Purpose

Body mass index (BMI) is a simple index of weight-to-height that is commonly used to classify people as underweight, overweight or obesity, and high BMI has been clearly linked to increased risk of illness in adults. However, few studies have examined the significance of upper normal weight as a risk factor for the development of chronic kidney disease (CKD) in the general Japanese population.

Methods

We conducted a prospective cohort study designed as part of the Nomura study. We recruited a random sample of 421 men aged 67 ± 10 (mean ± standard deviation; range 24–95) years and 565 women aged 68 ± 9 (22–84) years during their annual health examination in a single community. We examined the relationship between quartiles of baseline BMI and renal dysfunction after a 3-year evaluation based on estimated glomerular filtration rate (eGFR) using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations modified by the Japanese coefficient. CKD was defined as having dipstick-positive proteinuria (≥ 1 +) or a low eGFR (< 60 mL/min/1.73 m²).

Results

Of the 986 participants, a total of 134 (13.6%) participants, including 72 (17.1%) men and 62 (11.0%) women, received a new diagnosis of CKD during the study period, and 25 (9.7%), 19 (8.0%), 47 (19.0%), and 43 (17.8%) diagnoses were received in the BMI-1 (BMI, < 20.7 kg/m²), BMI-2 (BMI, 20.7 to 22.5 kg/m²), BMI-3 (BMI, 22.6 to 24.4 kg/m²), and BMI-4 (BMI ≥ 24.5 kg/m²) groups, respectively. Using BMI-2 as the reference group, the non-adjusted odds ratio (OR) (95% confidence interval) for CKD was 2.70 (1.53–4.75) for BMI-3 and 2.49 (1.40–4.42) for BMI-4, and the multivariable-adjusted OR was 2.52 (1.40–4.56) for BMI-3 and 2.30 (1.26–4.22) for BMI-4.

Conclusions

Increased BMI from upper normal weight is strongly associated with the development of CKD in community-dwelling persons.

中文翻译：

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高于正常上限的体重指数升高与社区居民的肾功能不全显着相关。

目的

身体质量指数（BMI），重量是一个简单的指标-到高度通常用来区分人的体重，超重或肥胖，高BMI已经明显与成人疾病的风险增加。但是，很少有研究检查普通日本人群中上正常体重作为发展慢性肾脏病（CKD）的危险因素的重要性。

方法

作为野村研究的一部分，我们进行了一项前瞻性队列研究。我们在一个社区中进行年度健康检查时，随机抽取了421名67±10（平均±标准差；范围24-95）岁的男性和565 68±9（22-84）岁的女性。我们使用日本系数修正的慢性肾脏病流行病学协作（CKD-EPI）方程，根据估计的肾小球滤过率（eGFR），在3年评估后检查了基线BMI的四分位数与肾功能不全之间的关系。CKD被定义为具有试纸阳性蛋白尿（≥1 +）或低eGFR（<60 mL / min / 1.73 m ²）。

结果

在986名参与者中，共有134名（13.6％）参与者，包括72名（17.1％）男性和62名（11.0％）女性在研究期间接受了CKD的新诊断，而25名（9.7％），19名（ BMI-1（BMI，<20.7 kg / m ²），BMI-2（BMI，20.7至22.5 kg / m ²）分别获得8.0％），47（19.0％）和43（17.8％）诊断， BMI-3（BMI，22.6至24.4 kg / m ²）和BMI-4（BMI≥24.5 kg / m ²）组。使用BMI-2作为参考组，CKD的未调整比值比（OR）（95％置信区间）对于BMI-3为2.70（1.53-4.75），对于BMI-4为2.49（1.40-4.42），以及对于BMI-3，多变量调整后的OR为2.52（1.40-4.56），对于BMI-4，为2.30（1.26-4.22）。

结论

体重正常人体重指数的增加与社区居民CKD的发生密切相关。