Association of body mass index with kidney function and mortality in high cardiovascular risk population: A nationwide prospective cohort study

被引:1
作者
Aiumtrakul, Noppawit [1 ]
Kittithaworn, Annop [1 ]
Supasyndh, Ouppatham [1 ]
Krittayaphong, Rungroj [2 ]
Phrommintikul, Arintaya [3 ]
Satirapoj, Bancha [1 ]
机构
[1] Phramongkutklao Hosp & Coll Med, Div Nephrol, Dept Med, Bangkok 10400, Thailand
[2] Mahidol Univ, Fac Med, Dept Med, Div Cardiol,Siriraj Hosp, Bangkok, Thailand
[3] Chiang Mai Univ, Dept Internal Med, Div Cardiol, Fac Med, Chiang Mai, Thailand
关键词
body mass index; end-stage renal disease; glomerular filtration rate; high cardiovascular risk; mortality; obesity; OBESITY; DISEASE; OVERWEIGHT; UNDERWEIGHT; OUTCOMES; PARADOX; CKD;
D O I
10.1111/nep.13970
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background There is increasing awareness of the impact of obesity and underweight on cardiovascular (CV) disease, chronic kidney disease (CKD) and mortality. Abnormal body mass index (BMI) might be associated with worse clinical outcomes, including CKD progression, but limited evidence exists among Asian patients with high CV risk. Objective To investigate the association of BMI with progressive loss of kidney function and all-cause mortality in Thai patients with high CV risk. Methods In a national cohort of 5887 high CV risk subjects, we assessed the association of high BMI with the composite renal outcome (estimated glomerular filtration rate [eGFR] decline over 40%, eGFR less than 15 mL/min/1.73 m(2), doubling of serum creatinine, initiation of dialysis and death related to renal causes) and with all-cause mortality in Cox proportional hazards models. Results A total of 5887 participants (3217 male and 2670 female) with high CV risk were enrolled. Participants were classified into five groups by their baseline BMI; <20 kg/m(2) (n = 482), 20-24.9 kg/m(2) (n = 2437), 25-29.9 kg/m(2) (n = 2140), 30-34.9 kg/m(2) (n = 665) and 35 kg/m(2) (n = 163), respectively. On multivariate analysis of Cox proportional hazards models, adjusted for other covariates, baseline BMI >= 35 kg/m(2) was an independent predictor of loss of kidney function (HR 1.60, 95% CI 1.04-2.40) and all-cause mortality (HR 2.68, 95% CI 1.50-4.80). Baseline BMI <20 kg/m(2) was an independent predictor of all-cause mortality as well (adjusted HR 2.26, 95% CI 1.50-3.42). Conclusion In the high CV risk Thai population, a BMI of 35 kg/m(2) or more is associated with loss of kidney function and mortality. On the other hand, a BMI less than 20 kg/m(2) is also associated with all-cause mortality.
引用
收藏
页码:25 / 34
页数:10
相关论文
共 36 条
  • [1] Health Effects of Overweight and Obesity in 195 Countries over 25 Years
    Afshin, Ashkan
    Forouzanfar, Mohammad H.
    Reitsma, Marissa B.
    Sur, Patrick
    Estep, Kara
    Lee, Alex
    Marczak, Laurie
    Mokdad, Ali H.
    Moradi-Lakeh, Maziar
    Naghavi, Mohsen
    Salama, Joseph S.
    Vos, Theo
    Abate, Kalkidan H.
    Abbafati, Cristiana
    Ahmed, Muktar B.
    Al-Aly, Ziyad
    Alkerwi, Ala'a
    Al-Raddadi, Rajaa
    Amare, Azmeraw T.
    Amberbir, Alemayehu
    Amegah, Adeladza K.
    Amini, Erfan
    Amrock, Stephen M.
    Anjana, Ranjit M.
    Arnlov, Johan
    Asayesh, Hamid
    Banerjee, Amitava
    Barac, Aleksandra
    Baye, Estifanos
    Bennett, Derrick A.
    Beyene, Addisu S.
    Biadgilign, Sibhatu
    Biryukov, Stan
    Bjertness, Espen
    Boneya, Dube J.
    Campos-Nonato, Ismael
    Carrero, Juan J.
    Cecilio, Pedro
    Cercy, Kelly
    Ciobanu, Liliana G.
    Cornaby, Leslie
    Damtew, Solomon A.
    Dandona, Lalit
    Dandona, Rakhi
    Dharmaratne, Samath D.
    Duncan, Bruce B.
    Eshrati, Babak
    Esteghamati, Alireza
    Feigin, Valery L.
    Fernandes, Joao C.
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2017, 377 (01) : 13 - 27
  • [2] [Anonymous], 2021, Adult Obesity Facts
  • [3] Podocyte lesions in patients with obesity-related glomerulopathy
    Chen, Hui-Mei
    Liu, Zhi-Hong
    Zeng, Cai-Hong
    Li, Shi-Jun
    Wang, Qing-Wen
    Li, Lei-Shi
    [J]. AMERICAN JOURNAL OF KIDNEY DISEASES, 2006, 48 (05) : 772 - 779
  • [4] Body-Mass Index and Mortality among 1.46 Million White Adults.
    de Gonzalez, Amy Berrington
    Hartge, Patricia
    Cerhan, James R.
    Flint, Alan J.
    Hannan, Lindsay
    MacInnis, Robert J.
    Moore, Steven C.
    Tobias, Geoffrey S.
    Anton-Culver, Hoda
    Freeman, Laura Beane
    Beeson, W. Lawrence
    Clipp, Sandra L.
    English, Dallas R.
    Folsom, Aaron R.
    Freedman, D. Michal
    Giles, Graham
    Hakansson, Niclas
    Henderson, Katherine D.
    Hoffman-Bolton, Judith
    Hoppin, Jane A.
    Koenig, Karen L.
    Lee, I-Min
    Linet, Martha S.
    Park, Yikyung
    Pocobelli, Gaia
    Schatzkin, Arthur
    Sesso, Howard D.
    Weiderpass, Elisabete
    Willcox, Bradley J.
    Wolk, Alicja
    Zeleniuch-Jacquotte, Anne
    Willett, Walter C.
    Thun, Michael J.
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2010, 363 (23) : 2211 - 2219
  • [5] Fatty kidney: emerging role of ectopic lipid in obesity-related renal disease
    de Vries, Aiko P. J.
    Ruggenenti, Piero
    Ruan, Xiong Z.
    Praga, Manuel
    Cruzado, Josep M.
    Bajema, Ingeborg M.
    D'Agati, Vivette D.
    Lamb, Hildo J.
    Barlovic, Drazenka Pongrac
    Hojs, Radovan
    Abbate, Manuela
    Rodriquez, Rosa
    Mogensen, Carl Erik
    Porrini, Esteban
    [J]. LANCET DIABETES & ENDOCRINOLOGY, 2014, 2 (05) : 417 - 426
  • [6] Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants
    Di Cesare, Mariachiara
    Bentham, James
    Stevens, Gretchen A.
    Zhou, Bin
    Danaei, Goodarz
    Lu, Yuan
    Bixby, Honor
    Cowan, Melanie J.
    Riley, Leanne M.
    Hajifathalian, Kaveh
    Fortunato, Lea
    Taddei, Cristina
    Bennett, James E.
    Ikeda, Nayu
    Khang, Young-Ho
    Kyobutungi, Catherine
    Laxmaiah, Avula
    Li, Yanping
    Lin, Hsien-Ho
    Miranda, J. Jaime
    Mostafa, Aya
    Turley, Maria L.
    Paciorek, Christopher J.
    Gunter, Marc
    Ezzati, Majid
    Abdeen, Ziad A.
    Hamid, Zargar Abdul
    Abu-Rmeileh, Niveen M.
    Acosta-Cazares, Benjamin
    Adams, Robert
    Aekplakorn, Wichai
    Aguilar-Salinas, Carlos A.
    Ahmadvand, Alireza
    Ahrens, Wolfgang
    Ali, Mohamed M.
    Alkerwi, Ala'a
    Alvarez-Pedrerol, Mar
    Aly, Eman
    Amouyel, Philippe
    Amuzu, Antoinette
    Andersen, Lars Bo
    Anderssen, Sigmund A.
    Andrade, Dolores S.
    Anjana, Ranjit Mohan
    Aounallah-Skhiri, Hajer
    Ariansen, Inger
    Aris, Tahir
    Arlappa, Nimmathota
    Arveiler, Dominique
    Assah, Felix K.
    [J]. LANCET, 2016, 387 (10026) : 1377 - 1396
  • [7] Obesity and risk for chronic renal failure
    Ejerblad, Elisabeth
    Fored, C. Michael
    Lindblad, Per
    Fryzek, Jon
    McLaughlin, Joseph K.
    Nyren, Olof
    [J]. JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2006, 17 (06): : 1695 - 1702
  • [8] Cause-specific excess deaths associated with underweight, overweight, and obesity
    Flegal, Katherine M.
    Graubard, Barry I.
    Williamson, David F.
    Gail, Mitchell H.
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2007, 298 (17): : 2028 - 2037
  • [9] Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index Categories A Systematic Review and Meta-analysis
    Flegal, Katherine M.
    Kit, Brian K.
    Orpana, Heather
    Graubard, Barry I.
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2013, 309 (01): : 71 - 82
  • [10] Overweight, obesity, and the development of stage 3 CKD: The Framingham Heart Study
    Foster, Meredith C.
    Hwang, Shih-Jen
    Larson, Martin G.
    Lichtman, Judith H.
    Parikh, Nisha I.
    Vasan, Ramachandran S.
    Levy, Daniel
    Fox, Caroline S.
    [J]. AMERICAN JOURNAL OF KIDNEY DISEASES, 2008, 52 (01) : 39 - 48