Central Obesity, C-Reactive Protein and Chronic Kidney Disease: A Community-Based Cross-Sectional Study in Southern China

Abstract

Objective: Previous studies have shown that central obesity is associated with chronic kidney disease (CKD). We hypothesized that the association of central obesity with CKD is modified by the presence of inflammation. To test this hypothesis, we performed this study. Methods: This was a cross-sectional study in southern China. Waist-to-height ratio (WHtR) was used as a central obesity index and C-reactive protein (CRP) was used as an index for inflammation. CKD was defined as estimated glomerular filtration rate(eGFR) <60 ml/min/1.73m² or albuminuria-to-creatinine ratio (ACR) >30mg/g. Multivariable logistic regressions were used and logistic regression models were adjusted for potential confounders and other components of metabolic syndrome. Results: 1834 subjects were included in the current study. WHtR, body mass index and waist circumference were significantly associated with the level of CRP. When adjustment for potential confounders, only central obesity with a higher CRP level was associated with CKD (Relavitve-risk Ratio, 95% CI: 1.68, 1.03 - 2.75, P = 0.04). In multivariate logistic models, WHtR was associated with CKD. The odd ratio for WHtR (every SD increment), was 1.38 (95% CI 1.15, 1.66, P < 0.001). Further adjustment for log-transformed CRP had an impact on the odd ratios. Conclusion: Central obesity is associated with CKD, independently of other MetS components. Central obesity is also associated with inflammation and the presence of inflammation modifies the associations of central obesity and CKD. This study is based on a community-based chinese population, and the results may only be applicable for Chinese population.

Association between metabolically unhealthy overweight/obesity and chronic kidney disease: The role of inflammation

“…The results indicate that inflammation could have an important role in obesity-related adverse events. Our previous study also supported such a view [25].…”

“…However, our present study did not include inflammatory markers in the definition of metabolically healthy. Inflammation might be a potentially adverse downstream consequence of increased fat mass, and might also be part of the causal pathway between obesity and CKD [1,25]. Our previous study indicated that obesity is associated with inflammation and that inflammation modifies the links between obesity and CKD [25].…”

“…Inflammation might be a potentially adverse downstream consequence of increased fat mass, and might also be part of the causal pathway between obesity and CKD [1,25]. Our previous study indicated that obesity is associated with inflammation and that inflammation modifies the links between obesity and CKD [25]. To examine the effects of modifications due to inflammation on the relationships between obesity, metabolic subtypes and CKD, the inflammatory marker CRP was additionally included in the adjusted models.…”

Insulin resistance and associated factors: a cross-sectional study of bank employees

“…The metabolic disorders that occur in IR are involved in the pathogenesis of type 2 diabetes mellitus (type 2 DM), and when associated with dyslipidaemia, obesity and hypertension (AH), these conditions constitute metabolic syndrome (MS) 3. MS is characterized by a complex network of nutritional and metabolic disorders, including inflammation, oxidative stress, vitamin D deficiency, anaemia and high levels of C reactive protein (CRP) 3,4.…”

Metabolic syndrome does not always play a critical role in decreased GFR

“…11,12 However, controversies still remain regarding the relationship between decreased estimated glomerular filtration rate (eGFR560 mL/min/1.73 2 ) and individual factors in MetS. Some researchers reported that obesity indicated by elevated body mass index (BMI) which can induce renal injury 13 is an independent culprit in CKD, 14,15 while others observed a U-shaped association between weight change categories and development of CKD. 16 In addition, few studies have focused on the relationship of CKD with different levels of individual factors in MetS.…”