류승호 (성균관대학교 의과대학, 강북삼성병원) | 한빛사논문 > 한빛사

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성균관대학교 의과대학, 강북삼성병원

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Ann. Intern. Med., Published online 9 February 2016 | doi:10.7326/M15-1323 Metabolically Healthy Obesity and Development of Chronic Kidney Disease: A Cohort Study

Abstract

Yoosoo Chang, MD, PhD; Seungho Ryu, MD, PhD; Yuni Choi, BS; Yiyi Zhang, PhD; Juhee Cho, PhD; Min-Jung Kwon, MD, PhD; Young Youl Hyun, MD, PhD; Kyu-Beck Lee, MD, PhD; Hyang Kim, MD, PhD; Hyun-Suk Jung, MD; Kyung Eun Yun, MD, PhD; Jiin Ahn, MSPH; Sanjay Rampal, MD, PhD; Di Zhao, PhD; Byung-Seong Suh, MD, PhD; Eun Cheol Chung, MD, PhD; Hocheol Shin, MD, PhD; Roberto Pastor-Barriuso, PhD; and Eliseo Guallar, MD, DrPH

Requests for Single Reprints: Seungho Ryu, MD, PhD, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Samsung Main Building B2, 250, Taepyung-ro 2ga, Jung-gu, Seoul, Korea, 100-742; or Eliseo Guallar, MD, DrPH, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, 2024 East Monument
Street, Room 2-645, Baltimore, MD 21205.

Current Author Addresses :
Drs. Chang and Ryu: Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Samsung Main Building B2, 250, Taepyung-ro 2ga, Jung-gu, Seoul, Korea 100-742; Department of Health Sciences and Technology, Samsung Advanced Institute of Health Sciences and Technology, Sungkyunkwan University, 50, Irwon-Dong, Gangnam-gu, Seoul, Korea 135-710.

Ms. Choi, Dr. Jung, and Ms. Ahn: Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Samsung Main Building B2, 250, Taepyung-ro 2ga, Jung-gu, Seoul, Korea 100-742.

Drs. Zhang, Zhao, and Guallar: Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, 2024 East Monument Street, Room 2-635, Baltimore, MD 21205.

Dr. Cho: Department of Health Sciences and Technology, Samsung Advanced Institute of Health Sciences and Technology, Sungkyunkwan University, 50, Irwon-Dong, Gangnam-Gu, Seoul, Korea 135-710.

Dr. Kwon: Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung dong, jongro-Ku, Seoul, Korea 110-746.

Drs. Hyun, Lee, and Kim: Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung dong, jongro-Ku, Seoul, Korea 110-746.

Dr. Rampal: Julius Centre for Clinical Epidemiology and Evidence-Based Medicine, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.

Dr. Suh: Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung dong, jongro-Ku, Seoul, Korea 110-746.

Dr. Chung: Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung dong, jongro-Ku, Seoul, Korea 110-746.

Dr. Shin: Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung dong, jongro-Ku, Seoul, Korea 110-746.

Dr. Pastor-Barriuso: National Center for Epidemiology, Carlos III Institute of Health, Av. Monforte de Lemos 5, 28029, Madrid, Spain.

Background: The risk for chronic kidney disease (CKD) among obese persons without obesity-related metabolic abnormalities, called metabolically healthy obesity, is largely unexplored.

Objective: To investigate the risk for incident CKD across categories of body mass index in a large cohort of metabolically healthy men and women.

Design: Prospective cohort study.

Setting: Kangbuk Samsung Health Study, Kangbuk Samsung Hospital, Seoul, South Korea.

Participants: 62 249 metabolically healthy, young and middle-aged men and women without CKD or proteinuria at baseline.

Measurements: Metabolic health was defined as a homeostasis model assessment of insulin resistance less than 2.5 and absence of any component of the metabolic syndrome. Underweight, normal weight, overweight, and obesity were defined as a body mass index less than 18.5 kg/m², 18.5 to 22.9 kg/m², 23 to 24.9 kg/m², and 25 kg/m² or greater, respectively. The outcome was incident CKD, defined as an estimated glomerular filtration rate less than 60 mL/min/1.73 m².

Results: During 369 088 person-years of follow-up, 906 incident CKD cases were identified. The multivariable-adjusted differences in 5-year cumulative incidence of CKD in underweight, overweight, and obese participants compared with normal-weight participants were -4.0 (95% CI, -7.8 to -0.3), 3.5 (CI, 0.9 to 6.1), and 6.7 (CI, 3.0 to 10.4) cases per 1000 persons, respectively. These associations were consistently seen in all clinically relevant subgroups.

Limitation: Chronic kidney disease was identified by a single measurement at each visit.

Conclusion: Overweight and obesity are associated with an increased incidence of CKD in metabolically healthy young and middle-aged participants. These findings show that metabolically healthy obesity is not a harmless condition and that the obese phenotype, regardless of metabolic abnormalities, can adversely affect renal function.

논문정보

형식Research article
게재일2016년 02월 (BRIC 등록일 2016-02-17)
연구진국내(교신)+국외 연구진
분야 의약학 > 응용의학
피인용횟수120회 이상 인용된 논문 (상위피인용논문 등록일 2020-05-27)

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