Association and interaction analysis of excess weight and chronic kidney disease for cardiovascular autonomic neuropathy in the general Chinese population

Figures & data

Table 1. The clinical baseline of subjects.

Variables	Entire sample	Normal BMI	High BMI	p-Value*
Demographical information
N	2092	1256	836	–
Age year	60.4 ± 8.67	59.94 ± 8.61	61.1 ± 8.74	0.003
Gender male (%)	699 (33.67%)	391 (31.13%)	308 (37.56%)	0.002
Height (cm)	161.46 ± 7.82	161.43 ± 7.82	161.5 ± 7.82	0.844
Weight (kg)	63.26 ± 10.65	57.67 ± 7.65	71.82 ± 8.75	<0.001
WC (cm)	85.08 ± 9.77	80.32 ± 7.94	92.34 ± 7.58	<0.001
SBP (mmHg)	127.63 ± 18.68	124.43 ± 18.09	132.53 ± 18.51	<0.001
DBP (mmHg)	79.86 ± 9.73	78.1 ± 9.3	82.56 ± 9.75	<0.001
Laboratory assays
FPG (mmol/L)	5.53 ± 1.82	5.39 ± 1.75	5.76 ± 1.91	<0.001
PBG (mmol/L)	7.68 ± 3.64	7.24 ± 3.51	8.34 ± 3.73	<0.001
HbAlc (%)	6 ± 1.08	5.87 ± 0.96	6.19 ± 1.21	<0.001
FINS (pmol/L)	50.07 ± 82.63	42.53 ± 62.32	61.59 ± 105.44	<0.001
TC (mmol/L)	5.32 ± 1	5.35 ± 0.99	5.28 ± 1.02	0.118
TG (mmol/L)	1.71 ± 0.98	1.58 ± 0.85	1.91 ± 1.12	<0.001
HDL (mmol/L)	1.36 ± 0.33	1.41 ± 0.34	1.27 ± 0.28	<0.001
LDL (mmol/L)	3.19 ± 0.77	3.17 ± 0.77	3.22 ± 0.77	0.161
SCr (μmol/L)	77.83 ± 26.16	77.51 ± 28.8	78.31 ± 21.49	0.496
GFR (mL/min/1.73 m^2)	84.08 ± 30.05	83.98 ± 29.5	84.23 ± 30.9	0.856
Ccr (mL/min)	81.99 ± 31.04	82.14 ± 30.25	81.76 ± 32.23	0.783
UA (μmol/L)	281.16 ± 83.95	270.13 ± 80.72	298.02 ± 86.02	<0.001
alb/cr (mg/mmol)	4.83 ± 14.44	4.57 ± 15.13	5.22 ± 13.35	0.419
HRV indices
HR (bpm)	72.41 ± 10.14	72.04 ± 10.28	72.98 ± 9.91	0.039
TP (ms^2)	873.16 ± 703.7	895.39 ± 618.73	839.1 ± 579.04	0.045
LF (ms^2)	190.88 ± 208.39	194.94 ± 205.84	184.65 ± 212.21	0.271
HF (ms^2)	182.42 ± 219.42	185.57 ± 232.55	177.59 ± 197.64	0.418
LF/HF	1.7 ± 1.97	1.75 ± 2.03	1.64 ± 1.88	0.203
Medical history
Smoking	304 (14.64%)	163 (12.98%)	141 (17.2%)	0.008
HTN	968 (46.63%)	478 (38.06%)	490 (59.76%)	<0.001
DM	443 (21.35%)	205 (16.33%)	238 (29.02%)	<0.001
MetS	831 (40.03%)	325 (25.88%)	506 (61.71%)	<0.001
CKD	174 (8.42%)	101 (8.09%)	73 (8.94%)	0.497
CAN	386 (18.59%)	208 (16.56%)	178 (21.71%)	0.003

Notes: WC – waist circumference, SBP – systolic blood pressure, DBP – diastolic blood pressure, FPG – fasting plasma glucose, PBG – plasma blood glucose, FINS – fasting blood insulin, TC – serum total cholesterol, TG – triglyceride, UA – uric acid, HDL – high-density lipoprotein cholesterol, LDL – low density lipoprotein cholesterol, SCr – serum creatinine, Ccr – creatinine clearance rate, GFR – glomerular filtration rate, HR – heart rate, TP – total power of variance, LF – low frequency, HF – high frequency, MetS – metabolic syndrome, HTN – hypertension, DM – Diabetes, CAN – cardiovascular autonomic neuropathy.

*Present the difference between subjects with normal BMI and overweight.

Table 2. Univariate logistic regression analysis for cardiovascular autonomic neuropathy.

Variable	β	S.E.	p-Value	OR	95% CI
Age	0.042	0.007	<0.001	1.043	1.029–1.103
BMI	0.066	0.016	<0.001	1.068	1.034–1.046
WC	0.034	0.006	<0.001	1.034	1.023–1.024
SBP	0.018	0.003	<0.001	1.018	1.012–1.030
DBP	0.019	0.006	0.001	1.019	1.007–1.261
FPG	0.178	0.027	<0.001	1.195	1.133–1.149
PBG	0.111	0.014	<0.001	1.117	1.087–1.722
FINS	0.014	0.006	0.015	1.014	1.003–1.159
IR	0.091	0.029	0.001	1.095	1.036–1.212
GFR	0.001	0.001	0.559	0.999	0.997–1.002
Ccr	0.001	0.002	0.623	0.999	0.995–1.003
HR	0.090	0.006	<0.001	1.094	1.081–1.108
HTN	0.779	0.116	<0.001	2.178	1.736–3.248
DM	0.936	0.123	<0.001	2.550	2.003–3.156
MetS	0.646	0.114	<0.001	1.907	1.527–1.307
CKD	0.329	0.188	0.081	1.389	0.961–2.009

Notes: MetS – metabolic syndrome, HR – heart rate, BMI – body mass index, WC – waist circumference, SBP – systolic blood pressure, DBP – diastolic blood pressure, FPG – fasting plasma glucose, PBG – plasma blood glucose, FINS – fasting blood insulin, IR – insulin resistance, Ccr – creatinine clearance rate, GFR – glomerular filtration rate, HTN – hypertension, DM – diabetes, CKD – chronic kidney disease.

Table 3. Multiple logistic regression analysis to include body mass index and chronic kidney disease for cardiovascular autonomic neuropathy.

Variable	β	S.E.	p-Value	OR	95% CI
BMI	0.253	0.052	0.006	1.288	1.163–1.426
CKD	0.208	0.091	0.763	1.064	0.709–1.599

Notes: BMI – body mass index, CKD – chronic kidney disease. Multiple logistic regression analysis adjusted for age, gender, smoking, serum total cholesterol, serum creatinine, uric acid, systolic blood pressure and diabetes.

Figure 1. Interaction analysis of body mass index (BMI) and chronic kidney disease (CKD) on cardiovascular autonomic neuropathy (CAN). In subjects with normal BMI, the prevalence of CAN was 16.30% and 18.58% in those subjects with non-CKD and CKD, respectively. In subjects with high BMI, the prevalence of CAN was 20.97% and 30.02% in the subjects with non-CKD and CKD, respectively. CKD was defined as the presence of albuminuria or an eGFR <60 mL/min/1.73 m².

Table 4. The interaction analysis of body mass index and chronic kidney disease on cardiovascular autonomic neuropathy.

Variables	β	S.E.	p-Value	OR	95% CI
BMI	0.338	0.120	0.005	1.402	1.108–1.773
CKD	0.378	0.254	0.137	1.459	0.887–2.401
BMI by CKD	0.132	0.062	0.038	1.141	1.011–1.289
RERI	0.473				0.062–0.884
AP	0.203				−0.055–0.461
S	1.550				0.667–2.589

Notes: BMI – body mass index, CKD – chronic kidney disease, CAN – cardiovascular autonomic neuropathy, RERI – relative excess risk due to interaction, AP – the proportion attributable to interaction, S – the synergy index. This interaction analysis adjusted for age, gender, smoking, serum total cholesterol, serum creatinine, uric acid, systolic blood pressure and diabetes.