TY - JOUR
T1 - Metabolically Healthy Obesity and Risk of Kidney Function Decline
AU - Chang, Alex R.
AU - Surapaneni, Aditya
AU - Kirchner, H. Lester
AU - Young, Amanda
AU - Kramer, Holly J.
AU - Carey, David J.
AU - Appel, Lawrence J.
AU - Grams, Morgan E.
N1 - Funding Information:
Funding agenices: AC is supported by National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases grant K23 DK106515-01. Disclosure: The authors declared no conflict of interest. Additional Supporting Information may be found in the online version of this article. Received: 10 November 2017; Accepted: 15 January 2018; Published online 2 March 2018. doi:10.1002/oby.22134
Funding Information:
An oral presentation of this work was presented at the American Society of Nephrology Kidney Week in San Diego, California, on November 6, 2015. Data reported here were supplied by the United States Renal Data System. The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy or interpretation of the US government.
Publisher Copyright:
© 2018 The Obesity Society
PY - 2018/4
Y1 - 2018/4
N2 - Objective: The aim of this study was to examine the association between BMI categories, stratified by metabolic health status, and the risk of kidney function decline (KFD). Methods: In this study, 42,128 adult patients with a stable BMI were classified over a 3-year baseline window by BMI and metabolic health status (assessed by Adult Treatment Panel-III criteria). KFD was defined as an estimated glomerular filtration rate (eGFR) decline ≥ 30%, eGFR < 15 mL/min/1.73 m2, or receipt of dialysis and/or transplant. Results: Over a median of 5.1 years (interquartile range 2.1-8.9), 6,533 (15.5%) individuals developed KFD. Compared with the normal weight, metabolically healthy category, metabolically healthy obesity was associated with a higher risk of KFD (adjusted hazard ratio [aHR] 1.52; 95% CI: 1.22-1.89). aHRs for KFD were 1.17 (95% CI: 0.89-1.53), 2.21 (95% CI: 1.59-3.08), and 2.20 (95% CI: 1.55-3.11) for metabolically healthy obesity with BMI 30 to 34.9, BMI 35 to 39.9, and BMI ≥ 40 kg/m2. These associations were consistent among men and women, patients with eGFR ≥ or < 90 mL/min/1.73 m2, and age ≥ or < 55 years. The risk of KFD was highest among metabolically unhealthy individuals with BMI ≥ 40 (aHR 4.02; 95% CI: 3.40-4.75 vs. metabolically healthy individuals with normal weight). Conclusions: Obesity, whether in the presence or absence of metabolic health, is a risk factor for KFD.
AB - Objective: The aim of this study was to examine the association between BMI categories, stratified by metabolic health status, and the risk of kidney function decline (KFD). Methods: In this study, 42,128 adult patients with a stable BMI were classified over a 3-year baseline window by BMI and metabolic health status (assessed by Adult Treatment Panel-III criteria). KFD was defined as an estimated glomerular filtration rate (eGFR) decline ≥ 30%, eGFR < 15 mL/min/1.73 m2, or receipt of dialysis and/or transplant. Results: Over a median of 5.1 years (interquartile range 2.1-8.9), 6,533 (15.5%) individuals developed KFD. Compared with the normal weight, metabolically healthy category, metabolically healthy obesity was associated with a higher risk of KFD (adjusted hazard ratio [aHR] 1.52; 95% CI: 1.22-1.89). aHRs for KFD were 1.17 (95% CI: 0.89-1.53), 2.21 (95% CI: 1.59-3.08), and 2.20 (95% CI: 1.55-3.11) for metabolically healthy obesity with BMI 30 to 34.9, BMI 35 to 39.9, and BMI ≥ 40 kg/m2. These associations were consistent among men and women, patients with eGFR ≥ or < 90 mL/min/1.73 m2, and age ≥ or < 55 years. The risk of KFD was highest among metabolically unhealthy individuals with BMI ≥ 40 (aHR 4.02; 95% CI: 3.40-4.75 vs. metabolically healthy individuals with normal weight). Conclusions: Obesity, whether in the presence or absence of metabolic health, is a risk factor for KFD.
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U2 - 10.1002/oby.22134
DO - 10.1002/oby.22134
M3 - Article
C2 - 29498223
AN - SCOPUS:85042591812
SN - 1930-7381
VL - 26
SP - 762
EP - 768
JO - Obesity
JF - Obesity
IS - 4
ER -