Gender Differences in the Association Between Obesity Indices and Chronic Kidney Disease Among Middle-Aged and Elderly Taiwanese Population: A Community-Based Cross-Sectional Study.
Gender Differences in the Association Between Obesity Indices and Chronic Kidney Disease Among Middle-Aged and Elderly Taiwanese Population: A Community-Based Cross-Sectional Study.
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DOI：
10.3389/fendo.2021.737586
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发表时间：
2021
影响因子：
5.2
通讯作者：
Chen JY
中科院分区：
文献类型：
--
作者：
Chen IJ;Hsu LT;Lu MC;Chen YJ;Tsou MT;Chen JY
慢性肾脏疾病（CKD）的传统危险因素包括糖尿病（DM）、高血压（HTN）和代谢综合征，这些都是与肥胖相关的健康状况。我们的目的是探讨三个肥胖指数中哪一个与CKD的关系最强，并探讨台湾中老年人群中这些关系是否存在性别差异。这是一项以社区为基础的横断面研究。研究对象为居住在台湾北部某社区的400名居民（141名男性，259名女性，年龄50-90岁）。每位参与者被要求填写一份收集个人信息、病史、药物使用和人体测量数据的问卷。实验室数据是通过检测血液和尿液样本获得的。比较基线特征，肥胖指数包括体重指数（BMI）、腰围（WC）和内脏脂肪指数（VAI）。CKD定义为存在肾功能不全（尿白蛋白-肌酐比值≥30mg /g）或估计肾小球滤过率(eGFR) < 60ml /min/1.73m2。我们使用多元逻辑回归模型来评估每个肥胖指数与男女CKD之间的关系。此外，我们使用受试者工作特征（ROC）曲线下面积（AUC）来检验预测不同性别CKD的最佳肥胖指标。受试者的平均年龄为64.47±8.45岁，男性明显高龄化。男性31例（22.0%），女性50例（19.3%）。在男性中，CKD组和非CKD组在三个肥胖指标上没有显著差异。然而，在女性中，只有CKD患者的VAI（1.9[1.1, 3.4]）显著高于无CKD患者（1.5 [1.0,2.2]）（p值= 0.03）。多因素logistic回归显示，即使在调整了可能的混杂因素后，VAI仍被发现是女性CKD的独立危险因素（OR: 1.32, 95% CI: 1.04-1.69, p = 0.02），但在男性中不是（OR: 1.20, 95% CI: 0.85-1.69, p = 0.30）。VAI的AUC对女性的CKD有显著的预测能力，而对男性则没有。我们的研究结果显示，在三个肥胖指数中，与BMI和WC相比，VAI与女性CKD的相关性最强。此外，女性VAI在台湾中老年人群CKD筛查中应给予更多的重视。
Traditional risk factors for chronic kidney disease (CKD) include diabetes mellitus (DM), hypertension (HTN), and metabolic syndrome, which are health conditions related to obesity. We aimed to investigate which of the three obesity indices has the strongest association with CKD and to explore whether there are gender differences in these relationships in the middle-aged and elderly Taiwanese population. This was a cross-sectional, community-based study. It included 400 residents (141 males and 259 females, age 50–90 years) residing in a community in northern Taiwan. Each participant was asked to fill a questionnaire that collected personal information, medical history, medication use, and anthropometric measurements. The laboratory data were obtained by testing the blood and urine samples. The baseline characteristics were compared, and the obesity indices included body mass index (BMI), waist circumference (WC), and visceral adiposity index (VAI). CKD was defined as the presence of renal dysfunction (urine albumin-creatinine ratio ≥ 30 mg/g) or estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2. We used a multiple logistic regression model to evaluate the association between each obesity index and CKD for both genders. Further, we used the area under the receiver operating characteristic (ROC) curve (AUC) to examine the best obesity indices to predict CKD in different genders. The average age of the subjects was 64.47 ± 8.45 years, and men were significantly older. CKD was found in 31 (22.0%) males and 50 (19.3%) females. In men, there was no significant difference between the CKD and non-CKD groups among the three obesity indices. However, in women, only VAI was significantly higher in subjects with CKD (1.9 [1.1, 3.4]) than in subjects without CKD (1.5 [1.0, 2.2]) (p-value = 0.03). The multivariate logistic regression revealed that even after adjusting for possible confounding factors, VAI was found to be an independent risk factor for CKD in women (OR: 1.32, 95% CI: 1.04-1.69, p = 0.02), but not in men (OR: 1.20, 95% CI: 0.85-1.69, p = 0.30). The AUC of VAI had a significant ability to predict CKD in women but not in men. Our results showed that among the three obesity indices, VAI had the strongest association with CKD compared to BMI and WC in women. In addition, VAI in women should be given more importance in the screening for CKD among the middle-aged and elderly Taiwanese population.