Neck circumference predicts renal function decline in overweight women A community-based prospective cohort study

Chang Yun Yoon, Jung Tak Park, Jong Hyun Jhee, Youn Kyung Kee, Changhwan Seo, Min Uk Cha, Su Young Jung, Seohyun Park, Hae Ryong Yun, Young Eun Kwon, Hyung Jung Oh, Seung Hyeok Han, Tae Hyun Yoo, Shin Wook Kang

Research output: Contribution to journalArticle

Abstract

Chronic kidney disease (CKD) is characterized by increased risks of morbidity and mortality. Upper-body subcutaneous fat, which is commonly estimated from the neck circumference (NC), was revealed to be the main reservoir of circulating nonesterified fatty acids in overweight patients. Despite a close association between NC and metabolic complications, the relationship of NC with renal function has not been fully investigated. In this study, the impact of NC on the development of incident CKD was elucidated. The data were retrieved from the Korean Genome and Epidemiology Study cohort. The subjects were followed at 2-year intervals from 2003 to 2011. Overweight was defined as a body mass index of ?23kg/m2. A total of 4298 cohort subjects were screened. After exclusion, 2268 overweight subjects were included for the final analysis. The primary end point was incident CKD, which was defined as a composite of estimated glomerular filtration rate (EGFR)<60mL/min/1.73m2 or the development of proteinuria. The mean patient age was 36.3±3.0 years, and 1285 (56.7%) were men. They were divided into 2 groups according to the median NC in male and female subjects, separately. In both sexes, hypertension (men, P<0.001; women, P=0.009) and diabetes (men, P= 0.002; women, P<0.001) were significantly more prevalent in the big NC group than in the small NC group. In contrast, EGFR was significantly lower only in male subjects of the big NC group (P<0.001), whereas it was comparable between the small and big NC groups (P=0.167). In multivariate Cox proportional hazards regression analysis, NC values were independently associated with incident CKD development in female subjects after adjusting for multiple confounding factors (per 1cm increase, hazard ratio [95% confidence interval]=1.159 [1.024-1.310], P=0.019) but not in male subjects. NC is independently associated with the development of CKD in overweight female subjects, suggesting that it could be a practical risk factor for CKD.

Original languageEnglish
Article numbere4844
JournalMedicine (United States)
Volume95
Issue number36
DOIs
Publication statusPublished - 2016 Jan 1

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Cohort Studies
Neck
Prospective Studies
Kidney
Chronic Renal Insufficiency
Glomerular Filtration Rate
Subcutaneous Fat
Proteinuria
Nonesterified Fatty Acids
Epidemiology
Body Mass Index
Regression Analysis
Genome
Confidence Intervals
Hypertension
Morbidity
Mortality

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Yoon, Chang Yun ; Park, Jung Tak ; Jhee, Jong Hyun ; Kee, Youn Kyung ; Seo, Changhwan ; Cha, Min Uk ; Jung, Su Young ; Park, Seohyun ; Yun, Hae Ryong ; Kwon, Young Eun ; Oh, Hyung Jung ; Han, Seung Hyeok ; Yoo, Tae Hyun ; Kang, Shin Wook. / Neck circumference predicts renal function decline in overweight women A community-based prospective cohort study. In: Medicine (United States). 2016 ; Vol. 95, No. 36.
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Neck circumference predicts renal function decline in overweight women A community-based prospective cohort study. / Yoon, Chang Yun; Park, Jung Tak; Jhee, Jong Hyun; Kee, Youn Kyung; Seo, Changhwan; Cha, Min Uk; Jung, Su Young; Park, Seohyun; Yun, Hae Ryong; Kwon, Young Eun; Oh, Hyung Jung; Han, Seung Hyeok; Yoo, Tae Hyun; Kang, Shin Wook.

In: Medicine (United States), Vol. 95, No. 36, e4844, 01.01.2016.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Neck circumference predicts renal function decline in overweight women A community-based prospective cohort study

AU - Yoon, Chang Yun

AU - Park, Jung Tak

AU - Jhee, Jong Hyun

AU - Kee, Youn Kyung

AU - Seo, Changhwan

AU - Cha, Min Uk

AU - Jung, Su Young

AU - Park, Seohyun

AU - Yun, Hae Ryong

AU - Kwon, Young Eun

AU - Oh, Hyung Jung

AU - Han, Seung Hyeok

AU - Yoo, Tae Hyun

AU - Kang, Shin Wook

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Chronic kidney disease (CKD) is characterized by increased risks of morbidity and mortality. Upper-body subcutaneous fat, which is commonly estimated from the neck circumference (NC), was revealed to be the main reservoir of circulating nonesterified fatty acids in overweight patients. Despite a close association between NC and metabolic complications, the relationship of NC with renal function has not been fully investigated. In this study, the impact of NC on the development of incident CKD was elucidated. The data were retrieved from the Korean Genome and Epidemiology Study cohort. The subjects were followed at 2-year intervals from 2003 to 2011. Overweight was defined as a body mass index of ?23kg/m2. A total of 4298 cohort subjects were screened. After exclusion, 2268 overweight subjects were included for the final analysis. The primary end point was incident CKD, which was defined as a composite of estimated glomerular filtration rate (EGFR)<60mL/min/1.73m2 or the development of proteinuria. The mean patient age was 36.3±3.0 years, and 1285 (56.7%) were men. They were divided into 2 groups according to the median NC in male and female subjects, separately. In both sexes, hypertension (men, P<0.001; women, P=0.009) and diabetes (men, P= 0.002; women, P<0.001) were significantly more prevalent in the big NC group than in the small NC group. In contrast, EGFR was significantly lower only in male subjects of the big NC group (P<0.001), whereas it was comparable between the small and big NC groups (P=0.167). In multivariate Cox proportional hazards regression analysis, NC values were independently associated with incident CKD development in female subjects after adjusting for multiple confounding factors (per 1cm increase, hazard ratio [95% confidence interval]=1.159 [1.024-1.310], P=0.019) but not in male subjects. NC is independently associated with the development of CKD in overweight female subjects, suggesting that it could be a practical risk factor for CKD.

AB - Chronic kidney disease (CKD) is characterized by increased risks of morbidity and mortality. Upper-body subcutaneous fat, which is commonly estimated from the neck circumference (NC), was revealed to be the main reservoir of circulating nonesterified fatty acids in overweight patients. Despite a close association between NC and metabolic complications, the relationship of NC with renal function has not been fully investigated. In this study, the impact of NC on the development of incident CKD was elucidated. The data were retrieved from the Korean Genome and Epidemiology Study cohort. The subjects were followed at 2-year intervals from 2003 to 2011. Overweight was defined as a body mass index of ?23kg/m2. A total of 4298 cohort subjects were screened. After exclusion, 2268 overweight subjects were included for the final analysis. The primary end point was incident CKD, which was defined as a composite of estimated glomerular filtration rate (EGFR)<60mL/min/1.73m2 or the development of proteinuria. The mean patient age was 36.3±3.0 years, and 1285 (56.7%) were men. They were divided into 2 groups according to the median NC in male and female subjects, separately. In both sexes, hypertension (men, P<0.001; women, P=0.009) and diabetes (men, P= 0.002; women, P<0.001) were significantly more prevalent in the big NC group than in the small NC group. In contrast, EGFR was significantly lower only in male subjects of the big NC group (P<0.001), whereas it was comparable between the small and big NC groups (P=0.167). In multivariate Cox proportional hazards regression analysis, NC values were independently associated with incident CKD development in female subjects after adjusting for multiple confounding factors (per 1cm increase, hazard ratio [95% confidence interval]=1.159 [1.024-1.310], P=0.019) but not in male subjects. NC is independently associated with the development of CKD in overweight female subjects, suggesting that it could be a practical risk factor for CKD.

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