Hypertriglyceridemic waist phenotype and risk of chronic kidney disease in community-dwelling adults aged 60 years and older in Tianjin, China: a 7-year cohort study

Abstract

Background The hypertriglyceridemic waist (HTGW) phenotype has been proposed to be related to the occurrence and progression of chronic kidney disease (CKD). The ageing trend of the Chinese population continues to intensify, and elderly individuals are at high risk of CKD. The purpose of this study was to investigate the cross-sectional and longitudinal associations between the HTGW phenotype and the risk of CKD by following community-dwelling adults aged 60 years and older in Tianjin, China, for 7 years. Methods This study was an observational cohort study conducted between 2013 and 2019. Of 2050 participants aged 60 years and older who underwent an annual health examination in 2013, 1605 individuals with complete data were enrolled in the cross-sectional analysis. Among them, 1271 individuals were observed until 2019. Detailed follow-up records were available for 816 participants, of whom 600 participants without CKD at baseline were eligible for inclusion in the retrospective analysis. The HTGW phenotype was defined as a waist circumference of 90 cm or more and triglyceride concentrations of 2.0 mmol/L or more in males or a waist circumference of 85 cm or more and triglyceride concentrations of 1.5 mmol/L or more in females. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2 and/or proteinuria (urinary albumin-to-creatinine ratio (ACR) ≥ 30 mg/g). Multivariable logistic regression analyses were performed to evaluate the relationship between the HTGW phenotype and CKD. Results In 2013, the prevalence of CKD among older adults was 31.03%, and the prevalence of CKD in the HTGW phenotype group was 37.81%. Over a 7-year observation period, 195 individuals developed CKD, with an incidence rate of 32.50%. Statistically significant associations were observed between the HTGW phenotype and CKD in older adults in both cross-sectional surveys and retrospective analyses, with odds ratios and 95% confidence intervals of 1.38 (95% CI: 1.03–1.86, P = 0.033) and 2.27 (95% CI: 1.30–3.97, P = 0.004), respectively, after adjustment for confounders. Conclusions In this community-based cohort study, the HTGW phenotype was confirmed to be independently associated with an increased risk of prevalent and incident CKD in older adults aged 60 years and above in Tianjin, China.

Relationship between Phenotype Models Based on Waist Circumference and Triglyceride Levels and the Risk of Chronic Kidney Disease: A Systematic Review and Meta-analysis

“…Our assessment of study quality using the NOS tool showed that both included cohort studies had good quality, with one study 23 having a total score of 8 and the other study 24 having a total score of 9. In addition, all the included cross-sectional studies were good quality, with total scores of 8 or 9 on the modified NOS tool.…”

Sex-related differences in the hypertriglyceridemic-waist phenotype in association with hyperuricemia: a longitudinal cohort study

“…Triglycerides were measured using an enzymatic color metric test, with an elevated triglyceride level defined as ≥ 1.5 mmol/L for females or ≥ 2.0 mmol/L for males. Waist circumference was measured by trained assessors using soft measuring tape, and enlarged waist circumference was defined as ≥ 85 cm in females or ≥ 90 cm in males [9,10]. We divided participants into the following four triglyceride-waist phenotypes: 1) NTNW, normal triglyceride levels and normal waist circumference; 2) NTGW, normal triglyceride levels and enlarged waist circumference; 3) HTNW, elevated triglyceride levels and normal waist circumference; and 4) HTGW, elevated triglyceride levels and enlarged waist circumference [10].…”

“…Previous studies reported that elevated triglycerides and enlarged waist circumference were associated with a higher risk of hyperuricemia [7,8]. The hypertriglyceridemic-waist (HTGW) phenotype (i.e., coexistence of elevated triglyceride levels and enlarged waist circumference) was first introduced in 2000 and has been confirmed as a measure of increased visceral adiposity and a predictor of chronic kidney disease [9,10]. A previous study determined the potential mechanism among them, i.e., insulin resistance induced by visceral obesity subsequently reduces the excretion of uric acid from the renal system, resulting in an increased risk of hyperuricemia [11].…”

Hypertriglyceridaemic waist phenotype and waist circumference triglyceride index are associated with higher incidence of acute pancreatitis: a nationwide population-based retrospective cohort study

“…It is also significantly correlated with early diabetic nephropathy in type 2 patients with diabetes 17. In a community-based cohort study conducted in China, it was independently associated with an increased risk of chronic kidney disease (CKD) prevalence and development in the elderly, aged ≥60 years 18. The HTGW phenotype is determined by measuring two components: the waist circumference (WC) and blood triglyceride levels.…”

“… 17 In a community-based cohort study conducted in China, it was independently associated with an increased risk of chronic kidney disease (CKD) prevalence and development in the elderly, aged ≥60 years. 18 The HTGW phenotype is determined by measuring two components: the waist circumference (WC) and blood triglyceride levels. Also, it is anticipated to be a predictive marker for the risk of AP.…”