Abstract
Obesity is a known risk factor for hypertension and diabetes, both of which ultimately promote renal dysfunction. In the current study, we investigated the association between body mass index (BMI) and chronic kidney disease (CKD) in 8,168 Japanese individuals (2,924 women, 5,244 men) who underwent general health screening. CKD was diagnosed if the estimated glomerular filtration rate (eGFR) was less than 60 mL/min/1.73 m2 (designated as low eGFR) and/or if the urinary albumin/creatinine value was equal to or greater than 30 mg/g (designated as albuminuria). Logistic regression analysis adjusted for age, systolic blood pressure, fasting glucose, and smoking habits showed that, in men, both overweight (BMI 25–29 kg/m2) and obesity (BMI ≥30 kg/m2) were associated with increased prevalence of low eGFR and albuminuria, whereas, in women, obesity was associated with albuminuria, but neither overweight nor obesity was associated with low eGFR. After multivariate adjustment, logistic regression analysis showed that BMI had a graded association with both low eGFR and albuminuria in men. On the other hand, in women, the second and third BMI quartiles were associated with a lower prevalence of albuminuria in comparison with the first BMI quartile. Essentially the same results were obtained when the subjects were subdivided according to the presence and absence of hypertension. Our data showed that overweight and obesity were associated with increased risk for CKD in Japanese individuals undergoing a general health screening, irrespective of the presence or absence of hypertension, although there was a gender difference in these associations.
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Flegal KM, Carroll MD, Ogden CL, Johnson CL : Prevalence and trends in obesity among US adults, 1999–2000. JAMA 2002; 288: 1723–1727.
Gutierrez-Fisac JL, Banegas Banegas JR, Artalejo FR, Regidor E : Increasing prevalence of overweight and obesity among Spanish adults, 1987–1997. Int J Obes Relat Metab Disord 2000; 24: 1677–1682.
Yoshiike N, Seino F, Tajima S, et al: Twenty-year changes in the prevalence of overweight in Japanese adults: the National Nutrition Survey 1976–95. Obes Rev 2002; 3: 183–190.
Stengel B, Tarver-Carr ME, Powe NR, Eberhardt MS, Brancati FL : Lifestyle factors, obesity and the risk of chronic kidney disease. Epidemiology 2003; 14: 479–487.
Hallan S, de Mutsert R, Carlsen S, Dekker FW, Aasarod K, Holmen J : Obesity, smoking, and physical inactivity as risk factors for CKD: are men more vulnerable? Am J Kidney Dis 2006; 47: 396–405.
Hall JE, Kuo JJ, da Silva AA, de Paula RB, Liu J, Tallam L : Obesity-associated hypertension and kidney disease. Curr Opin Nephrol Hypertens 2003; 12: 195–200.
Ravera M, Re M, Deferrari L, Vettoretti S, Deferrari G : Importance of blood pressure control in chronic kidney disease. J Am Soc Nephrol 2006; 17: S98–S103.
Kramer H, Luke A, Bidani A, Cao G, Cooper R, McGee D : Obesity and prevalent and incident CKD: the Hypertension Detection and Follow-Up Program. Am J Kidney Dis 2005; 46: 587–594.
Iseki K, Ikemiya Y, Kinjo K, Inoue T, Iseki C, Takishita S : Body mass index and the risk of development of end-stage renal disease in a screened cohort. Kidney Int 2004; 65: 1870–1876.
Sakurai M, Miura K, Takamura T, et al: Gender differences in the association between anthropometric indices of obesity and blood pressure in Japanese. Hypertens Res 2006; 29: 75–80.
Harada K, Karube Y, Saruhara H, Takeda K, Kuwajima I : Workplace hypertension is associated with obesity and family history of hypertension. Hypertens Res 2006; 29: 969–976.
Manjunath G, Sarnak MJ, Levey AS : Prediction equations to estimate glomerular filtration rate: an update. Curr Opin Nephrol Hypertens 2001; 10: 785–792.
Imai E, Horio M, Nitta K, et al: Estimation of glomerular filtration rate by the MDRD study equation modified for Japanese patients with chronic kidney disease. Clin Exp Nephrol 2007; 11: 41–50.
Molitch ME, Rupp D, Carnethon M : Higher levels of HDL cholesterol are associated with a decreased likelihood of albuminuria in patients with long-standing type 1 diabetes. Diabetes Care 2006; 29: 78–82.
K/DOQI clinical practice guidelines for chronic kidney disease : evaluation, classification, and stratification. Am J Kidney Dis 2002; 39: S1–S266.
Fox CS, Larson MG, Leip EP, Culleton B, Wilson PW, Levy D : Predictors of new-onset kidney disease in a community-based population. JAMA 2004; 291: 844–850.
Gelber RP, Kurth T, Kausz AT, et al: Association between body mass index and CKD in apparently healthy men. Am J Kidney Dis 2005; 46: 871–880.
Orth SR, Stockmann A, Conradt C, et al: Smoking as a risk factor for end-stage renal failure in men with primary renal disease. Kidney Int 1998; 54: 926–931.
Tozawa M, Iseki K, Iseki C, Oshiro S, Ikemiya Y, Takishita S : Influence of smoking and obesity on the development of proteinuria. Kidney Int 2002; 62: 956–962.
Vupputuri S, Sandler DP : Lifestyle risk factors and chronic kidney disease. Ann Epidemiol 2003; 13: 712–720.
Kurata A, Shigematsu Y, Higaki J : Sex-related differences in relations of uric acid to left ventricular hypertrophy and remodeling in Japanese hypertensive patients. Hypertens Res 2005; 28: 133–139.
Shigematsu Y, Norimatsu S, Ohtsuka T, Okayama H, Higaki J : Sex-related differences in the relations of insulin resistance and obesity to left ventricular hypertrophy in Japanese hypertensive patients. Hypertens Res 2006; 29: 499–504.
Paoletti E, Bellino D, Cassottana P, Rolla D, Cannella G : Left ventricular hypertrophy in nondiabetic predialysis CKD. Am J Kidney Dis 2005; 46: 320–327.
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Ishizaka, N., Ishizaka, Y., Toda, Ei. et al. Association between Obesity and Chronic Kidney Disease in Japanese: Differences in Gender and Hypertensive Status?. Hypertens Res 30, 1059–1064 (2007). https://doi.org/10.1291/hypres.30.1059
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DOI: https://doi.org/10.1291/hypres.30.1059
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