The association of chronic kidney disease and waist circumference and waist-to-height ratio in Chinese urban adults.
The association of chronic kidney disease and waist circumference and waist-to-height ratio in Chinese urban adults.
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DOI：
10.1097/md.0000000000003769
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发表时间：
2016-06
期刊：
影响因子：
1.6
通讯作者：
Zeng Q
中科院分区：
文献类型：
--
作者：
He Y;Li F;Wang F;Ma X;Zhao X;Zeng Q
本研究旨在探讨体重指数(BMI)、腰围(WC)和腰高比(WHtR)与慢性肾脏疾病(CKD)的关系。一项横断面调查在2008年至2009年期间对123629名参加健康检查的中国城市成年人进行了抽样调查。测定体重指数(BMI)、腰围(WC)、腰臀比(WHtR)以及血、尿生化指标。慢性肾功能不全定义为肾小球滤过率(60minL/ /1.73minm2)或尿蛋白阳性(蛋白尿)≥1+。男性和女性CKD的ROC曲线下面积以WHtR最大，其次是WC和BMI。BMI、WC和WHtR水平越高，男性患CKD的几率就越高。对于单位大小变化，CKD的多变量调整优势比(OR)和95%可信区间(CI)分别为：BMI 1.19(95%CI，1.13~1.25)，WC 1.12(95%CI，1.08~1.16)，WHTR 1.13(95%CI，1.10~1.17)。在40岁及以上女性中，相应的值在多变量模型中有显著意义。使用中国人推荐的体重指数(≥24 kg/m2)、腰围(≥85 cm，女性为≥80 cm)和腰围比(≥0.05)，男性的腰围与慢性肾脏病的相关性优于体重指数，而女性的腰围优于女性。肥胖指数的增加与慢性肾脏病的发生几率呈正相关。对于中国城市成年人来说，以腰围和腰围定义的中心性肥胖可能与慢性肾脏病更密切相关。
Supplemental Digital Content is available in the text This study aims to investigate the association of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with chronic kidney disease (CKD). A cross-sectional survey was conducted in a nationally representative sample of 123,629 Chinese urban adults who participated in health examinations between 2008 and 2009. BMI, WC, and WHtR were measured, as well as serum and urine biochemical tests. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or urine protein positivity (proteinuria)≥1+ with dipstick testing. WHtR had the largest areas under ROC curve for CKD in men and women, followed by WC and BMI. Higher levels of BMI, WC, and WHtR were each associated with an increased odds for CKD among men. For per unit size change, the multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of CKD were 1.19 (95% CI, 1.13–1.25) for BMI, 1.12 (95% CI, 1.08–1.16) for WC, and 1.13 (95% CI, 1.10–1.17) for WHtR. The corresponding values were significant in multivariable models among women aged 40 years and above. Using Chinese-recommended cutoffs for BMI (≥24 kg/m2), WC (≥85 cm for men, and ≥80 cm for women), and WHtR (≥0.05), WHtR was superior in the association with CKD than BMI for men, whereas WC was superior for women. Increased obesity indices were positively associated with the odds of CKD. Central obesity, defined by WC and WHtR, may be more closely correlated with CKD for Chinese urban adults.