Association between Adiposity Indexes and Kidney Disease: Findings from the Longitudinal Study of Adult Health (Elsa-Brazil)

Abstract

Introduction

Chronic kidney disease (CKD) is a public health problem and it is associated with a high risk of mortality. Overweight and obesity are known as independent risk factors for CKD.

Objective

To investigate the association between adiposity indexes and kidney disease.

Methods

This study included 14,636 adults from ELSA–Brazil. Outcome variables: altered glomerular filtration rate (GFR), categorized as yes (GFR <60 mL/min/1.73 m²) and no (GFR ≥60 mL/min/1.73 m²), albuminuria, estimated by albumin-creatinine ratio and categorized as yes (≥30 mg/g) and no (<30 mg/g), and presence of chronic kidney disease (CKD) (altered GFR and/or albuminuria). Exposure variables: obesity and overweight (body mass index (BMI)≥30 and ≥25 kg/m², respectively), high waist circumference (WC) (≥102 cm in men and ≥88 cm in women), high waist-to-hip ratio (WHR) (≥0.90 in men and ≥0.85 in women), and high waist-to-height ratio (WHtR) (≥0.5). To estimate the association between main exposures and outcomes, logistic regression analyses were performed using models adjusted for sociodemographic variables (age, gender, race/skin color, education), behavioral (smoking, physical activity, alcohol consumption), components of the metabolic syndrome (HDL cholesterol, triglycerides, hypertension, diabetes mellitus) and history of cardiovascular disease (myocardial infarction, angina or heart failure).

Results

Individuals with obesity, high WC, WHR and WHtR were more prone to albuminuria when compared to individuals with normal values for these measures. It was also observed that these altered measures were positively associated with the presence of CKD.

Conclusion

Adiposity indexes have a direct and significant association with albuminuria and CKD.

Keywords:

• Obesity
• glomerular filtration rate
• albuminuria
• chronic kidney disease

Acknowledgments

The authors thank the staff and participants of the ELSA-Brazil study for their important contributions. We also thank – FAPEMIG – Fundação de Amparo à Pesquisa do Estado de Minas Gerais- grant PPM00713-16.

Disclosure statement

We have submitted the manuscript “ASSOCIATION BETWEEN ADIPOSITY INDEXES AND KIDNEY DISEASE: FINDINGS FROM THE LONGITUDINAL STUDY OF ADULT HEALTH (ELSA-BRAZIL),” an original research, for consideration in the Journal of the American College of Nutrition.

Our study aimed to investigate the association between different adiposity indexes and markers of chronic kidney disease (CKD) using data from the Longitudinal Study of Adult Health (ELSA-BRAZIL).

Our main finding reveals that global and centralized obesity have a direct and significant association with albuminuria and kidney disease in Brazilian adults. We believe this result is an important contribution to the growing evidence that adiposity indexes are related to consequences to the kidney, especially in a context where excess weight and obesity are an increasing concern in the Brazilian population. We believe this might have serious implications on CKD and mortality.

Additional information

Funding

This work was supported by the Brazilian Ministry of Health (Department of Science and Technology) and the Brazilian Ministry of Science, Technology and Innovation (Financiadora de Estudos e Projetos, FINEP; and Conselho Nacional de Desenvolvimento Científico e Tecnológico, CNPq), through grant nos. 01 06 0010.00 RS, 01 06 0212.00 BA, 01 06 0300.00 ES, 01 06 0278.00 MG, 01 06 0115.00 SP and 01 06 0071.00 RJ. Sandhi Maria Barreto and Gustavo Velasquez-Melendez are CNPq research fellows.