHODS:

In this study, 42,128 adult patients with a stable BMI were classified over a 3-year baseline window by BMI and metabolic health status (assessed by Adult Treatment Panel-III criteria). KFD was defined as an estimated glomerular filtration rate (eGFR) decline ≥ 30%, eGFR < 15 mL/min/1.73 m2 , or receipt of dialysis and/or transplant.

RESULTS:

Over a median of 5.1 years (interquartile range 2.1-8.9), 6,533 (15.5%) individuals developed KFD. Compared with the normal weight, metabolically healthy category, metabolically healthy obesity was associated with a higher risk of KFD (adjusted hazard ratio [aHR] 1.52; 95% CI: 1.22-1.89). aHRs for KFD were 1.17 (95% CI: 0.89-1.53), 2.21 (95% CI: 1.59-3.08), and 2.20 (95% CI: 1.55-3.11) for metabolically healthy obesity with BMI 30 to 34.9, BMI 35 to 39.9, and BMI ≥ 40 kg/m2 . These associations were consistent among men and women, patients with eGFR ≥ or < 90 mL/min/1.73 m2 , and age ≥ or < 55 years. The risk of KFD was highest among metabolically unhealthy individuals with BMI ≥ 40 (aHR 4.02; 95% CI: 3.40-4.75 vs. metabolically healthy individuals with normal weight).

CONCLUSIONS:

Obesity, whether in the presence or absence of metabolic health, is a risk factor for KFD.

PMID:
29498223
PMCID:
PMC5866209
DOI:
10.1002/oby.22134
[Indexed for MEDLINE]
Free PMC Article

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