Metabolic Syndrome Rather than Obesity Alone Is More Significant for Kidney Disease
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Obesity is associated with metabolic syndrome, nonalcoholic steatohepatitis, and kidney disease. BMI may not be the ideal measure of obesity when used to assess its effect on kidney disease as it does not discriminate for age, sex, ethnicity, muscle, bone, or fat mass.
To assess the prevalence microalbuminuria and identify independent risk factors for development of kidney disease in the obese Indian population.
Age, weight, BMI, total body fat percentage, waist-to-hip ratio, hypertension, urinary albumin-to-creatinine ratio (UACR), and HbA1c were collected from 568 obese patients, presenting for bariatric surgery. Multivariate binary logistic regression was used to identify independent risk factors for kidney disease.
A total of 114 out of 568 (20.07%) obese patients had microalbuminuria (UACR range 30–283 μg/mg). HbA1C levels ≥ 6 (p = 0.01) and hypertension (p = 0.03) were the strongest independent variables for microalbuminuria. 14.67% with a BMI < 35 kg/m2, 21.30% with a BMI 35–50 kg/m2, and 19.44% with a BMI > 50 kg/m2 had microalbuminuria. Increasing BMI however was not statistically significant (p = 0.75). Total body fat percentage (p = 0.51), waist-to-hip ratio (p = 0.96), age (p = 0.30), sex (p = 0.38), and BMI (p = 0.75) were found to be statistically insignificant.
Kidney disease afflicts 1/5th of the obese Indian patients studied. Diabetes and hypertension remained as the most significant risk factors, while age, weight, increasing BMI, waist-to-hip ratio, or increasing body fat were found to be statistically insignificant for development and progression of kidney disease.
KeywordsMicroalbuminuria UACR Kidney disease Obesity BMI Total body fat percentage WHR Age Sex Weight Prevalence Risk factors Central obesity T2DM Hypertension Metabolic syndrome
We would like to thank Dr. V. P. D’sa, Director, Medical Affairs, and Dr. Iqbal Bagasrawala, Associate Director, Medical Affairs of Saifee Hospital, for providing us with the platform to conduct this study.
Compliance with Ethical Standards
All procedures performed in 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 was obtained from all individual participants included in the study.
Conflict of Interest
The authors declare that they have no conflicts of interest.
- 1.Geneva: WHO. [accessed on November 28, 2012]. World Health Organization (WHO). 2012. World health statistics 2012.Google Scholar
- 5.Gerstein HC, Mann JFE, Pogue J, et al. Prevalence and determinants of microalbuminuria in high-risk diabetic and nondiabetic patients in the heart outcomes prevention evaluation study. Diabetes Care. 2000;23(supplement 2):B35–9.Google Scholar
- 13.Yano Y, Hoshide S, Ishikawa J, et al. (2007) Differential impacts of adiponectin on low- grade albuminuria between obese and nonobese persons without diabetes. J Clin Hypertens (Greenwich) 9(10):775–782. [Epub 2007/10/06]Google Scholar
- 18.Herrera-Valdes R, Almaguer M, Chipi J, et al. Prevalence of obesity and its associ- ation with chronic kidney disease, hypertension and diabetes mellitus. Isle of Youth Study (ISYS), Cuba. MEDICC Rev. 2008;10(2):14–20.Google Scholar
- 19.KDOQI. KDOQI clinical practice guidelines and clinical practice recommendations for diabetes and chronic kidney disease. Am J Kidney Dis. 2007;49(2 Suppl 2):S12–154.Google Scholar
- 20.World Health Organisation. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:i–xii. 1–253Google Scholar
- 26.Atta MI, Abdalla NH, Ibrahim AA. Microalbuminuria and adiponectin in obese nondiabetic nonhypertensive people. Egypt J Obes Diabetes Endocrinol 2016;2:156–62Google Scholar