Body Mass Index, waist circumference, and health-related quality of life in adults with chronic kidney disease

  • Young Youl Hyun
  • Kyu-Beck LeeEmail author
  • Wookyung Chung
  • Yong-Soo Kim
  • Seung Hyeok Han
  • Yun Kyu Oh
  • Dong-Wan Chae
  • Sue Kyung Park
  • Kook-Hwan Oh
  • Curie Ahn
  • the KNOW-CKD Study Investigator



Obesity is linked to poor health-related quality of life (HRQOL) in the general population, but its role in chronic kidney disease (CKD) is uncertain.


We conducted a cross-sectional study that investigated 1880 participants from the KoreaN cohort study for Outcome in patients With CKD (KNOW-CKD) who underwent complete baseline laboratory tests, health questionnaires, and HRQOL. HRQOL was assessed by physical component summary (PCS) and mental component summary (MCS) of the SF-36 questionnaire. We used multivariable linear regression models to examine the relationship between Body Mass Index (BMI) and sex-specific waist circumference (WC) with HRQOL.


Adults with higher BMI and greater WC showed lower PCS. After adjusting for age, sex, socioeconomic state, comorbidities, and laboratory findings, we found that WC, but not BMI, was associated with PCS. Greater WC quintiles were associated with lower PCS [WC-4th quintile (β, − 2.63, 95% CI − 5.19 to − 0.06) and WC-5th quintile (β, − 3.71, 95% CI − 6.28 to − 1.15)]. The association between WC and PCS was more pronounced in older adults, woman, patients with diabetes, cardiovascular disease, or lower eGFR. The relationship between BMI and WC with MCS was not significant.


In adults with CKD, WC is a better indicator of poor physical HRQOL than BMI. The association between WC and physical HRQOL is modified by age, sex, eGFR, and comorbidities such as diabetes and cardiovascular disease.


BMI Waist circumference HRQOL CKD 



The authors would like to thank investigators and research staff for their contribution in patient recruitment and data collection.


The KNOW-CKD was funded by Grants 2011E3300300, 2012E3301100, and 2013E3301600 from Research of the Korea Centers for Disease Control and Prevention.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study

Supplementary material

11136_2018_2084_MOESM1_ESM.docx (682 kb)
Supplementary material 1 (DOCX 682 KB)


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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Young Youl Hyun
    • 1
  • Kyu-Beck Lee
    • 1
    Email author
  • Wookyung Chung
    • 2
  • Yong-Soo Kim
    • 3
  • Seung Hyeok Han
    • 4
  • Yun Kyu Oh
    • 5
  • Dong-Wan Chae
    • 6
  • Sue Kyung Park
    • 7
  • Kook-Hwan Oh
    • 8
  • Curie Ahn
    • 8
  • the KNOW-CKD Study Investigator
  1. 1.Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung HospitalSungkyunkwan University School of MedicineJongno-guKorea
  2. 2.Department of Internal Medicine, Gil HospitalGachon UniversityInchonKorea
  3. 3.Department of Internal Medicine, College of Medicine, Seoul St. Mary’s HospitalThe Catholic University of KoreaSeoulKorea
  4. 4.Department of Internal MedicineYonsei University College of MedicineSeoulKorea
  5. 5.Department of Internal MedicineSeoul National University Boramae Medical CenterSeoulKorea
  6. 6.Department of Internal MedicineSeoul National University Bundang HospitalSeongnamKorea
  7. 7.Department of Preventive Medicine, College of Medicine, Seoul National University HospitalSeoul National UniversitySeoulKorea
  8. 8.Department of Internal Medicine, College of Medicine, Seoul National University HospitalSeoul National UniversitySeoulKorea

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