<p>Association Between Hypertriglyceridemic Waist Phenotype and Increased Urinary Albumin–Creatinine Ratio in Chinese Adults: The REACTION Study</p>

Abstract

The hypertriglyceridemic waist (HTGW) phenotype can predict cardiovascular disease (CVD) risk. Additionally, strong evidence indicates that elevated urinary albumincreatinine ratio (UACR) is associated with increased prevalence of CVD. However, few studies have explored the association between the HTGW phenotype and UACR. Patients and Methods: In this cross-sectional descriptive study, a total of 40,674 subjects (28,562 women and 12,112 men older than 40 years) were recruited from seven different geographic regional centres. The HTGW phenotype was defined as increased triglyceride levels (triglyceride ≥ 1.5 mmol/L for female and ≥2.0 mmol/L for male) and waist circumference (WC; WC ≥ 85 for female and WC ≥ 90 cm for male). Logistic regression analyses were performed to assess the relationship between UACR and the HTGW phenotype. Results: Subjects with the HTGW phenotype showed a more significant trend towards increased excretion of UACR [among all subjects, odds ratio (OR) = 1.303, 95% CI: 1.132-1.499, P < 0.001; among men, OR = 1.406, 95% CI: 1.057-1.870, P = 0.019; among women, OR = 1.268, 95% CI: 1.074-1.496, P = 0.005]. Furthermore, the stratified analysis showed that the OR for high-risk significantly increased in individuals in the HTGW group aged below 65 years, with 5.6 ≤ fasting blood glucose < 7.0 or 7.8 ≤ post-load blood glucose <11.1 mmol/L, 120 ≤ systolic blood pressure < 140 or 80 ≤ diastolic blood pressure < 90, 24 ≤ body mass index < 28 kg/m 2 , and estimated globular filtration rate > 90 mL/min per 1.73 m 2. Conclusion: This study has advanced the understanding of visceral obesity and our results supported the fact that the HTGW phenotype is associated with elevated UACR excretion among general Chinese adults.

The association between hypertriglyceridemic-waist phenotype and chronic kidney disease: a cohort study and meta-analysis

“…The current finding on the increased risk of CKD among HTGW individuals were consistent with several previous studies 15 , 16 , 18 , 20 , 21 , 23 . For example, a cross-sectional study conducted in China showed that participants with HTGW phenotype were more likely to have CKD (OR 2.09, 95% CI 1.26 to 3.45) 15 .…”

“…Instead, we used 85 cm, which was considered an appropriate cut-off in Chinese women for central obesity 26 . Similarly, several studies used 2.0 mmol/L to define high triglycerides 15 , 18 , 19 , 21 , 22 , while we used the cut-off of 1.7 mmol/ L, which was recommended to define metabolic syndrome in Chinese 28 . Also, previous research has shown that triglyceride levels above 1.7 mmol/L was already significantly associated with increased risk of CKD 42 .…”

Association of Lipid Accumulation Product With Chronic Kidney Disease in Chinese Community Adults: A Report From the REACTION&nbsp;Study

“…Accumulating evidence indicates that obesity and CKD have increased in parallel worldwide and are positively correlated [12], and obesity, especially visceral obesity, is an important risk factor for CKD [3,5,6,7]. Visceral obesity has been reported to be associated with IR, dyslipidemia, nonalcoholic fatty liver disease, metabolic syndrome, hyperuricemia, diabetes, hypertension, and CVD events [5,6,8,9], all of which are involved in the pathogenesis of CKD [3,4,10]. Direct measurement of visceral adipose tissue by imaging techniques, i.e.…”

“…Compared with subcutaneous adipose tissue, visceral adipose tissue is more strongly associated with cardiometabolic risks [5]. Visceral adipose tissue secretes several proinfammatory cytokines such as C-reactive protein (CRP), interleukine-6 (IL-6), and distinct atherogenic lipoprotein pro les, contributes to the change in adipocytokines such as adiponectin, leptin, resistin, and omentin-1, which lead to subclinical in ammation, oxidative stress, insulin resistance (IR), and endothelial dysfunction, and subsequently, induces kidney structure and function changes such as glomerular sclerosis and increased albuminuria, and ultimately result in renal dysfunction [5,7,8,9]. Body mass index (BMI) is the most frequently used index in the assessment of adiposity in clinical practice, but lacks discriminatory power between lean vs. adipose tissue, or between subcutaneous and visceral fat, and also lacks the ability to track over time changes in the lipid compartment [10].…”

Association of Hypertriglyceridemic Waist Phenotype with Obstructive Sleep Apnea: A Cross-Sectional Study

“…[13][14][15] Hypertriglyceridemic waist (HTGW) phenotype, defined as increased WC with an elevated TG level, is cheap and easy to determine. It is commonly used to screen for gestational 16 or type2 17 diabetes mellitus, as well as for hypertension, 18 increased urinary albumincreatinine ratio, 19 hepatic steatosis, 20 and cardiovascular disease. 21 Because OSA is associated with MS and many of the aforementioned diseases, we hypothesized that HTGW phenotype might predict the risk of OSA.…”