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The Risk of Microalbuminuria by Obesity Phenotypes according to Metabolic Health and Obesity: The Korean National Health and Nutrition Examination Survey 2011–2014

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Background: The present study aimed at identifying the difference in the risk of microalbuminuria among individ-uals with various obesity phenotypes in terms of metabolic health and obesity.Methods: This cross-sectional study included 15,268 individuals and used data from the National Health and Nu-trition Survey conducted from 2011 to 2014. Obesity was defined as body mass index ≥25 kg/m². Metabolically un-healthy was defined as meeting two or more of the following criteria: systolic and diastolic blood pressure ≥130/85 mm Hg or current use of hypertensive drugs; triglyceride level ≥150 mg/dL; high-density lipoprotein level <40/50 mg/dL (in both men and women); and fasting blood glucose level ≥100 mg/dL or current use of oral antidiabetic medications. The participants were further classified into four subgroups: metabolically healthy non-obese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUNO), and metabolically unhealthy obese (MUO).Results: A significant difference was observed in the microalbuminuria ratio among the four groups. The MHNO group was considered as the reference group, and the MHO, MUNO, and MUO groups were at an increased risk for microalbuminuria by 1.42 fold (95% confidence interval [95% CI], 1.03–1.96), 2.02 fold (95% CI, 1.61–2.53), and 3.40 fold (95% CI, 2.70–4.26), respectively, after adjusting confounding factors.Conclusion: The MUNO group had a higher risk of developing microalbuminuria than the MHNO group. Thus, based on this result, differences were observed in the risk of developing microalbuminuria among individuals with various obesity subtypes.

Abstract

Background: The present study aimed at identifying the difference in the risk of microalbuminuria among individ-uals with various obesity phenotypes in terms of metabolic health and obesity.Methods: This cross-sectional study included 15,268 individuals and used data from the National Health and Nu-trition Survey conducted from 2011 to 2014. Obesity was defined as body mass index ≥25 kg/m². Metabolically un-healthy was defined as meeting two or more of the following criteria: systolic and diastolic blood pressure ≥130/85 mm Hg or current use of hypertensive drugs; triglyceride level ≥150 mg/dL; high-density lipoprotein level <40/50 mg/dL (in both men and women); and fasting blood glucose level ≥100 mg/dL or current use of oral antidiabetic medications. The participants were further classified into four subgroups: metabolically healthy non-obese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUNO), and metabolically unhealthy obese (MUO).Results: A significant difference was observed in the microalbuminuria ratio among the four groups. The MHNO group was considered as the reference group, and the MHO, MUNO, and MUO groups were at an increased risk for microalbuminuria by 1.42 fold (95% confidence interval [95% CI], 1.03–1.96), 2.02 fold (95% CI, 1.61–2.53), and 3.40 fold (95% CI, 2.70–4.26), respectively, after adjusting confounding factors.Conclusion: The MUNO group had a higher risk of developing microalbuminuria than the MHNO group. Thus, based on this result, differences were observed in the risk of developing microalbuminuria among individuals with various obesity subtypes.

참고문헌 (30)

  1. 강재헌, "Socioeconomic Costs of Overweight and Obesity in Korean Adults", Journal of Korean Medical Science, 26(12), pp.1533~1540 (2011), 대한의학회
  2. Zhang C, "Abdominal obesity and the risk of all-cause, cardiovascular, and cancer mortality: sixteen years of follow-up in US women", Circulation, 117, pp.1658~1667 (2008)[DOI]
  3. Wang Y, "Association between obesity and kidney disease: a systematic review and meta-analysis", Kidney Int, 73, pp.19~33 (2008)[DOI]
  4. Galassi A, "Metabolic syndrome and risk of cardiovascular disease: a meta-analysis", Am J Med, 119, pp.812~819 (2006)[DOI]
  5. Thomas G, "Metabolic syndrome and kidney disease: a systematic review and meta-analysis", Clin J Am Soc Nephrol, 6, pp.2364~2373 (2011)[DOI]
  6. Hamer M, "Metabolically healthy obesity and risk of allcause and cardiovascular disease mortality", J Clin Endocrinol Metab, 97, pp.2482~2488 (2012)[DOI]
  7. Appleton SL, "Diabetes and cardiovascular disease outcomes in the metabolically healthy obese phenotype: a cohort study", Diabetes Care, 36, pp.2388~2394 (2013)[DOI]
  8. Kuk JL, "Are metabolically normal but obese individuals at lower risk for all-cause mortality", Diabetes Care, 32, pp.2297~2299 (2009)[DOI]
  9. Calori G, "Prevalence, metabolic features, and prognosis of metabolically healthy obese Italian individuals: the Cremona Study", Diabetes Care, 34, pp.210~215 (2011)[DOI]
  10. Hinnouho GM, "Metabolically healthy obesity and the risk of cardiovascular disease and type 2 diabetes: the Whitehall II cohort study", Eur Heart J, 36, pp.551~559 (2015)[DOI]
  11. Hinnouho GM, "Metabolically healthy obesity and risk of mortality: does the definition of metabolic health matter?", Diabetes Care, 36, pp.2294~2300 (2013)[DOI]
  12. Serne EH, "Microvascular dysfunction: a potential pathophysiological role in the metabolic syndrome", Hypertension, 50, pp.204~211 (2007)[DOI]
  13. Czernichow S, "Microvascular dysfunction in healthy insulin-sensitive overweight individuals", J Hypertens, 28, pp.325~332 (2010)[DOI]
  14. Futrakul N, "Microalbuminuria: a biomarker of renal microvascular disease", Ren Fail, 31, pp.140~143 (2009)[DOI]
  15. Chronic Kidney Disease Prognosis Consortium, "Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis", Lancet, 375, pp.2073~2081 (2010)[DOI]
  16. Klausen KP, "Very low level of microalbuminuria is associated with increased risk of death in subjects with cardiovascular or cerebrovascular diseases", J Intern Med, 260, pp.231~237 (2006)[DOI]
  17. Chang A, "Lifestyle-related factors, obesity, and incident microalbuminuria: the CARDIA (Coronary Artery Risk Development in Young Adults) study", Am J Kidney Dis, 62, pp.267~275 (2013)[DOI]
  18. Kim H, "Visceral obesity is associated with microalbuminuria in nondiabetic Asians", Hypertens Res, 37, pp.679~684 (2014)[DOI]
  19. Rowley KG, "Albuminuria in Australian Aboriginal people: prevalence and associations with components of the metabolic syndrome", Diabetologia, 43, pp.1397~1403 (2000)[DOI]
  20. Konta T, "Prevalence and risk factor analysis of microalbuminuria in Japanese general population: the Takahata study", Kidney Int, 70, pp.751~756 (2006)[DOI]
  21. Lin CC, "Microalbuminuria and the metabolic syndrome and its components in the Chinese population", Eur J Clin Invest, 37, pp.783~790 (2007)[DOI]
  22. Kweon S, "Data resource profile: the Korea National Health and Nutrition Examination Survey (KNHANES)", Int J Epidemiol, 43, pp.69~77 (2014)[DOI]
  23. WHO Expert Consultation, "Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies", Lancet, 363, pp.157~163 (2004)[DOI]
  24. Expert Panel on Detection, "Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)", JAMA, 285, pp.2486~2497 (2001)[DOI]
  25. Ortega FB, "The intriguing metabolically healthy but obese phenotype: cardiovascular prognosis and role of fitness", Eur Heart J, 34, pp.389~397 (2013)[DOI]
  26. National Kidney Foundation, "K", DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification, 2002, pp.39(2 Suppl 1), S1~S266
  27. Bardach AE, "Impact of level and patterns of alcohol drinking on coronary heart disease and stroke burden in Argentina", PLoS One, 12, pp.e0173704~ (2017)[DOI]
  28. American College of Sports Medicine, "ACSM's guidelines for exercise testing and prescription" (2013), Lippincott Williams & Wilkins
  29. Choi KM, "Higher mortality in metabolically obese normal-weight people than in metabolically healthy obese subjects in elderly Koreans", Clin Endocrinol (Oxf), 79, pp.364~370 (2013)[DOI]
  30. Roberson LL, "Beyond BMI: the "metabolically healthy obese" phenotype & its association with clinical", subclinical cardiovascular disease and allcause mortality: a systematic review, 2014, pp.14, 14~

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