Nutrition, metabolism, and cardiovascular diseases : NMCD · 2024
Sex- and metabolic-specific association between cumulative body mass index and incident chronic kidney disease: A prospective community-based cohort study.
СтатьяСравнительное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Zuo Yingting, Xia Zhang, Chen Shuohua, Chu Lulu, Zhang Yijun, Li Yuhao, Zheng Manqi, Xu Guozheng, He Yan, Wu Shouling, Wang Anxin
Аннотация
BACKGROUND AND AIM: Difference in metabolic status may cause inconsistent association between body mass index (BMI) and chronic kidney disease (CKD) in men and women. This study aimed to quantify sex-specific association between cumulative BMI (cumBMI) and incident CKD by different metabolic status.
METHODS AND RESULTS: Participants free of CKD from the Kailuan Study were followed biennially from baseline (June 2006 to October 2007) to December 2019. cumBMI was calculated by use of follow-up BMI and follow-up time and was divided into low weight (<18.5 kg/m2), normal weight (18.5-23.9 kg/m2), overweight (24-27.9 kg/m2), and obesity (≥28 kg/m2) according to Chinese criteria. Metabolic health was defined as the absence of hypertension, dyslipidemia, and diabetes at baseline. CKD was defined as having estimated glomerular filtration rate <60 mL/min/1.73 m2. This study included 76984 participants, with a mean age of 50.0 ± 11.6 years and 80.0 % of men. Overweight (HR = 1.24, 95 % CI: 1.16-1.31) and obesity (HR = 1.94, 95 % CI: 1.77-2.12) were associated with higher risk of incident CKD in men regardless of metabolic status. Corresponding population attributable risk percentages for overweight and obesity were 10.3 % (95%CI: 7.1-12.9) and 12.7 % (95%CI: 10.6-14.7), respectively. However, low weight (HR = 1.56, 95 % CI: 1.05-2.30) and obesity (HR = 1.32, 95 % CI: 1.01-1.73) were associated with higher risk of incident CKD in metabolically healthy women but not in metabolically unhealthy women.
CONCLUSIONS: This study demonstrated sex- and metabolic-specific associations between BMI and CKD occurrence and advocates an individualized weight management strategy.
METHODS AND RESULTS: Participants free of CKD from the Kailuan Study were followed biennially from baseline (June 2006 to October 2007) to December 2019. cumBMI was calculated by use of follow-up BMI and follow-up time and was divided into low weight (<18.5 kg/m2), normal weight (18.5-23.9 kg/m2), overweight (24-27.9 kg/m2), and obesity (≥28 kg/m2) according to Chinese criteria. Metabolic health was defined as the absence of hypertension, dyslipidemia, and diabetes at baseline. CKD was defined as having estimated glomerular filtration rate <60 mL/min/1.73 m2. This study included 76984 participants, with a mean age of 50.0 ± 11.6 years and 80.0 % of men. Overweight (HR = 1.24, 95 % CI: 1.16-1.31) and obesity (HR = 1.94, 95 % CI: 1.77-2.12) were associated with higher risk of incident CKD in men regardless of metabolic status. Corresponding population attributable risk percentages for overweight and obesity were 10.3 % (95%CI: 7.1-12.9) and 12.7 % (95%CI: 10.6-14.7), respectively. However, low weight (HR = 1.56, 95 % CI: 1.05-2.30) and obesity (HR = 1.32, 95 % CI: 1.01-1.73) were associated with higher risk of incident CKD in metabolically healthy women but not in metabolically unhealthy women.
CONCLUSIONS: This study demonstrated sex- and metabolic-specific associations between BMI and CKD occurrence and advocates an individualized weight management strategy.