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Neck circumference predicts renal function decline in overweight women: A community-based prospective cohort study

Authors
 Chang-Yun Yoon  ;  Jung Tak Park  ;  Jong Hyun Jhee  ;  Youn Kyung Kee  ;  Changhwan Seo  ;  Misol Lee  ;  Min-Uk Cha  ;  Su-Young Jung  ;  Seohyun Park  ;  Hae-Ryong Yun  ;  Young Eun Kwon  ;  Hyung Jung Oh  ;  Seung Hyeok Han  ;  Tae-Hyun Yoo  ;  Shin-Wook Kang 
Citation
 MEDICINE, Vol.95(36) : 4844, 2016 
Journal Title
 MEDICINE 
ISSN
 0025-7974 
Issue Date
2016
MeSH
Adult ; Body Weights and Measures ; Diabetes Mellitus/epidemiology ; Female ; Glomerular Filtration Rate ; Humans ; Hypertension/epidemiology ; Incidence ; Male ; Middle Aged ; Neck/anatomy & histology* ; Overweight/epidemiology ; Overweight/physiopathology* ; Prospective Studies ; Proteinuria/urine ; Renal Insufficiency, Chronic/epidemiology ; Renal Insufficiency, Chronic/physiopathology* ; Republic of Korea/epidemiology ; Sex Factors ; Subcutaneous Fat/anatomy & histology*
Keywords
chronic kidney disease ; estimated glomerular filtration rate ; neck circumference ; overweight ; proteinuria
Abstract
Chronic kidney disease (CKD) is characterized by increased risks of morbidity and mortality. Upper-body subcutaneous fat, which is commonly estimated from the neck circumference (NC), was revealed to be the main reservoir of circulating nonesterified fatty acids in overweight patients. Despite a close association between NC and metabolic complications, the relationship of NC with renal function has not been fully investigated. In this study, the impact of NC on the development of incident CKD was elucidated.The data were retrieved from the Korean Genome and Epidemiology Study cohort. The subjects were followed at 2-year intervals from 2003 to 2011. Overweight was defined as a body mass index of ≥23?kg/m. A total of 4298 cohort subjects were screened. After exclusion, 2268 overweight subjects were included for the final analysis. The primary end point was incident CKD, which was defined as a composite of estimated glomerular filtration rate (eGFR)?<?60?mL/min/1.73?m or the development of proteinuria.The mean patient age was 36.3?±?3.0 years, and 1285 (56.7%) were men. They were divided into 2 groups according to the median NC in male and female subjects, separately. In both sexes, hypertension (men, P?<?0.001; women, P = 0.009) and diabetes (men, P = 0.002; women, P?<?0.001) were significantly more prevalent in the big NC group than in the small NC group. In contrast, eGFR was significantly lower only in male subjects of the big NC group (P?<?0.001), whereas it was comparable between the small and big NC groups (P = 0.167). In multivariate Cox proportional hazards regression analysis, NC values were independently associated with incident CKD development in female subjects after adjusting for multiple confounding factors (per 1?cm increase, hazard ratio [95% confidence interval] = 1.159 [1.024-1.310], P = 0.019) but not in male subjects.NC is independently associated with the development of CKD in overweight female subjects, suggesting that it could be a practical risk factor for CKD.
Files in This Item:
T201603386.pdf Download
DOI
10.1097/MD.0000000000004844
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Kwon, Young Eun(권영은)
Kee, Youn Kyung(기연경)
Park, Seo Hyun(박서현)
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Seo, Changhwan(서창환)
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Yoon, Chang Yun(윤창연)
Yun, Hae Ryong(윤해룡) ORCID logo https://orcid.org/0000-0002-7038-0251
Lee, Mi Sol(이미솔)
Jung, Su Young(정수영)
Jhee, Jong Hyun(지종현)
Cha, Min Uk(차민욱)
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151943
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