Metabolically Healthy Obesity and Risk of Kidney Function Decline

Alex R. Chang, Aditya Surapaneni, H. Lester Kirchner, Amanda Young, Holly J. Kramer, David J. Carey, Lawrence Appel, Morgan Grams

Research output: Contribution to journalArticle

Abstract

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<15mL/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<90mL/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.

Original languageEnglish (US)
JournalObesity
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Kidney
Glomerular Filtration Rate
Health Status
Weights and Measures
Metabolically Benign Obesity
Dialysis
Obesity
Transplants
Health
Therapeutics

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Nutrition and Dietetics

Cite this

Chang, A. R., Surapaneni, A., Kirchner, H. L., Young, A., Kramer, H. J., Carey, D. J., ... Grams, M. (Accepted/In press). Metabolically Healthy Obesity and Risk of Kidney Function Decline. Obesity. https://doi.org/10.1002/oby.22134

Metabolically Healthy Obesity and Risk of Kidney Function Decline. / Chang, Alex R.; Surapaneni, Aditya; Kirchner, H. Lester; Young, Amanda; Kramer, Holly J.; Carey, David J.; Appel, Lawrence; Grams, Morgan.

In: Obesity, 01.01.2018.

Research output: Contribution to journalArticle

Chang, AR, Surapaneni, A, Kirchner, HL, Young, A, Kramer, HJ, Carey, DJ, Appel, L & Grams, M 2018, 'Metabolically Healthy Obesity and Risk of Kidney Function Decline', Obesity. https://doi.org/10.1002/oby.22134
Chang AR, Surapaneni A, Kirchner HL, Young A, Kramer HJ, Carey DJ et al. Metabolically Healthy Obesity and Risk of Kidney Function Decline. Obesity. 2018 Jan 1. https://doi.org/10.1002/oby.22134
Chang, Alex R. ; Surapaneni, Aditya ; Kirchner, H. Lester ; Young, Amanda ; Kramer, Holly J. ; Carey, David J. ; Appel, Lawrence ; Grams, Morgan. / Metabolically Healthy Obesity and Risk of Kidney Function Decline. In: Obesity. 2018.
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