Obesity Without Metabolic Abnormality and Incident CKD: A Population-Based British Cohort Study.

Wang, Jingya, Niratharakumar, Krishnarajah, Gokhale, Krishna, Tahrani, Abd A, Taverner, Tom, Thomas, G Neil and Dasgupta, Indranil (2021) Obesity Without Metabolic Abnormality and Incident CKD: A Population-Based British Cohort Study. American journal of kidney diseases : the official journal of the National Kidney Foundation. ISSN 1523-6838. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Abstract

RATIONALE & OBJECTIVE

Metabolically healthy obesity (obesity without any metabolic abnormality) is considered not to be associated with increased risk of morbidity and mortality. We aimed to examine and quantify the association between metabolically healthy overweight/obesity and the risk of incident chronic kidney disease (CKD) in a British primary care population.

DESIGN

Retrospective population-based cohort study.

SETTING & PARTICIPANTS

4,447,955 of the 5,182,908 adults in The Health Improvement Network (THIN) database (United Kingdom, 1995-2015) with a recorded body mass index (BMI) at the time of registration date who were free of CKD and cardiovascular disease.

EXPOSURES

11 body size phenotypes were created, defined by body mass index categories (underweight, normal weight, overweight, and obesity) and 3 metabolic abnormalities (diabetes, hypertension, and dyslipidemia).

OUTCOMES

Incident CKD defined as a recorded diagnosis of kidney replacement therapy (KRT), a recorded diagnosis of CKD, or by an estimated glomerular filtration rate <60 ml/min/1.73 m for ≥90 days, or a urinary albumin-creatinine ratio >3 mg/mmol for ≥90 days.

RESULTS

Of the 4.5 million individuals, 1,040,921 (23.4%) and 588,909 (13.2%) were metabolically healthy overweight and metabolically healthy obese, respectively. During a mean follow-up of 5.4 (SD 4.3) years, compared to individuals with metabolically healthy normal weight (n=1,656,231), those who had metabolically healthy overweight (adjusted HR = 1.30, 95% CI 1.28 to 1.33) and metabolically healthy obesity (adjusted HR = 1.66, 95% CI 1.62 to 1.70) had a higher risk of incident CKD. The association was stronger in those younger than 65 years of age. The risk of incident CKD in all BMI categories increased with an increasing number of metabolic abnormalities in a graded manner.

LIMITATIONS

Potential misclassification of metabolic status due to delayed diagnosis and residual confounding due to unmeasured factors.

CONCLUSIONS

Overweight and obesity without metabolic abnormality are associated with a higher risk of incident CKD compared to those with normal body weight and no metabolic abnormality.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WA Patients. Primary care. Medical profession. Forensic medicine
Divisions: Emergency Services > Renal
Related URLs:
Depositing User: Jamie Edgar
Date Deposited: 28 Jun 2021 10:15
Last Modified: 28 Jun 2021 10:15
URI: http://www.repository.uhblibrary.co.uk/id/eprint/4451

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