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The purpose of this study was to investigate associations between combinations of body mass index(BMI) categories and metabolic status and the risk of chronic kidney diseases (CKD) in Elderly Individuals.
A total of 17,302 elderly subjects aged 60 years and older who underwent annual health examinations between 2009 and 2012 in the Third Xiangya Hospital were enrolled in the cross-sectional survey. BMI was categorized using the WHO classification: 18.5-24.9 kg/m2(normal weight), 25-29.9 kg/m2 (overweight), ≥30 kg/m2 (obese). We used standard operating protocols to measure ATP-III components to define a metabolically healthy state. Patients with proteinuria and/or an estimated glomerular filtration rate(eGFR) of <60 mL/min/1.73 m2 were considered CKD cases. To calculate the odds ratio for CKD, logistic regression analyses were performed.
The crude proportions of CKD were 6.5%, 12.7%, 6.9%, 13.7%, 2.2%, 18.3% in participants with the metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy overweight (MHOW), metabolically unhealthy overweight (MUOW), metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO) phenotype, respectively. Compared with MHNW phenotype, the odds ratios for risk of CKD were 1.20 (0.99-1.46) for MUNW, 0.92 (0.72-1.16) for MHOW, 1.29 (1.08-1.54) for MUOW, 0.29 (0.06-1.41) for MHO and 1.62 (1.31-2.00) for MUO phenotype after adjustment for confounders, including age, sex, smoking statues, alcohol use, creatinine, uric acid, systolic BP, HDL cholesterol, and impaired fasting glucose or diabetes.
Metabolic health significantly modified the association of BMI with CKD. Hence, it is important to consider metabolic health along with BMI when evaluating CKD risk.