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, Seung Hyeok 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, Tae Hyun Yoo

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


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
Issue number6
Publication statusPublished - 2016 Dec 1

Bibliographical note

Funding Information:
This study was supported by grants 2011E3300300, 2012E3301100, and 2013E3301600 from the Research of Korea Centers for Disease Control and Prevention. This work was presented as an oral abstract at the Annual Meeting of the American Society of Nephrology (November 5–8, 2015), in San Diego, CA. The study was supervised by the CKD Advisory Committee composed of the members from the Korea Centers for Disease Control and Prevention and the Korean Society of Nephrology ( NCT01630486 at ).

Publisher Copyright:
© 2016 International Society of Nephrology

All Science Journal Classification (ASJC) codes

  • Nephrology


Dive into the research topics of 'Normal body mass index with central obesity has increased risk of coronary artery calcification in Korean patients with chronic kidney disease'. Together they form a unique fingerprint.

Cite this