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      Visceral Adiposity Index and Chronic Kidney Disease in a Non-Diabetic Population: A Cross-Sectional Study

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          Abstract

          Purpose

          To investigate the correlation between visceral obesity and pathogenesis of chronic kidney disease (CKD) among non-diabetic individuals, and to evaluate the potential of visceral adiposity index (VAI) as a predictor of CKD.

          Patients and Methods

          From December 2017 to March 2018, 1877 non-diabetic participants (male n=699, female n=1208) in southern China were recruited for a cross-sectional survey. Males and females were divided into four groups according to gender-specific quartiles of VAI scores. A logistic regression model was established to analyze the correlation between visceral adiposity index and CKD.

          Results

          Visceral adiposity index was positively correlated with CKD and was negatively associated with estimated glomerular filtration rate (eGFR). Using group one as the control, odds ratios (ORs) were calculated to determine the risk of developing CKD as VAI increased (male: group four 2.73 [P<0.005]; female: Group three 1.76 [P<0.05], Group four 2.88 [P<0.005]). When related factors such as history of hypertension, smoking, alcohol use, and physical inactivity were normalized in the logistic model before calculation, ORs became 2.73 (male: P<0.05), and 2.18 (female: P<0.05), respectively. The results differed after normalizing further for systolic blood pressure (SBP), diastolic blood pressure (DBP), hypersensitive c-reactive protein (hsCRP), interleukin-6 (IL-6), homocysteine (Hcy), superoxide dismutase (SOD), and retinol-binding protein (RBP). There were no significant differences in ORs among the female groups.

          Conclusion

          Visceral adiposity index was significantly associated with CKD in non-diabetic individuals. It may be a good predictor of the pathogenesis of CKD and was dependent on hsCRP, IL-6, Hcy, SOD, RBP, and blood pressure levels in females and males with VAI scores of 1.41 and higher. Visceral adiposity index may be used to predict CKD in males with VAI less than 0.983.

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          Most cited references26

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          The Definition and Prevalence of Obesity and Metabolic Syndrome.

          Atilla Engin (2017)
          Increase in prevalence of obesity has become a worldwide major health problem in adults, as well as among children and adolescents. Furthermore, total adiposity and truncal subcutaneous fat accumulation during adolescence are positively and independently associated with atherosclerosis at adult ages. Centrally accumulation of body fat is associated with insulin resistance, whereas distribution of body fat in a peripheral pattern is metabolically less important. Obesity is associated with a large decrease in life expectancy. The effect of extreme obesity on mortality is greater among younger than older adults. In this respect, obesity is also associated with increased risk of several cancer types. However, up to 30% of obese patients are metabolically healthy with insulin sensitivity similar to healthy normal weight individuals, lower visceral fat content, and lower intima media thickness of the carotid artery than the majority of metabolically "unhealthy" obese patients.Abdominal obesity is the most frequently observed component of metabolic syndrome. The metabolic syndrome; clustering of abdominal obesity, dyslipidemia, hyperglycemia and hypertension, is a major public health challenge. The average prevalence of metabolic syndrome is 31%, and is associated with a two-fold increase in the risk of coronary heart disease, cerebrovascular disease, and a 1.5-fold increase in the risk of all-cause mortality.
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            The global burden of chronic kidney disease: estimates, variability and pitfalls

            Richard Glassock, David Warnock, Pierre Delanaye (2016)
            Chronic kidney disease (CKD) is currently defined by abnormalities of kidney structure or function assessed using a matrix of variables — including glomerular filtration rate (GFR), thresholds of albuminuria and duration of injury — and is considered by many to be a common disorder globally.
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              Obesity trajectories and risk of dementia: 28 years of follow-up in the Whitehall II Study

              Archana Singh-Manoux, Aline Dugravot, Martin J. Shipley … (2018)
              Introduction We examined whether obesity at ages 50, 60, and 70 years is associated with subsequent dementia. Changes in body mass index (BMI) for more than 28 years before dementia diagnosis were compared with changes in BMI in those free of dementia. Methods A total of 10,308 adults (33% women) aged 35 to 55 years in 1985 were followed up until 2015. BMI was assessed six times and 329 cases of dementia were recorded. Results Obesity (BMI ≥30 kg/m2) at age 50 years (hazard ratio = 1.93; 1.35–2.75) but not at 60 or 70 years was associated with risk of dementia. Trajectories of BMI differed in those with dementia compared with all others (P < .0001) or to matched control subjects (P < .0001) such that BMI in dementia cases was higher from 28 years (P = .001) to 16 years (P = .05) and lower starting 8 years before diagnosis. Discussion Obesity in midlife and weight loss in the preclinical phase characterizes dementia; the current obesity epidemic may affect future dementia rates.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Diabetes Metab Syndr Obes
                Journal ID (iso-abbrev): Diabetes Metab Syndr Obes
                Journal ID (publisher-id): DMSO
                Journal ID (pmc): dmso
                Title: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
                Publisher: Dove
                ISSN (Electronic): 1178-7007
                Publication date (Electronic): 04 February 2020
                Publication date Collection: 2020
                Volume: 13
                Pages: 257-265
                Affiliations
                [1 ]Department of Nephrology, The Third Affiliated Hospital, Southern Medical University , Guangzhou 510630, People’s Republic of China
                Author notes
                Correspondence: Hequn Zou Department of Nephrology, The Third Affiliated Hospital, Southern Medical University , 183, Zhongshan West Avenue, Tianhe District, Guangzhou510630, People’s Republic of ChinaTel +86 20 6278 4391 Email hequnzou@hotmail.com
                [*]

                These authors contributed equally to this work

                Article
                Publisher ID: 231656
                DOI: 10.2147/DMSO.S231656
                PMC ID: 7007790
                PubMed ID: 32099432
                SO-VID: b92e4e35-b787-4c33-9464-c261a1c946b6
                Copyright © © 2020 Xiao et al.
                License:

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                Date received : 28 September 2019
                Date accepted : 15 January 2020
                Page count
                Figures: 1, Tables: 4, References: 35, Pages: 9
                Funding
                This study was supported by Risk factors and prediction model of chronic kidney disease caused by metabolic syndrome: A multicentric prospective cohort study Clinical trial training project of Southern Medical University (LC2016PY047, 2016), Science and Technique Program of Guangzhou (201604020015, 2015), and South Wisdom Valley Innovative Research Team Program (CXTD-004, 2014), the National Natural Science Foundation of China (81873620).
                Categories
                Subject: Original Research

                ScienceOpen disciplines: Endocrinology & Diabetes
                Keywords: visceral adiposity index,chronic kidney disease,non-diabetic population
                Data availability:
                ScienceOpen disciplines: Endocrinology & Diabetes
                Keywords: visceral adiposity index, chronic kidney disease, non-diabetic population

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