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 Measure||Odds Ratio of CKD Associated with Abdominal Obesity|
|Data Source||Jackson Heart Study|
|Type of Data Source||Cross sectional study of baseline data|
|Data Set||Jackson Heart Study summarized data from published literature|
|Health Care Data System||No|
|Regional or National?||Regional|
|Demographic Group||5,301 noninstitutionalized African Americans, aged 21 years and older from Jackson, Mississippi, Metropolitan Statistical Area counties (Hinds, Madison, Rankin)|
|Numerator||Prevalent CKD cases |
|Denominator||Baseline participants who did not have missing data for the necessary covariates (excluded 368 participants)|
|Definition of CKD||Estimated 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 rate||Estimated, 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)|
|Proteinuria||Spot or 24-hour urine test|
|Primary Data Source Indicator||Visceral obesity (WC)|
|Primary Indicator Method of Measurement||WC measurement|
|Secondary Data Source Indicator||Age and sex (adjustment variables)|
|Secondary (1) Indicator Method of Measurement||Self-administered questionnaire|
|Secondary Data Source Indicator||Education, active living index, body mass index, cigarette smoking, and non-steroidal anti-inflammatory drugs (adjustment variables)|
|Secondary (2) Indicator Method of Measurement||Self-administered questionnaire, and weight and height measurements|
|Period Currently Available||2004|
|Frequency of Measurement (Primary)||WC - Once|
|U.S. Region Covered by Primary Variable||Jackson, Mississippi|
|Limitations of Indicator||CKD 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 Considerations||Analysis 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.