Association between weight status, metabolic syndrome, and chronic kidney disease among middle-aged and elderly Chinese

Yi Wang; Bin Sun; Li-Ting Sheng; Xiong-Fei Pan; Yanfeng Zhou; Jiang Zhu; Xiulou Li; Kun Yang; Kunquan Guo; Xiaomin Zhang; Meian He; Handong Yang; Tangchun Wu; An Pan

doi:10.1016/j.numecd.2020.06.025

Association between weight status, metabolic syndrome, and chronic kidney disease among middle-aged and elderly Chinese

Nutr Metab Cardiovasc Dis. 2020 Oct 30;30(11):2017-2026. doi: 10.1016/j.numecd.2020.06.025. Epub 2020 Jul 1.

Authors

Yi Wang¹, Bin Sun¹, Li-Ting Sheng¹, Xiong-Fei Pan², Yanfeng Zhou¹, Jiang Zhu³, Xiulou Li³, Kun Yang⁴, Kunquan Guo⁴, Xiaomin Zhang⁵, Meian He⁵, Handong Yang³, Tangchun Wu⁵, An Pan⁶

Affiliations

¹ Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, PR China.
² Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, PR China; Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
³ Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, Hubei Province, 442000, PR China.
⁴ Department of Endocrinology, Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, Hubei Province, 442000, PR China.
⁵ Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, PR China; Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, PR China.
⁶ Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, PR China. Electronic address: panan@hust.edu.cn.

PMID: 32826134
DOI: 10.1016/j.numecd.2020.06.025

Abstract

Background and aims: Obesity often initiates or coexists with certain metabolic abnormalities. This study sought to examine the independent and joint relations of weight and metabolic syndrome (MetS) with incident chronic kidney disease (CKD) among Chinese elderly people.

Methods and results: A total of 15,229 participants (mean age: 62.8 years) from the Dongfeng-Tongji cohort with complete baseline questionnaire and medical examination data were followed from 2008 to 2010 to 2013. All participants were categorized into four phenotypes: metabolically healthy non-overweight/obesity (MHNO), metabolically healthy overweight/obesity (MHO), metabolically unhealthy non-overweight/obesity (MUNO), metabolically unhealthy overweight/obesity (MUO). Multivariable-adjusted logistic regression models were applied to estimate the odds ratios (ORs) and confidence intervals (CIs) of four phenotypes with the risk of incident CKD, which was defined as estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m². A total of 1151 CKD cases were identified during a mean of 4.6-year follow-up. After adjusting for potential confounders, both overweight/obesity and MetS were associated with higher risk of CKD, and the ORs (95% CI) were 1.32 (1.15-1.52) and 1.50 (1.31-1.73), respectively. The risk of CKD was progressively higher in MHO (1.31, 1.09-1.57), MUNO (1.54, 1.22-1.93), and MUO (2.05, 1.73-2.42) as compared with MHNO phenotype, without significant multiplicative interaction between overweight/obesity and MetS (P_interaction = 0.906). These associations were slightly stronger among those aged >60 years or with baseline diabetes.

Conclusion: Both overweight/obesity and MetS were associated with an increased risk of CKD. It is worth noting that MHO and MUNO also have an elevated risk. Maintaining both normal weight and healthy metabolic profile is recommended.

Keywords: Chronic kidney disease; Cohort study; Metabolic syndrome; Obesity; Overweight.

Copyright © 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Age Factors
Aged
Body Weight
China / epidemiology
Female
Health Status
Humans
Incidence
Male
Metabolic Syndrome / diagnosis
Metabolic Syndrome / epidemiology*
Middle Aged
Obesity / diagnosis
Obesity / epidemiology*
Obesity, Metabolically Benign / epidemiology
Prospective Studies
Renal Insufficiency, Chronic / diagnosis
Renal Insufficiency, Chronic / epidemiology*
Risk Assessment
Risk Factors
Time Factors