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Associations between visceral obesity and renal impairment in health checkup participants: a retrospective cohort study

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Abstract

Background

Obesity is a risk factor for chronic kidney disease. Although body mass index (BMI) or waist circumference is indicators of obesity, actual measurements of visceral fat area (VFA) more accurately reflect the amount of visceral fat. We aimed to determine the most sensitive obesity indicator for predicting renal impairment among VFA, BMI, waist circumference, waist-to-height ratio, and visceral-to-subcutaneous fat ratio (VSR).

Methods

Subjects who underwent VFA measurements during health checkups in 2012 were included. Obesity was defined using a separate baseline value for each indicator [VFA (100 cm2), BMI (25 kg/m2), waist circumference (85 cm for men and 90 cm for women), waist-to-height ratio (0.5), VSR (0.4)]. Changes in estimated glomerular filtration rate (eGFRcr) and time to new-onset proteinuria were measured. The relationships between obesity indicators and eGFRcr were evaluated using a linear mixed-effects model. The relationships between obesity indicators and new-onset proteinuria were evaluated using Poisson regression analysis.

Results

Analysis was performed on 2753 subjects (mean age 50.3 years). The VFA ≥ 100 cm2 group exhibited a larger annual difference in eGFRcr compared to the < 100 cm2 group (− 0.24 mL/min/1.73 m2, P = 0.03). There was a statistically significant difference in the proteinuria incidence rate ratio, which was 1.54 times (95% confidence interval 1.01–2.35) in the VFA ≥ 100 cm2 group. Statistically significant correlations were not observed with any of the other obesity indicators.

Conclusion

VFA is suggested to be the most sensitive obesity indicator for decline in kidney function and new-onset proteinuria.

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Acknowledgements

This study was funded by the Leading Initiative for Excellent Young Researchers of the University of Tokyo. All authors were responsible for the study concept and design. Yoshikazu Miyasato and KO carried out the statistical analysis and drafted the manuscript. All authors contributed to the interpretation of data and the critical revision of the manuscript. All authors approved the final version of the manuscript.

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Authors and Affiliations

  1. Department of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Bunkyo-ku, Hongo, Tokyo, 1130033, Japan

    Yoshikazu Miyasato, Koji Oba & Yutaka Matsuyama

  2. Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan

    Koji Oba

  3. Clinical Research Support Center, Jikei University School of Medicine, Tokyo, 1058461, Japan

    Shinji Yasuno

  4. Takeda Hospital Medical Examination Center, Kyoto, 6008216, Japan

    Izuru Masuda

Authors
  1. Yoshikazu Miyasato
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  2. Koji Oba
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  3. Shinji Yasuno
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  4. Yutaka Matsuyama
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  5. Izuru Masuda
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Corresponding author

Correspondence to Koji Oba.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee at which the studies were conducted (IRB approval number: the Takeda Hospital Group (Approval no. 1807), the University of Tokyo Graduate School of Medicine and Faculty of Medicine (Screening no. 2018063NI)), and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This was a retrospective study involving human data that were previously collected and did not require the additional recruitment of human subjects; thus, the need for informed consent was waived via the opt-out method on the hospital’s information.

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Miyasato, Y., Oba, K., Yasuno, S. et al. Associations between visceral obesity and renal impairment in health checkup participants: a retrospective cohort study. Clin Exp Nephrol 24, 935–945 (2020). https://doi.org/10.1007/s10157-020-01921-9

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  • DOI: https://doi.org/10.1007/s10157-020-01921-9

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