Changes in obese metabolic phenotypes over time and risk of incident chronic kidney disease

Ki Heon Nam, Hae Ryong Yun, Young Su Joo, Joohwan Kim, Sangmi Lee, Changhyun Lee, Kyoung Sook Park, Jung Tak Park, Tae Ik Chang, Ea Wha Kang, Tae Hyun Yoo, Shin Wook Kang, Seung Hyeok Han

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Aim: To examine the association between metabolically healthy obese (MHO) phenotype and incident chronic kidney disease (CKD) and study whether changes in metabolic phenotypes over time could affect CKD risk. Methods: A total of 8589 subjects from the Korean Genome and Epidemiology Study were categorized into four groups based on the presence of obesity and metabolic abnormalities (MA). The primary endpoint was an onset of incident CKD defined as an estimated glomerular filtration rate of ≤ 60 mL/min/1.73 m2. Multivariable Cox analysis and time-varying Cox analysis were performed to delineate the relationship between obese metabolic phenotypes and incident CKD after adjustment for sociodemographic factors and clinical and laboratory parameters. Results: During a mean follow-up duration of 9.3 years, CKD occurred in 782 (9.1%) participants. In the multivariable Cox model, the hazard ratio (HR) for incident CKD in the MHO, metabolically abnormal non-obese (MANO), and metabolically abnormal obese (MAO) groups was 1.42 (P = 0.002), 1.45 (P < 0.001), and 1.77 (P < 0.001), respectively, compared with the metabolically healthy non-obese (MHNO) group. Time-varying analysis with these four phenotypes as time-varying exposures showed the same results. Furthermore, subjects with persistent MHO through follow-up were at a 2.0-fold increased risk of CKD (P < 0.001). 41.0% of subjects experienced phenotype changes during follow-up. Over the long term, the MHO group had a higher proportion of transition to the MA phenotype and unfavourable metabolic profiles than the MHNO group. Among MHO subjects, those who transitioned to MAO were at a 4.1-fold increased risk of incident CKD than those who regressed to MHNO. In addition, transition to MHO from other groups carried a higher risk of CKD than persistent MHNO. Conclusion: MHO subjects are at increased risk for incident CKD.

Original languageEnglish
Pages (from-to)2778-2791
Number of pages14
JournalDiabetes, Obesity and Metabolism
Volume20
Issue number12
DOIs
Publication statusPublished - 2018 Dec

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Chronic Renal Insufficiency
Phenotype
Healthy Volunteers
Metabolome
Glomerular Filtration Rate
Proportional Hazards Models
Epidemiology
Obesity
Genome

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Nam, Ki Heon ; Yun, Hae Ryong ; Joo, Young Su ; Kim, Joohwan ; Lee, Sangmi ; Lee, Changhyun ; Park, Kyoung Sook ; Park, Jung Tak ; Chang, Tae Ik ; Kang, Ea Wha ; Yoo, Tae Hyun ; Kang, Shin Wook ; Han, Seung Hyeok. / Changes in obese metabolic phenotypes over time and risk of incident chronic kidney disease. In: Diabetes, Obesity and Metabolism. 2018 ; Vol. 20, No. 12. pp. 2778-2791.
@article{345584ca81df4d09abc3e805e8c8eb82,
title = "Changes in obese metabolic phenotypes over time and risk of incident chronic kidney disease",
abstract = "Aim: To examine the association between metabolically healthy obese (MHO) phenotype and incident chronic kidney disease (CKD) and study whether changes in metabolic phenotypes over time could affect CKD risk. Methods: A total of 8589 subjects from the Korean Genome and Epidemiology Study were categorized into four groups based on the presence of obesity and metabolic abnormalities (MA). The primary endpoint was an onset of incident CKD defined as an estimated glomerular filtration rate of ≤ 60 mL/min/1.73 m2. Multivariable Cox analysis and time-varying Cox analysis were performed to delineate the relationship between obese metabolic phenotypes and incident CKD after adjustment for sociodemographic factors and clinical and laboratory parameters. Results: During a mean follow-up duration of 9.3 years, CKD occurred in 782 (9.1{\%}) participants. In the multivariable Cox model, the hazard ratio (HR) for incident CKD in the MHO, metabolically abnormal non-obese (MANO), and metabolically abnormal obese (MAO) groups was 1.42 (P = 0.002), 1.45 (P < 0.001), and 1.77 (P < 0.001), respectively, compared with the metabolically healthy non-obese (MHNO) group. Time-varying analysis with these four phenotypes as time-varying exposures showed the same results. Furthermore, subjects with persistent MHO through follow-up were at a 2.0-fold increased risk of CKD (P < 0.001). 41.0{\%} of subjects experienced phenotype changes during follow-up. Over the long term, the MHO group had a higher proportion of transition to the MA phenotype and unfavourable metabolic profiles than the MHNO group. Among MHO subjects, those who transitioned to MAO were at a 4.1-fold increased risk of incident CKD than those who regressed to MHNO. In addition, transition to MHO from other groups carried a higher risk of CKD than persistent MHNO. Conclusion: MHO subjects are at increased risk for incident CKD.",
author = "Nam, {Ki Heon} and Yun, {Hae Ryong} and Joo, {Young Su} and Joohwan Kim and Sangmi Lee and Changhyun Lee and Park, {Kyoung Sook} and Park, {Jung Tak} and Chang, {Tae Ik} and Kang, {Ea Wha} and Yoo, {Tae Hyun} and Kang, {Shin Wook} and Han, {Seung Hyeok}",
year = "2018",
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Nam, KH, Yun, HR, Joo, YS, Kim, J, Lee, S, Lee, C, Park, KS, Park, JT, Chang, TI, Kang, EW, Yoo, TH, Kang, SW & Han, SH 2018, 'Changes in obese metabolic phenotypes over time and risk of incident chronic kidney disease', Diabetes, Obesity and Metabolism, vol. 20, no. 12, pp. 2778-2791. https://doi.org/10.1111/dom.13458

Changes in obese metabolic phenotypes over time and risk of incident chronic kidney disease. / Nam, Ki Heon; Yun, Hae Ryong; Joo, Young Su; Kim, Joohwan; Lee, Sangmi; Lee, Changhyun; Park, Kyoung Sook; Park, Jung Tak; Chang, Tae Ik; Kang, Ea Wha; Yoo, Tae Hyun; Kang, Shin Wook; Han, Seung Hyeok.

In: Diabetes, Obesity and Metabolism, Vol. 20, No. 12, 12.2018, p. 2778-2791.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Changes in obese metabolic phenotypes over time and risk of incident chronic kidney disease

AU - Nam, Ki Heon

AU - Yun, Hae Ryong

AU - Joo, Young Su

AU - Kim, Joohwan

AU - Lee, Sangmi

AU - Lee, Changhyun

AU - Park, Kyoung Sook

AU - Park, Jung Tak

AU - Chang, Tae Ik

AU - Kang, Ea Wha

AU - Yoo, Tae Hyun

AU - Kang, Shin Wook

AU - Han, Seung Hyeok

PY - 2018/12

Y1 - 2018/12

N2 - Aim: To examine the association between metabolically healthy obese (MHO) phenotype and incident chronic kidney disease (CKD) and study whether changes in metabolic phenotypes over time could affect CKD risk. Methods: A total of 8589 subjects from the Korean Genome and Epidemiology Study were categorized into four groups based on the presence of obesity and metabolic abnormalities (MA). The primary endpoint was an onset of incident CKD defined as an estimated glomerular filtration rate of ≤ 60 mL/min/1.73 m2. Multivariable Cox analysis and time-varying Cox analysis were performed to delineate the relationship between obese metabolic phenotypes and incident CKD after adjustment for sociodemographic factors and clinical and laboratory parameters. Results: During a mean follow-up duration of 9.3 years, CKD occurred in 782 (9.1%) participants. In the multivariable Cox model, the hazard ratio (HR) for incident CKD in the MHO, metabolically abnormal non-obese (MANO), and metabolically abnormal obese (MAO) groups was 1.42 (P = 0.002), 1.45 (P < 0.001), and 1.77 (P < 0.001), respectively, compared with the metabolically healthy non-obese (MHNO) group. Time-varying analysis with these four phenotypes as time-varying exposures showed the same results. Furthermore, subjects with persistent MHO through follow-up were at a 2.0-fold increased risk of CKD (P < 0.001). 41.0% of subjects experienced phenotype changes during follow-up. Over the long term, the MHO group had a higher proportion of transition to the MA phenotype and unfavourable metabolic profiles than the MHNO group. Among MHO subjects, those who transitioned to MAO were at a 4.1-fold increased risk of incident CKD than those who regressed to MHNO. In addition, transition to MHO from other groups carried a higher risk of CKD than persistent MHNO. Conclusion: MHO subjects are at increased risk for incident CKD.

AB - Aim: To examine the association between metabolically healthy obese (MHO) phenotype and incident chronic kidney disease (CKD) and study whether changes in metabolic phenotypes over time could affect CKD risk. Methods: A total of 8589 subjects from the Korean Genome and Epidemiology Study were categorized into four groups based on the presence of obesity and metabolic abnormalities (MA). The primary endpoint was an onset of incident CKD defined as an estimated glomerular filtration rate of ≤ 60 mL/min/1.73 m2. Multivariable Cox analysis and time-varying Cox analysis were performed to delineate the relationship between obese metabolic phenotypes and incident CKD after adjustment for sociodemographic factors and clinical and laboratory parameters. Results: During a mean follow-up duration of 9.3 years, CKD occurred in 782 (9.1%) participants. In the multivariable Cox model, the hazard ratio (HR) for incident CKD in the MHO, metabolically abnormal non-obese (MANO), and metabolically abnormal obese (MAO) groups was 1.42 (P = 0.002), 1.45 (P < 0.001), and 1.77 (P < 0.001), respectively, compared with the metabolically healthy non-obese (MHNO) group. Time-varying analysis with these four phenotypes as time-varying exposures showed the same results. Furthermore, subjects with persistent MHO through follow-up were at a 2.0-fold increased risk of CKD (P < 0.001). 41.0% of subjects experienced phenotype changes during follow-up. Over the long term, the MHO group had a higher proportion of transition to the MA phenotype and unfavourable metabolic profiles than the MHNO group. Among MHO subjects, those who transitioned to MAO were at a 4.1-fold increased risk of incident CKD than those who regressed to MHNO. In addition, transition to MHO from other groups carried a higher risk of CKD than persistent MHNO. Conclusion: MHO subjects are at increased risk for incident CKD.

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U2 - 10.1111/dom.13458

DO - 10.1111/dom.13458

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