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Comparison between Different Measures of Body Fat with Kidney Function Decline and Incident CKD.
Clin J Am Soc Nephrol 2017; 12(6):893-903CJ

Abstract

BACKGROUND AND OBJECTIVES

Although anthropometric measures of body fat are associated with development of CKD, they may not be able to distinguish between various forms of fat and therefore may be less accurate than computed tomography (CT) measures. We compared the association of CT and anthropometric measures of obesity with kidney outcomes in the Health Aging and Body Composition Study.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS

Participants were recruited from March of 1997 through July of 1998. CT measures included visceral abdominal fat (VAT), subcutaneous adipose tissue (SAT), and intermuscular fat area (IMAT), whereas anthropometric measures included waist circumference (WC) and body mass index (BMI). Kidney outcomes included kidney function (KF) decline (30% decrease in eGFRcysC in follow-up at either year 3 or 10) or incident CKD (follow-up eGFRcysC≤60 ml/min per 1.73 m2 in individuals with baseline GFR>60 ml/min per 1.73 m2). Multivariable logistic regression models and Poisson regression models were used to evaluate the association with decline in KF and incident kidney disease, respectively. We also assessed for the independent associations among the exposure measures by including them in the same model.

RESULTS

Two-thousand four-hundred and eighty-nine individuals were included. Mean age was 74±3 years, 49% were men, 39% were black, 59% were hypertensive, and 15% were diabetic. KF decline occurred in 17% of the population, whereas incident CKD also occurred in 17% of those at risk. In continuous models, SAT, VAT, IMAT, BMI, and WC (per SD increase) were all significantly associated with KF decline. There was a significant interaction between VAT and CKD with regard to KF decline (P=0.01). Only VAT, BMI, and WC were associated with incident CKD. Only VAT remained a significant risk factor for incident CKD when other exposure variables were included in the same model. There was no association between any measure of obesity and kidney outcomes when creatinine values at years 3 and 10 were used to estimate changes in eGFR.

CONCLUSIONS

Anthropometric measures of body fat appear to provide as consistent estimates of KF decline risk as CT measures in elders.

Authors+Show Affiliations

Due to the number of contributing authors, the affiliations are provided in the Supplemental Material. madero.magdalena@gmail.com.Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

28522656

Citation

Madero, Magdalena, et al. "Comparison Between Different Measures of Body Fat With Kidney Function Decline and Incident CKD." Clinical Journal of the American Society of Nephrology : CJASN, vol. 12, no. 6, 2017, pp. 893-903.
Madero M, Katz R, Murphy R, et al. Comparison between Different Measures of Body Fat with Kidney Function Decline and Incident CKD. Clin J Am Soc Nephrol. 2017;12(6):893-903.
Madero, M., Katz, R., Murphy, R., Newman, A., Patel, K., Ix, J., ... Sarnak, M. (2017). Comparison between Different Measures of Body Fat with Kidney Function Decline and Incident CKD. Clinical Journal of the American Society of Nephrology : CJASN, 12(6), pp. 893-903. doi:10.2215/CJN.07010716.
Madero M, et al. Comparison Between Different Measures of Body Fat With Kidney Function Decline and Incident CKD. Clin J Am Soc Nephrol. 2017 Jun 7;12(6):893-903. PubMed PMID: 28522656.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison between Different Measures of Body Fat with Kidney Function Decline and Incident CKD. AU - Madero,Magdalena, AU - Katz,Ronit, AU - Murphy,Rachel, AU - Newman,Anne, AU - Patel,Kushang, AU - Ix,Joachim, AU - Peralta,Carmen, AU - Satterfield,Suzanne, AU - Fried,Linda, AU - Shlipak,Michael, AU - Sarnak,Mark, Y1 - 2017/05/18/ PY - 2016/07/06/received PY - 2017/03/01/accepted PY - 2017/5/20/pubmed PY - 2018/3/20/medline PY - 2017/5/20/entrez KW - Aged KW - Body Composition KW - Body Mass Index KW - Follow-Up Studies KW - Humans KW - Intra-Abdominal Fat KW - Logistic Models KW - Male KW - Renal Insufficiency, Chronic KW - Subcutaneous Fat KW - Subcutaneous Fat, Abdominal KW - Tomography KW - Tomography, X-Ray Computed KW - Waist Circumference KW - chronic kidney disease KW - diabetes mellitus KW - obesity KW - renal function decline KW - risk factors SP - 893 EP - 903 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 12 IS - 6 N2 - BACKGROUND AND OBJECTIVES: Although anthropometric measures of body fat are associated with development of CKD, they may not be able to distinguish between various forms of fat and therefore may be less accurate than computed tomography (CT) measures. We compared the association of CT and anthropometric measures of obesity with kidney outcomes in the Health Aging and Body Composition Study. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Participants were recruited from March of 1997 through July of 1998. CT measures included visceral abdominal fat (VAT), subcutaneous adipose tissue (SAT), and intermuscular fat area (IMAT), whereas anthropometric measures included waist circumference (WC) and body mass index (BMI). Kidney outcomes included kidney function (KF) decline (30% decrease in eGFRcysC in follow-up at either year 3 or 10) or incident CKD (follow-up eGFRcysC≤60 ml/min per 1.73 m2 in individuals with baseline GFR>60 ml/min per 1.73 m2). Multivariable logistic regression models and Poisson regression models were used to evaluate the association with decline in KF and incident kidney disease, respectively. We also assessed for the independent associations among the exposure measures by including them in the same model. RESULTS: Two-thousand four-hundred and eighty-nine individuals were included. Mean age was 74±3 years, 49% were men, 39% were black, 59% were hypertensive, and 15% were diabetic. KF decline occurred in 17% of the population, whereas incident CKD also occurred in 17% of those at risk. In continuous models, SAT, VAT, IMAT, BMI, and WC (per SD increase) were all significantly associated with KF decline. There was a significant interaction between VAT and CKD with regard to KF decline (P=0.01). Only VAT, BMI, and WC were associated with incident CKD. Only VAT remained a significant risk factor for incident CKD when other exposure variables were included in the same model. There was no association between any measure of obesity and kidney outcomes when creatinine values at years 3 and 10 were used to estimate changes in eGFR. CONCLUSIONS: Anthropometric measures of body fat appear to provide as consistent estimates of KF decline risk as CT measures in elders. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/28522656/Comparison_between_Different_Measures_of_Body_Fat_with_Kidney_Function_Decline_and_Incident_CKD_ L2 - http://cjasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=28522656 DB - PRIME DP - Unbound Medicine ER -