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Metabolic phenotypes of obese, overweight, and normal weight individuals and risk of chronic kidney disease: a systematic review and meta-analysis.
Arch Endocrinol Metab. 2019 Jul 29; 63(4):427-437.AE

Abstract

OBJECTIVE

Chronic kidney disease (CKD) risk is inconsistent in the normal-weight, overweight, and obese individuals due to the heterogeneity of metabolic status. This meta-analysis aimed to examine the combined effects of body mass index (BMI) and metabolic status on CKD risk.

MATERIALS AND METHODS

The MEDLINE, EMBASE, and Web of Knowledge databases were systematically searched up to March 2019 to identify all eligible studies investigating the CKD risk (defined as GFR < 60 mL/min per 1.73 m2 and/or microalbuminuria or proteinuria) associated with the body size phenotypes which are known as metabolically unhealthy normal-weight (MUNW), metabolically healthy overweight (MHOW), metabolically unhealthy overweight, metabolically healthy obese (MHO) and metabolically unhealthy obese (MUHO). The classification of subjects in included studies as metabolically unhealthy was based on the presence of three components of metabolic syndrome. BMI categorization was based on the criteria of included studies. The risk estimates and 95% confidence intervals (CIs) were extracted and pooled using random effects analysis.

RESULTS

A total of 9 prospective cohort studies with 128773 participants and 4797 incident cases were included in the meta-analysis. Compared with healthy normal-weight individuals as reference, MUNW and MHO subjects showed an increased risk for CKD events with a pooled RR of 1.58 (95% CI = 1.28-1.96) in MUNW and 1.55 (95% CI = 1.34-1.79) in MHO persons. Also, MHOW was at increased risk for CKD (RR = 1.34, 95% CI = 1.20-1.51). MUHO individuals were at the highest risk for the development of CKD (RR = 2.13, 95% CI = 1.66-2.72).

CONCLUSIONS

Individuals with metabolic abnormality, although at normal-weight, have an increased risk for CKD. Healthy overweight and obese individuals had higher risk; refuting the notion that metabolically healthy overweight and obese phenotypes are benign conditions.

Authors+Show Affiliations

Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.Department of Nutrition and Food Hygiene, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran.Department of Medical Surgical Nursing, Nasibeh Nursing & Midwifery School, Mazandaran University of Medical Sciences, Sari, Iran.Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.Department of Sports Biomechanics, hysical Education and Sport Science College, Kharazmi University, Tehran, Iran.Department of Nutrition and Food Hygiene, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

31365625

Citation

Alizadeh, Shahab, et al. "Metabolic Phenotypes of Obese, Overweight, and Normal Weight Individuals and Risk of Chronic Kidney Disease: a Systematic Review and Meta-analysis." Archives of Endocrinology and Metabolism, vol. 63, no. 4, 2019, pp. 427-437.
Alizadeh S, Esmaeili H, Alizadeh M, et al. Metabolic phenotypes of obese, overweight, and normal weight individuals and risk of chronic kidney disease: a systematic review and meta-analysis. Arch Endocrinol Metab. 2019;63(4):427-437.
Alizadeh, S., Esmaeili, H., Alizadeh, M., Daneshzad, E., Sharifi, L., Radfar, H., & Radaei, M. K. (2019). Metabolic phenotypes of obese, overweight, and normal weight individuals and risk of chronic kidney disease: a systematic review and meta-analysis. Archives of Endocrinology and Metabolism, 63(4), 427-437. https://doi.org/10.20945/2359-3997000000149
Alizadeh S, et al. Metabolic Phenotypes of Obese, Overweight, and Normal Weight Individuals and Risk of Chronic Kidney Disease: a Systematic Review and Meta-analysis. Arch Endocrinol Metab. 2019 Jul 29;63(4):427-437. PubMed PMID: 31365625.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metabolic phenotypes of obese, overweight, and normal weight individuals and risk of chronic kidney disease: a systematic review and meta-analysis. AU - Alizadeh,Shahab, AU - Esmaeili,Hamed, AU - Alizadeh,Mohammad, AU - Daneshzad,Elnaz, AU - Sharifi,Loghman, AU - Radfar,Hossein, AU - Radaei,Mohammad Kazem, Y1 - 2019/07/29/ PY - 2017/11/11/received PY - 2019/03/29/accepted PY - 2019/8/1/pubmed PY - 2019/9/7/medline PY - 2019/8/1/entrez SP - 427 EP - 437 JF - Archives of endocrinology and metabolism JO - Arch Endocrinol Metab VL - 63 IS - 4 N2 - OBJECTIVE: Chronic kidney disease (CKD) risk is inconsistent in the normal-weight, overweight, and obese individuals due to the heterogeneity of metabolic status. This meta-analysis aimed to examine the combined effects of body mass index (BMI) and metabolic status on CKD risk. MATERIALS AND METHODS: The MEDLINE, EMBASE, and Web of Knowledge databases were systematically searched up to March 2019 to identify all eligible studies investigating the CKD risk (defined as GFR < 60 mL/min per 1.73 m2 and/or microalbuminuria or proteinuria) associated with the body size phenotypes which are known as metabolically unhealthy normal-weight (MUNW), metabolically healthy overweight (MHOW), metabolically unhealthy overweight, metabolically healthy obese (MHO) and metabolically unhealthy obese (MUHO). The classification of subjects in included studies as metabolically unhealthy was based on the presence of three components of metabolic syndrome. BMI categorization was based on the criteria of included studies. The risk estimates and 95% confidence intervals (CIs) were extracted and pooled using random effects analysis. RESULTS: A total of 9 prospective cohort studies with 128773 participants and 4797 incident cases were included in the meta-analysis. Compared with healthy normal-weight individuals as reference, MUNW and MHO subjects showed an increased risk for CKD events with a pooled RR of 1.58 (95% CI = 1.28-1.96) in MUNW and 1.55 (95% CI = 1.34-1.79) in MHO persons. Also, MHOW was at increased risk for CKD (RR = 1.34, 95% CI = 1.20-1.51). MUHO individuals were at the highest risk for the development of CKD (RR = 2.13, 95% CI = 1.66-2.72). CONCLUSIONS: Individuals with metabolic abnormality, although at normal-weight, have an increased risk for CKD. Healthy overweight and obese individuals had higher risk; refuting the notion that metabolically healthy overweight and obese phenotypes are benign conditions. SN - 2359-4292 UR - https://www.unboundmedicine.com/medline/citation/31365625/Metabolic_phenotypes_of_obese_overweight_and_normal_weight_individuals_and_risk_of_chronic_kidney_disease:_a_systematic_review_and_meta_analysis_ L2 - http://www.diseaseinfosearch.org/result/3996 DB - PRIME DP - Unbound Medicine ER -