Association between obesity and urinary albumin-creatinine ratio in the middle-aged and elderly population of Southern and Northern China: a cross-sectional study

Abstract

ObjectiveThe relationship between obesity and albuminuria has not been clarified. This study aimed to investigate the correlation between obesity and the urinary albumin-creatinine ratio (UACR) in Southern and Northern China.DesignA descriptive, cross-sectional study.SettingEight regional centres in REACTION (China’s Risk Evaluation of cAncers in Chinese diabeTic Individuals, a lONgitudinal study), including Dalian, Lanzhou, Zhengzhou, Guangzhou, Guangxi, Luzhou, Shanghai and Wuhan.ParticipantsA total of 41 085 patients who were not diagnosed with chronic kidney disease (CKD) and had good compliance were selected according to the inclusion criteria. Patients who were diagnosed with CKD, who had other kidney diseases that could lead to increased urinary protein excretion, who were using angiotensin-converting-enzyme inhibitors or angiotensin II receptor blockers and whose important data were missing were excluded.ResultsParticipants with both, central and peripheral obesity, had a higher risk of elevated UACR, even after adjusting for multiple factors (OR: 1.14, 95% CI: 1.07 to 1.12, p<0.001), and the risk of high UACR in the South was more prominent than that in the North (OR South: 1.22, 95% CI: 1.11 to 1.34; OR North: 1.13, 95% CI: 1.04 to 1.22, p<0.001). The risk was also elevated in the male population, hypertensive individuals, glycosylated haemoglobin (HbA1c)≥6.5% and age ≥60 years in the South. Besides the above groups, diabetes was also a risk factor for the Northern population.ConclusionsIn China, people with both central and peripheral obesity are prone to a high UACR, and the southern population has a higher risk than northern population. Factors such as male sex, hypertension, HbA1c≥6.5% and an age ≥60 years are also risk factors for CKD.

Association of lipid accumulation product with chronic kidney disease in Chinese community adults: a report from the REACTION study

“…Several reports have suggested that age is an important risk factor for CKD [ 11 ]. The present study also revealed that the prevalence of CKD was significantly and positively associated with age, and also suggested a positive relationship of LAP quartiles with risk of CKD prevalence in subjects aged ≥60 years but not those aged < 60 years, which was similar to a previous study [ 27 ]. These results suggest older age might be associated with CKD prevalence because elderly individuals have higher prevalenceof comorbidities, such as obesity, hyperuricaemia, dyslipidaemia, diabetes, and hypertension, and more use of medications for these chronic diseases, which may have a profound negative impact on kidney function.…”

“…Emerging epidemiologic studies have suggested that diabetes, hypertension, and dyslipidaemia are important risk factors for CKD [ 1 , 4 , 6 , 27 – 29 ]. Thepresent study also showed that male and female subjects with CKD had significantly more users of hypoglycaemic drugs, higher blood glucose (FBG, PBG, and HbA1c), prevalence of T2DM and hypertension compared with those without CKD.…”

Metabolic Risk Factors Associated With Chronic Kidney Disease in a Middle-Aged and Elderly Taiwanese Population: A Cross-Sectional Study

“…Some studies have shown that hypertriglyceridemia or low HDL-C levels are only significantly associated with the development of CKD in patients with metabolic syndrome ( 32 , 44 ). Regarding central obesity, a longitudinal study in China found that people with both central and peripheral obesity had higher risks of elevated urine albumin-creatinine ratio, even after adjusting for multiple factors (OR: 1.14, 95% CI: 1.07–1.21, p < 0.001) ( 45 ). However, there is no consensus on the role of central obesity in the development of CKD ( 33 , 35 , 44 , 46 , 47 ).…”

Association Between Chinese Visceral Adipose Index and Albuminuria in Chinese Adults: A Cross-Sectional Study

“…7,8 Many studies have shown that obese people are more prone to increased UACR, and obesity is closely related to the risk of CKD progressing to end stage kidney disease (ESKD). 9,10 Obesity can also participate in the whole process of increased urinary protein excretion, occurrence and progression of CKD to ESKD through the indirect effect of related metabolic abnormalities caused by obesity. There is a causal relationship between obesity and the risk of CKD.…”

“…The Chinese Diabetes Cancer Risk Cohort Study (REACTION study) also found that obesity was significantly associated with a higher risk of elevated UACR, but unlike this study, the association was not significant in simple abdominal obesity people or simple systemic obesity people. 10 Given that the REACTION study excluded people with a diagnosis of CKD, and the REACTION study was based on the ratio of UACR to the median UACR in each sub-center population not directly study the level of UACR, we still believe that abdominal obesity is associated with increased UACR.…”