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Visceral Adiposity and Physical Fitness in CKD

CKD 中的内脏肥胖和身体健康

基本信息

批准号：
9335346
负责人：
Sankar Dass Navaneethan
金额：
$ 53.38万
依托单位：
BAYLOR COLLEGE OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-09-22 至 2019-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9335346
关键词：
Abdomen Address Adipose tissue Adult Affect American Area Body Weight decreased Body fat Body mass index Cardiovascular Diseases Cardiovascular system Cessation of life Chronic Kidney Failure Chronic Kidney Insufficiency Clinic Clinical Cohort Studies Data Development Diabetes Mellitus Disease Progression End stage renal failure Enrollment Event Fatty acid glycerol esters Future Glomerular Filtration Rate Goals Health Healthcare Hospitalization Hypertension Image Incidence Inflammation Inflammatory Insulin Resistance Investigation Kidney Kidney Diseases Laboratories Low Prevalence Magnetic Resonance Imaging Measures Mediating Metabolic Methods Modeling Morbidity - disease rate Obesity Outcome Outcome Measure Oxidative Stress Participant Pathway interactions Patient Self-Report Patients Pennsylvania Physical Fitness Physical activity Population Protocols documentation Public Health Reading Risk Risk Factors Sampling Standardization Testing Therapeutic Universities Visceral Visit Walking adipokines adverse outcome base cardiorespiratory fitness cardiovascular disorder risk cardiovascular risk factor clinical practice cohort diabetic experience fitness fitness intervention frailty mortality multidisciplinary muscle form non-diabetic patient oriented physical inactivity public health relevance stem subcutaneous

项目摘要

DESCRIPTION (provided by applicant): Obesity and chronic kidney disease (CKD) are major public health problems. Obesity independent of its relationship with diabetes and hypertension is associated with the development and progression of kidney disease. However, higher body mass index (BMI) in those with pre-existing CKD is associated with lower mortality (obesity paradox). This may be due to the inability of BMI to differentiate fat mass and muscle mass, which may have opposite relationship with cardiovascular disease and death. Body fat distribution is a major factor of metabolic health with metabolic abnormalities correlating better with visceral than subcutaneous adipose tissue. Further, higher fitness levels among those with higher BMI are associated with a lower prevalence of cardiovascular risk factors and mortality that might explain this obesity paradox. Therefore, among Chronic Renal Insufficiency Cohort (CRIC) study participants, we propose (a) to examine whether visceral adiposity is associated with a higher incidence of composite outcomes (i.e., mortality, cardiovascular events, end stage renal disease, and 50% decline in estimated glomerular filtration rate), (b) to determine if physical fitness modifies the association between adiposity and outcomes, and (c) to study whether visceral adiposity and physical fitness are associated with altered adipokine profile, inflammation, insulin resistance, and oxidative stress. We propose to enroll 526 patients with varying degrees of kidney disease from 7 clinical centers involved in the CRIC study. Visceral adiposity will be measured by magnetic resonance imaging (MRI) of the abdomen using a standard protocol, and physical fitness will be measured using a 400 m walk test during routine CRIC study visits. The imaging data will be assessed at the central reading center at the Cleveland Clinic, and samples will be analyzed at the University of Pennsylvania central core laboratory. We have assembled a well-experienced, multi-disciplinary team to address these important public health questions. Results from this study will help us understand the independent and combined effects of visceral adiposity and physical fitness on cardiovascular disease and kidney disease progression among CKD patients. This study will also highlight potential pathways that mediate the relationship between adiposity and outcomes, which will become the focus of future therapeutic investigations in CKD.