Abdominal obesity phenotypes and risk of kidney function decline: Tehran Lipid and Glucose Study

Obes Res Clin Pract. 2020 Mar-Apr;14(2):168-175. doi: 10.1016/j.orcp.2020.03.006. Epub 2020 Apr 16.

Abstract

Objective: Obesity and related health risk in different obesity phenotypes has always been a controversial subject. The present study was conducted with the aim of investigating the risk of kidney function decline (KFD) incidence in different abdominal obesity phenotypes.

Methods: In this prospective observational cohort study, 7002 individuals (56.1% female), aged ≥20 years, were followed for the incidence of KFD defined as 40% decline in eGFR. Abdominal obesity was defined based on waist circumference cut-offs ≥89/91cm for men/women, respectively. Metabolic health was defined as ≤1 criterion of the metabolic syndrome criteria, according to the Joint Interim Statement (JIS) definition.

Results: At baseline 4273 individuals (61.0%) were abdominally obese, among whom, 1188 (27.8%) belonged to the metabolically healthy abdominal obese (MHAO) phenotype. Totally, 251 incidences of KFD was indicated throughout the 12-year follow-up. After adjusting for the confounding variables, MHAO phenotype was not associated with increased risk of KFD in both males and females. Furthermore, results indicated that hazard ratios (HRs) for incidence of KFD did not increase in males with unhealthy obesity phenotypes. However, females with metabolically unhealthy abdominal obese (MUAO) phenotype had increased risk of KFD.

Conclusion: Findings of this study indicated that MHAO phenotype was not associated with KFD incidence, regardless of the participants gender. Furthermore, MUAO phenotype was associated with higher risk of KFD only in females. Further studies with longer follow up and larger sample size are needed to shed more light upon the regarded relationship and the influential role of gender.

Keywords: Abdominal; Chronic kidney disease; End stage renal disease; Metabolic syndrome; Obesity.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Blood Glucose / metabolism
  • Body Mass Index
  • Cluster Analysis
  • Female
  • Humans
  • Incidence
  • Iran / epidemiology
  • Kidney / physiopathology
  • Lipids / blood
  • Male
  • Middle Aged
  • Obesity, Abdominal / complications
  • Obesity, Abdominal / physiopathology*
  • Obesity, Metabolically Benign / complications
  • Obesity, Metabolically Benign / physiopathology*
  • Phenotype
  • Proportional Hazards Models
  • Prospective Studies
  • Renal Insufficiency / epidemiology*
  • Renal Insufficiency / etiology*
  • Risk Factors
  • Sex Factors
  • Waist Circumference

Substances

  • Blood Glucose
  • Lipids