Anthropometric Measures of Adiposity as Markers of Kidney Dysfunction: A Cross-Sectional Study

The present study was designed to provide information on the ability of several different anthropometric markers to reflect the renal impairment associated with body weight increase and to predict the development of renal alterations linked to overweight and obesity. In 574 subjects representative of the general population of the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study, with an age range between 57 and 73 years, we investigated the association between different anthropometric markers of body fat, as alternative to body mass index, and renal failure, to obtain information useful for determining their potential predictive value. Renal dysfunction was significantly associated with almost all anthropometric markers of adiposity related to body weight and body shape. After adjustment for confounders, such as age, sex, office blood pressure, serum glucose, antihypertensive drugs and smoking habit, association remained significant only for waist-to-hip ratio (WHR), lipid accumulation product (LAP) and visceral adiposity index (VAI). These 3 markers also displayed at the receiver operating curves (ROC) analysis the best ability to detect subjects with or without kidney dysfunction. The results of the present study provide evidence that WHR, LAP and VAI represent the best markers of renal dysfunction associated with visceral body fat accumulation.

Lipid accumulation product, visceral adiposity index and risk of chronic kidney disease

BACKGROUND

Lipid accumulation product (LAP) and visceral adiposity index (VAI) are novel, non-imaging markers of visceral adiposity that are calculated by using body mass index (BMI), waist circumference (WC) and serum lipid concentrations. We hypothesized that LAP and VAI are more strongly associated with adverse kidney outcomes than BMI and WC.

METHODS

Using data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, we used multivariable logistic regression to evaluate associations of LAP, VAI, BMI and WC with incident chronic kidney disease (CKD), (incident eGFR < 60 ml/min/1.73m2 and > 25% decline).

RESULTS

Among the overall cohort of 27,550 participants, the mean baseline age was 65 years; 54% were women; and 41% were African American. After a median of 9.4 years (IQR 8.6, 9.9) of follow-up, a total of 1127 cases of incident CKD were observed. Each two-fold higher value of VAI (OR 1.12, 95% CI 1.04, 1.20), LAP (OR 1.21, 95% CI 1.13, 1.29), WC (OR 2.10, 95% CI 1.60, 2.76) and BMI (OR: 2.66, 95% CI 1.88, 3.77), was associated with greater odds of incident CKD.

CONCLUSIONS

LAP and VAI as measures of visceral adiposity are associated with higher odds of incident CKD but may not provide information beyond WC and BMI.

Association of metabolic syndrome with TyG index and TyG-related parameters in an urban Chinese population: a 15-year prospective study

BACKGROUND

The metabolic syndrome (Mets) is a multiplex risk factor for atherosclerotic cardiovascular diseases. The aims of the study were to assess the association of the Mets with TyG index and TyG-related parameters in an urban Chinese population.

METHODS

The data were collected in 1992 and then again in 2007 from the same group of 590 individuals (363 males and 227 females) without Mets in 1992. The fasting lipid profile and blood glucose were measured. TyG index and related parameters were calculated, and Mets defined according to the harmonized criteria. The area under the curve (AUC) of receiver operating characteristic curves was used to evaluate TyG index and related parameters for their diagnostic ability to identify people with Mets. Odd ratios (OR) for Mets prediction were calculated using stepwise logistic regression analyses.

RESULTS

The incidence of Mets was 18.64% over the 15-year follow-up period.During 15 years' follow-up, TyG-waist to height ratio (TyG-WHtR) shows the largest AUC for Mets detection (0.686) followed by TyG-waist circumference (TyG-WC) (0.660), TyG-waist-to-hip ratio (TyG-WHpR) (0.564), and TyG index (0.556) in all participants. Gender analysis revealed that TyG-WHtR and TyG-WC have the largest AUC in both genders. TyG-WHtR significantly predicted Mets in all participants, with an unadjusted odds ratio of 5.63 (95% CI 3.23-9.83 P < 0.001). Associations remained significant after adjustment for smoking, drinking, physical exercise and components of Mets.

CONCLUSIONS

TyG-WHtR might be a strong and independent predictor for Mets in all participants in an urban Chinese population. TyG-related markers that combine obesity markers with TyG index are superior to other parameters in identifying Mets in both genders.

Vitamin D status and obesity markers in older adults: results from West China Health and Aging Trends study

Backgrounds

Vitamin D deficiency and insufficiency in older adults seems to be common, but the prevalence estimates are lacking in West China. Previous studies suggested that low vitamin D status was associated with obesity. However, most of them evaluated obesity based on body mass index (BMI) and there are no studies at present exploring the association between vitamin D status and different obesity markers. The present study aims to investigate the prevalence of low vitamin D status and evaluate the association between the vitamin D status and different obesity markers among older adults in West China.

Methods

Data was based on the baseline of West China Health and Aging Trends study (WCHAT). All of the participants were older than 60 years old in the present study. Vitamin D status was based on laboratory data, and obesity markers were assessed by bioelectrical impedance analysis (BIA) using the InBody 770 analyzer. Multiple linear regression was performed to find the association between the vitamin D status and various obesity markers.

Results

The study included 2661 individuals (mean age: 67.7 ± 6.0 years; males: 41 %). The mean vitamin D level was 18.8 ± 6.3 ng/ml (range: 5 to 59 ng/ml); 5.2 % of participants had a sufficient level of vitamin D, 31.8 % had vitamin D insufficiency, and 63.0 % had vitamin D deficiency. Our results showed that vitamin D status was negatively associated with fat mass index (FMI), visceral fat area (VFA), and waist-hip ratio (WHR) in both sexes. Comparing to other obesity markers, WHR had the strongest correlation with vitamin D status in both sexes (β = -6.090, P = 0.046 in males; β = -11.253, P < 0.001 in females). No significant association was found between vitamin D status and BMI in males.

Conclusion

The prevalence of vitamin D insufficiency and deficiency among older adults in West China was high. Among the older adults in west China, WHR showed stronger association with vitamin D status and was better for the prediction of vitamin D insufficiency or deficiency in both sexes, compared to BMI.

Trial registration

Chinese Clinical Trial Registry: ChiCTR1800018895.