Obesity Without Metabolic Abnormality and Incident CKD: A Population-Based British Cohort Study
Chronic Kidney Disease serves to be a crucial risk factor for cardiovascular disease.
Similar to the global patterns of the pervasiveness of CKD, Obesity is also reported to be on the rise. With additional risk factors, such as dyslipidemia, diabetes and hypertension the mortality rate rises.
A subset of obese individuals without these metabolic irregularities portrayed as having “Metabolically Healthy Obesity” (MHO) has been implicated to not be considered with increased risk of morbidity and mortality. The research titled “Obesity Without Metabolic Abnormality and Incident CKD: A Population-Based British Cohort Study” has thereby been put forth by Jingya Wang and colleagues and published in the American Journal of Kidney Disease. The summary of the article has been given below:
Objective:
To evaluate the link between Metabolically Healthy Obesity and the probability of incident CKD.
Method:
It was a retrospective cohort study design with the data assembled from “The Health Improvement Network” (THIN) database. Patients whose Body Mass Index data was available at the time of enrollment and those who did not have CKD or cardiovascular disease were considered.
11 body size phenotypes had been developed based on their BMI categorization (i.e underweight, normal weight, overweight and obesity) as well as metabolic abnormalities such as diabetes, dyslipidemia and hypertension. The key endpoint was a complex outcome of incident CKD described as a recorded code of kidney replacement therapy or CKD, or by an eGFR; 2 assessments of <60 mL/min/1.73 m2 or by UACR; 2 readings of >3 mg/mmol for a period of >90 days.
The Cox proportional regression model was used to analyse Hazard Ratios and Confidence intervals.
Findings:
It has been extrapolated that individuals with a Metabolically Healthy Overweight and Obesity have 30% and 66% respective chances of developing CKD compared to Metabolically Healthy normal weight individuals.
Furthermore it has been highlighted that presence of other metabolic irregularities can also increase the risk of CKD.
Limitations:
The sample size was limited and there was a probability of bias observed. Considerable variability in the sample size, span of follow-up period, genetic history, GFR estimation equation used, potential confounders controlled for, and use of metabolically determined body size phenotypes. The description of MHO also varied because a few studies comprised some elements of the metabolic syndrome. Lastly, the study was carried out among Asian population hence it could not be generalized.
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