RESEARCH PAPER
Association of anthropometric measures of obesity and chronic kidney disease in elderly women
 
More details
Hide details
1
Department of Family Medicine, Medical University of Lublin, Poland
 
2
Out-Patient Clinic Esculap Gniewkowo,Gniewkowo, Poland
 
3
Department of Cardiology, Medical University of Lublin, Poland
 
4
Department of Vascular Surgary and Angiology Nicolaus Copernicus University, Bydgoszcz, Poland
 
5
Department of Nephrology, Medical University of Lublin, Poland
 
6
Institute of Rural Health, Lublin, Poland
 
 
Corresponding author
Andrzej Jaroszynski   

Department of Family Medicine, Medical University of Lublin, Poland
 
 
Ann Agric Environ Med. 2016;23(4):636-640
 
KEYWORDS
ABSTRACT
Introduction and objective:
Growing evidence suggests that obesity is an important contributor to the development of chronic kidney disease (CKD). The relationship between obesity and CKD is complex and not completely understood, and the best anthropometric index of obesity in predicting CKD is controversial. This study aimed to determine the best anthropometric index of obesity in predicting CKD in a population of elderly women.

Material and Methods:
Anthropometric indexes of obesity including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WheiR) and waist-to-hip-ratio (WHR), were obtained in 730 selected females. Biochemical measurements including blood glucose, lipid profile, and 2-h postprandial blood glucose were performed. GFR was estimated by using CKD-EPI equation.

Results:
The prevalence of CKD stage ≥ 3 was 12.2%. Overweight and obesity was found in 50% and 36% of participants, respectively. Increased central fat distribution, as defined by WheiR, WC and WHR, was found in 89.6%, 91.7% and 89.4% individuals, respectively. Univariate linear regression analysis showed positive correlations between CKD and age (p<0.001), BMI (p<0.001), WC (p<0.001), WHR (p=0.007), WheiR (p<0.001), diabetes (p=0.002), as well as triglicerydes (p=0.031), and negative correlation between CKD and HDL level (p=0.017). Multivariable analysis demonstrated that hypertension, diabetes, WC and WheiR were independent predictors of CKD. The area under the receiver operating characteristics curve was best for WheiR (0.647), followed by WC (0.620), BMI (0.616), and WHR (0.532).

Conclusions:
Abdominal obesity is an important predictor of CKD. Of commonly used anthropometric parameters of obesity WheiR ≥ 0.6 is particularly associated with CKD in elderly females.

 
REFERENCES (25)
1.
Flegal K, Carroll M, Kit B, Ogden C. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010.JAMA 2012; 307: 491–497.
 
2.
Zatońska K, Janik-Koncewicz K, Regulska-Ilow B, Ilow R, Różańska D, Szuba A, et al. Prevalence of obesity – baseline assessment in the prospective cohort ‘PONS’ study. Ann Agric Environ Med. 2011; 18: 246–250.
 
3.
Levey A, de Jong P, Coresh J, El Nahas M, Astor B, Matsushita K, et al. The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report. Kidney Int. 2011; 80: 17–28.
 
4.
Ting S, Nair H, Ching I, Taheri S, Dasgupta I. Overweight, obesity and chronic kidney disease. Nephron Clin Pract. 2009; 112: 121–127.
 
5.
Burton J, Gray L, Webb D, Davies M, Khunti K, Crasto W, et al. Association of anthropometric obesity measures with chronic kidney disease risk in a non-diabetic patient population. Nephrol Dial Transplant. 2012; 27: 1860–1866.
 
6.
Iseki K, Ikemiya Y, Kinjo K, Inoue T, Iseki C, Takishita S. Body mass index and the risk of development of end-stage renal disease in a careened cohort. Kidney Int 2004; 65: 1870–1876.
 
7.
Bartali B, Benvenuti E, Corsi A, Bandinelli S, Iorio A, Lauretani F, et al. Changes in anthropometric measures in man and women across the life-span: finding from the InCHIANTI study. Soz Praventivmed 2002; 47: 336–348.
 
8.
Lin Ch, Chou C, Lin C, Huang C, Liu C, Lai S. Waist-to-height ratio is the best index of obesity in association with chronic kidney disease. Nutrition 2007; 23: 788–79.
 
9.
Stevens L, Claybon M, Schmid C, Chen J, Horio M, Imai E, et al. Evaluation of the Chronic Kidney Disease Epidemiology Collaboration equation for estimating the glomerular filtration rate in multiple ethnicities. Kidney Int. 2011; 79, 555–562.
 
10.
World Health Organisation. Waist circumference and waist–hip ratio: report of a WHO expert consultation, Geneva, 8–11 December 200World Health Organisation; 2011.
 
11.
Cordeiro A, Qureshi A, Lindholm B, Amparo F, Tito-Paladino-Filho A, Perini M, et al. Visceral fat and coronary artery calcification in patients with chronic kidney disease. Nephrol Dial Transplant 2013; doi:10.1093/ndt/gft250.
 
12.
Gelber R, Gaziano J, Orav E, Manson J, Buring J, Kurth T. Measures of obesity and cardiovascular risk among men and women. J Am Coll Cardiol. 2008; 52: 605–615.
 
13.
Klein S, Allison D, Heymsfield S , Kelley D, Leibel R, Nonas C, et al. Waist circumference and cardiometabolic risk: a consensus statement from Shaping America’s Health: Association for Weight Management and Obesity Prevention; NAASO, The Obesity Society; the American Society for Nutrition; and the American Diabetes Association. Am J Clin Nutr. 2007; 85: 1197–1202.
 
14.
Guasch-Ferré M, Bulló M, Martínez-González M, Corella D, Estruch R, Covas M, et al. Waist-to-height ratio and cardiovascular risk factors in elderly individuals at high cardiovascular risk. PLoS One 2012; 7:e43275.
 
15.
Evans P, McIntyre N, Fluck R, McIntyre C, Taal M. Anthropomorphic Measurements That Include Central Fat Distribution Are More Closely Related with Key Risk Factors than BMI in CKD Stage PLoS ONE 2012; 7: e34699.
 
16.
Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev. 2012; 13: 275–286.
 
17.
Pinto-Sietsma S, Navis G, Janssen W, de Zeeuw D, Gans R, dr Jong P, et al. A central body fat distribution is related to renal function impairment, even in lean subjects. Am J Kidney Dis. 2003; 41: 733–741.
 
18.
Elsayed E, Tighiouart H, Weiner D, Griffith J, Salem D, Levey A, et al. Waist-to-hip ratio and body mass index as risk factors for cardiovascular events in CKD. Am J Kidney Dis. 2008; 52: 49–57.
 
19.
Kramer H, Shoham D, McClure L, Durazo-Arvizu R, Howard G, Judd S, et al. Association of waist circumference and body mass index with all-cause mortality in CKD: The REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study. Am J Kidney Dis. 58: 177–185.
 
20.
Witasp A, Carrero J, Heimburger O, Lindholm B, Hammarqvist P, Nordfors L. Increased expression of pro-inflammatory genes in abdominal subcutaneous fat in advanced chronic kidney disease patients. J Intern Med. 2011; 269: 410–419.
 
21.
Tseng CH. Waist-to-Height Ratio Is Independently and Better Associated With Urinary Albumin Excretion Rate Than Waist Circumference or Waist-to-Hip Ratio in Chinese Adult Type 2 Diabetic Women but Not Men. Diabetes Car. 2005; 28: 2249–2251.
 
22.
Ashwell M, Hsieh S. Six reasons why the waist-to-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity. Int J Food Sci Nutr. 2005; 56: 303–307.
 
23.
Browning L, Hsieh S, Ashwell M. A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0.5 could be a suitable global boundary value. Nutr Res Rev. 2010; 23: 247–269.
 
24.
Oh H, Quan S, Jeong J, Jang S, Lee J, Kim D. Waist Circumference, Not Body Mass Index, Is Associated with Renal Function Decline in Korean Population: Hallym Aging Study. PLoS ONE 2013; 8: e59071.
 
25.
Cox B, Whichelow M, Ashwell M, Prevost A, Lejeune S. Association of anthropometric indices with elevated blood pressure in British adults. Int J Obes Metab Disord. 1997; 21: 674–680.
 
eISSN:1898-2263
ISSN:1232-1966
Journals System - logo
Scroll to top