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Indicator Details — Emerging Topics: Odds Ratio of CKD Associated with Abdominal Obesitya
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  • Jackson Heart Study

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a Abdominal obesity defined as WC ≥ 102 cm in men and WC ≥ 88 cm in women. Multivariable adjustment included age, gender, education, active living index, BMI, cigarette smoking, and non-steroidal anti-inflammatory drugs. 

Obesity has been called a risk factor for chronic kidney disease (CKD), but the evidence for such a conclusion remains unclear. A cross-sectional analysis of the Jackson Heart Study at baseline suggests that an independent association between obesity and CKD exists in an African American population. Broad generalization of these findings cannot be made as rates of obesity and CKD are known to vary by race and ethnicity. In addition, because this is a cross sectional study, we cannot be sure that obesity is causing CKD. 
Chart Explanation: In the unadjusted model, those with abdominal obesity (waist circumference [WC] ≥ 102 cm in men; WC ≥ 88 cm in women) had a 2.17 times greater odds (95% confidence interval [CI]: 1.77, 2.67) of CKD (estimated glomerular filtration rate [eGFR] < 60 mL/min/1.73 m2, urine albumin creatinine ratio (UACR) > 30 mg/g, or dialysis) than those without abdominal obesity. The fully adjusted model attenuated the odds ratio greatly, but an association between abdominal obesity and CKD remained. After adjusting for age, gender, education, income, active living index, BMI, cigarette smoking, and non-steroidal anti-inflammatory drugs (NSAIDs), those with abdominal obesity had a 1.41 times greater odds (95% CI: 1.06, 1.89) than those without abdominal obesity. 
The objective of Mendy, et al. was to determine the association between the metabolic syndrome, and its individual components, and chronic kidney disease (CKD) in the African American population of Jackson, Mississippi. The analysis observed the relationship of interest in baseline data of the Jackson Heart Study. The Jackson Heart Study is a longitudinal cohort study of noninstitutionalized African Americans aged 21 years or older from three Jackson, Mississippi, Metropolitan Statistical Area counties, Hinds, Madison, and Rankin. A total of 5,301 participants were examined at baseline. The primary objective of the study is to monitor the cause and progression of cardiovascular disease in African Americans from Jackson, Mississippi. Baseline data, which was collected between September 2000 and March 2004, were collected from a home visit, self-administered questionnaires, and a clinic visit. At the clinic visit, medication use was ascertained, fasting blood and urine samples were obtained, and blood pressure readings were taken. On the website, we present the portion of the analysis from the study related to association of visceral obesity (waist circumference [WC]) and CKD. 
Description of MeasureOdds Ratio of CKD Associated with Abdominal Obesity
Data SourceJackson Heart Study
Type of Data SourceCross sectional study of baseline data
Data SetJackson Heart Study summarized data from published literature
Health Care Data SystemNo
Regional or National?Regional
Demographic Group5,301 noninstitutionalized African Americans, aged 21 years and older from Jackson, Mississippi, Metropolitan Statistical Area counties (Hinds, Madison, Rankin)
NumeratorPrevalent CKD cases 
DenominatorBaseline participants who did not have missing data for the necessary covariates (excluded 368 participants)
Definition of CKDEstimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 for men, urine albumin to urine creatinine ratio > 30 mg/g, or being on dialysis
Glomerular filtration rateEstimated, Modification of Diet in Renal Disease Study equation: GFR = 186.0 x (serum creatinine)-1.154 x (age)-0.203 x (0.742 if female) x (1.210 if African American)
ProteinuriaSpot or 24-hour urine test
Primary Data Source IndicatorVisceral obesity (WC)
Primary Indicator Method of MeasurementWC measurement
Secondary Data Source IndicatorAge and sex (adjustment variables)
Secondary (1) Indicator Method of MeasurementSelf-administered questionnaire
Secondary Data Source IndicatorEducation, active living index, body mass index, cigarette smoking, and non-steroidal anti-inflammatory drugs (adjustment variables)
Secondary (2) Indicator Method of MeasurementSelf-administered questionnaire, and weight and height measurements
Period Currently Available2004
Frequency of Measurement (Primary)WC - Once
Pending DataNone
U.S. Region Covered by Primary VariableJackson, Mississippi
Limitations of IndicatorCKD definition did not require persistence over time and included some end-stage renal disease patients; Cross-sectional study cannot rule out reverse causation; study is demographically limited.
Analytical ConsiderationsAnalysis performed by Jackson Heart Study investigators.
References and Sources:
  • Mendy VL, Azevedo MJ, Sarpong DF. The association between individual and combined components of metabolic syndrome and chronic kidney disease among African Americans: The Jackson Heart Study. PLoS ONE. 2014;9(7):e101610.

Suggested Citation:
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd