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

doi: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

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

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

11 Citations (Scopus)

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 language	English
Pages (from-to)	1368-1376
Number of pages	9
Journal	Kidney International
Volume	90
Issue number	6
DOIs	https://doi.org/10.1016/j.kint.2016.09.011
Publication status	Published - 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 http://www.clinicaltrials.gov ).

Publisher Copyright:
© 2016 International Society of Nephrology

All Science Journal Classification (ASJC) codes

Nephrology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.kint.2016.09.011

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Lee, M. J., Park, J. T., Park, K. S., Kwon, Y. E., Han, S. H., Kang, S. W., Choi, K. H., Oh, K. H., Park, S. K., Chae, D. W., Lee, K., Hwang, Y. H., Kim, S. W., Kim, Y. H., Kang, S. W., Lee, J., Ahn, C., & Yoo, T. H. (2016). Normal body mass index with central obesity has increased risk of coronary artery calcification in Korean patients with chronic kidney disease. Kidney International, 90(6), 1368-1376. https://doi.org/10.1016/j.kint.2016.09.011

@article{14f1afc4560f4f659b10fea6e9432e6a,

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

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.",

author = "Lee, {Mi Jung} and Park, {Jung Tak} and Park, {Kyoung Sook} and Kwon, {Young Eun} and Han, {Seung Hyeok} and Kang, {Shin Wook} and Choi, {Kyu Hun} and Oh, {Kook Hwan} and Park, {Sue Kyung} and Chae, {Dong Wan} and Kyubeck Lee and Hwang, {Young Hwan} and Kim, {Soo Wan} and Kim, {Yeong Hoon} and Kang, {Sun Woo} and Joongyub Lee and Curie Ahn and Yoo, {Tae Hyun}",

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 http://www.clinicaltrials.gov ). Publisher Copyright: {\textcopyright} 2016 International Society of Nephrology",

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doi = "10.1016/j.kint.2016.09.011",

language = "English",

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Lee, MJ, Park, JT, Park, KS, Kwon, YE, Han, SH , Kang, SW, Choi, KH, Oh, KH, Park, SK, Chae, DW, Lee, K, Hwang, YH, Kim, SW, Kim, YH, Kang, SW, Lee, J, Ahn, C & Yoo, TH 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

TY - JOUR

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, Seung Hyeok

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, Tae Hyun

N1 - 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 http://www.clinicaltrials.gov ). Publisher Copyright: © 2016 International Society of Nephrology

PY - 2016/12/1

Y1 - 2016/12/1

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.

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

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

UN SDGs

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