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Association Between Midlife Obesity and Kidney Function Trajectories: The Atherosclerosis Risk in Communities (ARIC) Study.


ABSTRACT:

Rationale & objective

Obesity has been related to risk for chronic kidney disease. However, the associations of different measures of midlife obesity with long-term kidney function trajectories and whether they differ by sex and race are unknown.

Study design

Observational study.

Setting & participants

13,496 participants from the Atherosclerosis Risk in Communities (ARIC) Study.

Predictors

Midlife obesity status as measured by body mass index (BMI), waist-to-hip ratio, and predicted percent fat at baseline.

Outcomes

Estimated glomerular filtration rate (eGFR) calculated using serum creatinine level measured at 5 study visits, and incident kidney failure with replacement therapy (KFRT).

Analytical approach

Mixed models with random intercepts and random slopes for eGFR. Cox proportional hazards models for KFRT.

Results

Baseline mean age was 54 years, median eGFR was 103mL/min/1.73m2, and median BMI was 27kg/m2. Over 30 years of follow-up, midlife obesity measures were associated with eGFR decline in White and Black women but not consistently in men. Adjusted for age, center, smoking, and coronary heart disease, the differences in eGFR slope per 1-SD higher BMI, waist-to-hip ratio, and predicted percent fat were 0.09 (95% CI, -0.18 to 0.36), -0.25 (95% CI, -0.50 to 0.01), and-0.14 (95% CI, -0.41 to 0.13) mL/min/1.73m2 per decade for White men; -0.91 (95% CI, -1.15 to-0.67), -0.82 (95% CI, -1.06 to-0.58), and-1.02 (95% CI, -1.26 to-0.78) mL/min/1.73m2 per decade for White women; -0.70 (95% CI, -1.54 to 0.14), -1.60 (95% CI, -2.42 to-0.78), and-1.24 (95% CI, -2.08 to-0.40) mL/min/1.73m2 per decade for Black men; and-1.24 (95% CI, -2.08 to-0.40), -1.50 (95% CI, -2.05 to-0.95), and-1.43 (95% CI, -2.00 to-0.86) mL/min/1.73m2 per decade for Black women. Obesity indicators were independently associated with risk for KFRT for all sex-race groups except White men.

Limitations

Loss to follow-up during 3 decades of follow-up with 5 eGFR assessments.

Conclusions

Obesity status is a risk factor for future decline in kidney function and development of KFRT in Black and White women, with less consistent associations among men.

SUBMITTER: Yu Z 

PROVIDER: S-EPMC7904650 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Publications

Association Between Midlife Obesity and Kidney Function Trajectories: The Atherosclerosis Risk in Communities (ARIC) Study.

Yu Zhi Z   Grams Morgan E ME   Ndumele Chiadi E CE   Wagenknecht Lynne L   Boerwinkle Eric E   North Kari E KE   Rebholz Casey M CM   Giovannucci Edward L EL   Coresh Josef J  

American journal of kidney diseases : the official journal of the National Kidney Foundation 20200924 3


<h4>Rationale & objective</h4>Obesity has been related to risk for chronic kidney disease. However, the associations of different measures of midlife obesity with long-term kidney function trajectories and whether they differ by sex and race are unknown.<h4>Study design</h4>Observational study.<h4>Setting & participants</h4>13,496 participants from the Atherosclerosis Risk in Communities (ARIC) Study.<h4>Predictors</h4>Midlife obesity status as measured by body mass index (BMI), waist-to-hip rat  ...[more]

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