Normal body mass index with central obesity has increased risk of coronary artery calcification in Korean patients with chronic kidney disease

Mi Jung Lee, Jung Tak Park, Kyoung Sook Park, Young Eun Kwon, SeungHyeok Han, Shin-Wook Kang, Kyu Hun Choi, Kook Hwan Oh, Sue Kyung Park, Dong Wan Chae, Kyubeck Lee, Young Hwan Hwang, Soo Wan Kim, Yeong Hoon Kim, Sun Woo Kang, Joongyub Lee, Curie Ahn, TaeHyun Yoo

Research output: Contribution to journalArticle

Abstract

In chronic kidney disease (CKD), overweight and mild obesity have shown the lowest cardiovascular (CV) risk. However, central obesity has been directly associated with CV risk in these patients. This bidirectional relationship of body mass index (BMI) and central obesity prompted us to evaluate CV risk based on a combination of BMI and waist-to-hip ratio (WHR) in nondialysis CKD patients. We included 1078 patients with CKD stage 2 through 5 (nondialysis) enrolled in a nationwide prospective cohort of Korea. Patients were divided into 3 groups by BMI (normal BMI, 18.5–22.9; overweight, 23.0–27.4; and obese, 27.5 and over kg/m2) and were dichotomized by a sex-specific median WHR (0.92 in males and 0.88 in females). Coronary artery calcification (CAC) was determined by multislice computed tomography. CAC (score above 10 Agatston units) was found in 477 patients. Multivariate logistic regression analysis indicated that BMI was not independently associated with CAC. However, WHR showed an independent linear and significant association with CAC (odds ratio, 1.036; 95% confidence interval, 1.007-1.065 per 0.01 increase). Furthermore, when patients were categorized into 6 groups according to a combination of BMI and WHR, normal BMI but higher WHR had the highest risk of CAC compared with the normal BMI with lower WHR group (2.104; 1.074–4.121). Thus, a normal BMI with central obesity was associated with the highest risk of CAC, suggesting that considering BMI and WHR, 2 surrogates of obesity, can help to discriminate CV risk in Korean nondialysis CKD patients.

Original languageEnglish
Pages (from-to)1368-1376
Number of pages9
JournalKidney International
Volume90
Issue number6
DOIs
Publication statusPublished - 2016 Dec 1

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Abdominal Obesity
Chronic Renal Insufficiency
Coronary Vessels
Waist-Hip Ratio
Body Mass Index
Obesity
Multidetector Computed Tomography
Korea
Logistic Models
Odds Ratio
Regression Analysis
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Lee, Mi Jung ; Park, Jung Tak ; Park, Kyoung Sook ; Kwon, Young Eun ; Han, SeungHyeok ; Kang, Shin-Wook ; Choi, Kyu Hun ; Oh, Kook Hwan ; Park, Sue Kyung ; Chae, Dong Wan ; Lee, Kyubeck ; Hwang, Young Hwan ; Kim, Soo Wan ; Kim, Yeong Hoon ; Kang, Sun Woo ; Lee, Joongyub ; Ahn, Curie ; Yoo, TaeHyun. / Normal body mass index with central obesity has increased risk of coronary artery calcification in Korean patients with chronic kidney disease. In: Kidney International. 2016 ; Vol. 90, No. 6. pp. 1368-1376.
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abstract = "In chronic kidney disease (CKD), overweight and mild obesity have shown the lowest cardiovascular (CV) risk. However, central obesity has been directly associated with CV risk in these patients. This bidirectional relationship of body mass index (BMI) and central obesity prompted us to evaluate CV risk based on a combination of BMI and waist-to-hip ratio (WHR) in nondialysis CKD patients. We included 1078 patients with CKD stage 2 through 5 (nondialysis) enrolled in a nationwide prospective cohort of Korea. Patients were divided into 3 groups by BMI (normal BMI, 18.5–22.9; overweight, 23.0–27.4; and obese, 27.5 and over kg/m2) and were dichotomized by a sex-specific median WHR (0.92 in males and 0.88 in females). Coronary artery calcification (CAC) was determined by multislice computed tomography. CAC (score above 10 Agatston units) was found in 477 patients. Multivariate logistic regression analysis indicated that BMI was not independently associated with CAC. However, WHR showed an independent linear and significant association with CAC (odds ratio, 1.036; 95{\%} confidence interval, 1.007-1.065 per 0.01 increase). Furthermore, when patients were categorized into 6 groups according to a combination of BMI and WHR, normal BMI but higher WHR had the highest risk of CAC compared with the normal BMI with lower WHR group (2.104; 1.074–4.121). Thus, a normal BMI with central obesity was associated with the highest risk of CAC, suggesting that considering BMI and WHR, 2 surrogates of obesity, can help to discriminate CV risk in Korean nondialysis CKD patients.",
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Lee, MJ, Park, JT, Park, KS, Kwon, YE, Han, S, Kang, S-W, Choi, KH, Oh, KH, Park, SK, Chae, DW, Lee, K, Hwang, YH, Kim, SW, Kim, YH, Kang, SW, Lee, J, Ahn, C & Yoo, T 2016, 'Normal body mass index with central obesity has increased risk of coronary artery calcification in Korean patients with chronic kidney disease', Kidney International, vol. 90, no. 6, pp. 1368-1376. https://doi.org/10.1016/j.kint.2016.09.011

Normal body mass index with central obesity has increased risk of coronary artery calcification in Korean patients with chronic kidney disease. / Lee, Mi Jung; Park, Jung Tak; Park, Kyoung Sook; Kwon, Young Eun; Han, SeungHyeok; Kang, Shin-Wook; Choi, Kyu Hun; Oh, Kook Hwan; Park, Sue Kyung; Chae, Dong Wan; Lee, Kyubeck; Hwang, Young Hwan; Kim, Soo Wan; Kim, Yeong Hoon; Kang, Sun Woo; Lee, Joongyub; Ahn, Curie; Yoo, TaeHyun.

In: Kidney International, Vol. 90, No. 6, 01.12.2016, p. 1368-1376.

Research output: Contribution to journalArticle

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T1 - Normal body mass index with central obesity has increased risk of coronary artery calcification in Korean patients with chronic kidney disease

AU - Lee, Mi Jung

AU - Park, Jung Tak

AU - Park, Kyoung Sook

AU - Kwon, Young Eun

AU - Han, SeungHyeok

AU - Kang, Shin-Wook

AU - Choi, Kyu Hun

AU - Oh, Kook Hwan

AU - Park, Sue Kyung

AU - Chae, Dong Wan

AU - Lee, Kyubeck

AU - Hwang, Young Hwan

AU - Kim, Soo Wan

AU - Kim, Yeong Hoon

AU - Kang, Sun Woo

AU - Lee, Joongyub

AU - Ahn, Curie

AU - Yoo, TaeHyun

PY - 2016/12/1

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N2 - In chronic kidney disease (CKD), overweight and mild obesity have shown the lowest cardiovascular (CV) risk. However, central obesity has been directly associated with CV risk in these patients. This bidirectional relationship of body mass index (BMI) and central obesity prompted us to evaluate CV risk based on a combination of BMI and waist-to-hip ratio (WHR) in nondialysis CKD patients. We included 1078 patients with CKD stage 2 through 5 (nondialysis) enrolled in a nationwide prospective cohort of Korea. Patients were divided into 3 groups by BMI (normal BMI, 18.5–22.9; overweight, 23.0–27.4; and obese, 27.5 and over kg/m2) and were dichotomized by a sex-specific median WHR (0.92 in males and 0.88 in females). Coronary artery calcification (CAC) was determined by multislice computed tomography. CAC (score above 10 Agatston units) was found in 477 patients. Multivariate logistic regression analysis indicated that BMI was not independently associated with CAC. However, WHR showed an independent linear and significant association with CAC (odds ratio, 1.036; 95% confidence interval, 1.007-1.065 per 0.01 increase). Furthermore, when patients were categorized into 6 groups according to a combination of BMI and WHR, normal BMI but higher WHR had the highest risk of CAC compared with the normal BMI with lower WHR group (2.104; 1.074–4.121). Thus, a normal BMI with central obesity was associated with the highest risk of CAC, suggesting that considering BMI and WHR, 2 surrogates of obesity, can help to discriminate CV risk in Korean nondialysis CKD patients.

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