Waist Circumference, Body Mass Index, and ESRD in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study
Background The association between waist circumference and end-stage renal disease (ESRD) remains poorly explored. Study Design Longitudinal population-based cohort. Setting & Participants Participants in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study (n = 30,239) wi...
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| Veröffentlicht in: | American journal of kidney diseases 2016-01, Vol.67 (1), p.62-69 |
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| creator | Kramer, Holly, MD, MPH Gutiérrez, Orlando M., MD, MMSc Judd, Suzanne E., PhD Muntner, Paul, PhD Warnock, David G., MD Tanner, Rikki M., MPH Panwar, Bhupesh, MD Shoham, David A., PhD McClellan, William, MD, MPH |
| description | Background The association between waist circumference and end-stage renal disease (ESRD) remains poorly explored. Study Design Longitudinal population-based cohort. Setting & Participants Participants in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study (n = 30,239) with information for body mass index (BMI), waist circumference, spot urine albumin-creatinine ratio (ACR), and estimated glomerular filtration rate (eGFR; n = 26,960). Predictor Elevated waist circumference or BMI. Outcomes & Measurements Incident cases of ESRD were identified through linkage of REGARDS participants with the US Renal Data System. Results Mean baseline age was 64.8 years, 45.8% were men, and 40.3% were black. Overall, 297 (1.1%) individuals developed ESRD during a median of 6.3 years. After adjustment for all covariates including waist circumference, no significant association was noted between BMI categories and ESRD incidence compared to BMI of 18.5 to 24.9 kg/m2 (referent). Higher waist circumference categories showed significantly increased hazard rates of ESRD, with waist circumference ≥ 108 cm in women and ≥122 cm in men (highest category) showing a 3.97-fold higher hazard rate (95% CI, 2.10-6.86) for ESRD compared to waist circumference |
| doi_str_mv | 10.1053/j.ajkd.2015.05.023 |
| format | Article |
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Study Design Longitudinal population-based cohort. Setting & Participants Participants in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study (n = 30,239) with information for body mass index (BMI), waist circumference, spot urine albumin-creatinine ratio (ACR), and estimated glomerular filtration rate (eGFR; n = 26,960). Predictor Elevated waist circumference or BMI. Outcomes & Measurements Incident cases of ESRD were identified through linkage of REGARDS participants with the US Renal Data System. Results Mean baseline age was 64.8 years, 45.8% were men, and 40.3% were black. Overall, 297 (1.1%) individuals developed ESRD during a median of 6.3 years. After adjustment for all covariates including waist circumference, no significant association was noted between BMI categories and ESRD incidence compared to BMI of 18.5 to 24.9 kg/m2 (referent). Higher waist circumference categories showed significantly increased hazard rates of ESRD, with waist circumference ≥ 108 cm in women and ≥122 cm in men (highest category) showing a 3.97-fold higher hazard rate (95% CI, 2.10-6.86) for ESRD compared to waist circumference < 80 cm in women and <94 cm in men (referent) after adjusting for demographic factors and BMI. However, no significant association was noted between any waist circumference category and ESRD incidence after adjustment for obesity-associated comorbid conditions and baseline ACR and eGFR. Limitations Short follow-up period (6.3 years) to assess ESRD risk among adults with eGFRs > 60 mL/min/1.73 m2. Conclusions In this cohort of older adults, obesity as measured by waist circumference is associated with higher ESRD risk even with adjustment for BMI, whereas obesity as measured by BMI is not associated with higher ESRD risk after adjustment for waist circumference. However, no significant association is noted between increased waist circumference and ESRD risk after adjustment for obesity-related comorbid conditions, eGFR, and ACR.</description><identifier>ISSN: 0272-6386</identifier><identifier>EISSN: 1523-6838</identifier><identifier>DOI: 10.1053/j.ajkd.2015.05.023</identifier><identifier>PMID: 26187471</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adiposity ; Aged ; Body Mass Index ; body mass index (BMI) ; chronic kidney disease (CKD) ; chronic renal failure ; dialysis ; end-stage renal disease (ESRD) ; Female ; Humans ; Incidence ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - epidemiology ; Longitudinal Studies ; Male ; Middle Aged ; Nephrology ; obesity ; Obesity - complications ; Obesity - epidemiology ; Racial Groups ; renal failure ; Stroke - complications ; Stroke - epidemiology ; US Renal Data System (USRDS) ; Waist Circumference</subject><ispartof>American journal of kidney diseases, 2016-01, Vol.67 (1), p.62-69</ispartof><rights>National Kidney Foundation, Inc.</rights><rights>2016 National Kidney Foundation, Inc.</rights><rights>Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c525t-fba380996347407bcac25b34f5a966984819923b941d25c7bc6880404720f8ba3</citedby><cites>FETCH-LOGICAL-c525t-fba380996347407bcac25b34f5a966984819923b941d25c7bc6880404720f8ba3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1053/j.ajkd.2015.05.023$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27922,27923,45993</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26187471$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kramer, Holly, MD, MPH</creatorcontrib><creatorcontrib>Gutiérrez, Orlando M., MD, MMSc</creatorcontrib><creatorcontrib>Judd, Suzanne E., PhD</creatorcontrib><creatorcontrib>Muntner, Paul, PhD</creatorcontrib><creatorcontrib>Warnock, David G., MD</creatorcontrib><creatorcontrib>Tanner, Rikki M., MPH</creatorcontrib><creatorcontrib>Panwar, Bhupesh, MD</creatorcontrib><creatorcontrib>Shoham, David A., PhD</creatorcontrib><creatorcontrib>McClellan, William, MD, MPH</creatorcontrib><title>Waist Circumference, Body Mass Index, and ESRD in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study</title><title>American journal of kidney diseases</title><addtitle>Am J Kidney Dis</addtitle><description>Background The association between waist circumference and end-stage renal disease (ESRD) remains poorly explored. Study Design Longitudinal population-based cohort. Setting & Participants Participants in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study (n = 30,239) with information for body mass index (BMI), waist circumference, spot urine albumin-creatinine ratio (ACR), and estimated glomerular filtration rate (eGFR; n = 26,960). Predictor Elevated waist circumference or BMI. Outcomes & Measurements Incident cases of ESRD were identified through linkage of REGARDS participants with the US Renal Data System. Results Mean baseline age was 64.8 years, 45.8% were men, and 40.3% were black. Overall, 297 (1.1%) individuals developed ESRD during a median of 6.3 years. After adjustment for all covariates including waist circumference, no significant association was noted between BMI categories and ESRD incidence compared to BMI of 18.5 to 24.9 kg/m2 (referent). Higher waist circumference categories showed significantly increased hazard rates of ESRD, with waist circumference ≥ 108 cm in women and ≥122 cm in men (highest category) showing a 3.97-fold higher hazard rate (95% CI, 2.10-6.86) for ESRD compared to waist circumference < 80 cm in women and <94 cm in men (referent) after adjusting for demographic factors and BMI. However, no significant association was noted between any waist circumference category and ESRD incidence after adjustment for obesity-associated comorbid conditions and baseline ACR and eGFR. Limitations Short follow-up period (6.3 years) to assess ESRD risk among adults with eGFRs > 60 mL/min/1.73 m2. Conclusions In this cohort of older adults, obesity as measured by waist circumference is associated with higher ESRD risk even with adjustment for BMI, whereas obesity as measured by BMI is not associated with higher ESRD risk after adjustment for waist circumference. However, no significant association is noted between increased waist circumference and ESRD risk after adjustment for obesity-related comorbid conditions, eGFR, and ACR.</description><subject>Adiposity</subject><subject>Aged</subject><subject>Body Mass Index</subject><subject>body mass index (BMI)</subject><subject>chronic kidney disease (CKD)</subject><subject>chronic renal failure</subject><subject>dialysis</subject><subject>end-stage renal disease (ESRD)</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Kidney Failure, Chronic - complications</subject><subject>Kidney Failure, Chronic - epidemiology</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nephrology</subject><subject>obesity</subject><subject>Obesity - complications</subject><subject>Obesity - epidemiology</subject><subject>Racial Groups</subject><subject>renal failure</subject><subject>Stroke - complications</subject><subject>Stroke - epidemiology</subject><subject>US Renal Data System (USRDS)</subject><subject>Waist Circumference</subject><issn>0272-6386</issn><issn>1523-6838</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2P0zAQhi0EYsvCH-CAfFykTfFH7DgSQlraUlZahJSCOFquM2GdpnGxE0QP_HccWjhwQBppLs_7SvMMQs8pmVMi-Kt2btpdPWeEijlJw_gDNKOC8Uwqrh6iGWEFyyRX8gI9ibElhJRcysfogkmqirygM_Tzi3FxwAsX7LhvIEBv4Rq_9fURfzAx4tu-hh_X2PQ1Xm2qJXY9Hu4BV6v1TbXc4KsKTPR9xI0PeA3-azCHe2d_85WxznR46Zpzb5zSmyH4HbxMe6yPT9GjxnQRnp33Jfr8bvVp8T67-7i-XdzcZVYwMWTN1nBFylLyvMhJsbXGMrHleSNMKWWpckXLkvFtmdOaCZsAqRTJSV4w0qgUvkRXp95D8N9GiIPeu2ih60wPfoyaFsma4EzQhLITaoOPMUCjD8HtTThqSvSkXbd60q4n7ZqkYTyFXpz7x-0e6r-RP54T8PoEQLryu4Ogo3WTk9oFsIOuvft__5t_4rZzvbOm28ERYuvH0Cd_murINNGb6fHT36kgRAlB-C8L-KV9</recordid><startdate>20160101</startdate><enddate>20160101</enddate><creator>Kramer, Holly, MD, MPH</creator><creator>Gutiérrez, Orlando M., MD, MMSc</creator><creator>Judd, Suzanne E., PhD</creator><creator>Muntner, Paul, PhD</creator><creator>Warnock, David G., MD</creator><creator>Tanner, Rikki M., MPH</creator><creator>Panwar, Bhupesh, MD</creator><creator>Shoham, David A., PhD</creator><creator>McClellan, William, MD, MPH</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160101</creationdate><title>Waist Circumference, Body Mass Index, and ESRD in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study</title><author>Kramer, Holly, MD, MPH ; Gutiérrez, Orlando M., MD, MMSc ; Judd, Suzanne E., PhD ; Muntner, Paul, PhD ; Warnock, David G., MD ; Tanner, Rikki M., MPH ; Panwar, Bhupesh, MD ; Shoham, David A., PhD ; McClellan, William, MD, MPH</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c525t-fba380996347407bcac25b34f5a966984819923b941d25c7bc6880404720f8ba3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adiposity</topic><topic>Aged</topic><topic>Body Mass Index</topic><topic>body mass index (BMI)</topic><topic>chronic kidney disease (CKD)</topic><topic>chronic renal failure</topic><topic>dialysis</topic><topic>end-stage renal disease (ESRD)</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Kidney Failure, Chronic - complications</topic><topic>Kidney Failure, Chronic - epidemiology</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nephrology</topic><topic>obesity</topic><topic>Obesity - complications</topic><topic>Obesity - epidemiology</topic><topic>Racial Groups</topic><topic>renal failure</topic><topic>Stroke - complications</topic><topic>Stroke - epidemiology</topic><topic>US Renal Data System (USRDS)</topic><topic>Waist Circumference</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kramer, Holly, MD, MPH</creatorcontrib><creatorcontrib>Gutiérrez, Orlando M., MD, MMSc</creatorcontrib><creatorcontrib>Judd, Suzanne E., PhD</creatorcontrib><creatorcontrib>Muntner, Paul, PhD</creatorcontrib><creatorcontrib>Warnock, David G., MD</creatorcontrib><creatorcontrib>Tanner, Rikki M., MPH</creatorcontrib><creatorcontrib>Panwar, Bhupesh, MD</creatorcontrib><creatorcontrib>Shoham, David A., PhD</creatorcontrib><creatorcontrib>McClellan, William, MD, MPH</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of kidney diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kramer, Holly, MD, MPH</au><au>Gutiérrez, Orlando M., MD, MMSc</au><au>Judd, Suzanne E., PhD</au><au>Muntner, Paul, PhD</au><au>Warnock, David G., MD</au><au>Tanner, Rikki M., MPH</au><au>Panwar, Bhupesh, MD</au><au>Shoham, David A., PhD</au><au>McClellan, William, MD, MPH</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Waist Circumference, Body Mass Index, and ESRD in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study</atitle><jtitle>American journal of kidney diseases</jtitle><addtitle>Am J Kidney Dis</addtitle><date>2016-01-01</date><risdate>2016</risdate><volume>67</volume><issue>1</issue><spage>62</spage><epage>69</epage><pages>62-69</pages><issn>0272-6386</issn><eissn>1523-6838</eissn><abstract>Background The association between waist circumference and end-stage renal disease (ESRD) remains poorly explored. Study Design Longitudinal population-based cohort. Setting & Participants Participants in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study (n = 30,239) with information for body mass index (BMI), waist circumference, spot urine albumin-creatinine ratio (ACR), and estimated glomerular filtration rate (eGFR; n = 26,960). Predictor Elevated waist circumference or BMI. Outcomes & Measurements Incident cases of ESRD were identified through linkage of REGARDS participants with the US Renal Data System. Results Mean baseline age was 64.8 years, 45.8% were men, and 40.3% were black. Overall, 297 (1.1%) individuals developed ESRD during a median of 6.3 years. After adjustment for all covariates including waist circumference, no significant association was noted between BMI categories and ESRD incidence compared to BMI of 18.5 to 24.9 kg/m2 (referent). Higher waist circumference categories showed significantly increased hazard rates of ESRD, with waist circumference ≥ 108 cm in women and ≥122 cm in men (highest category) showing a 3.97-fold higher hazard rate (95% CI, 2.10-6.86) for ESRD compared to waist circumference < 80 cm in women and <94 cm in men (referent) after adjusting for demographic factors and BMI. However, no significant association was noted between any waist circumference category and ESRD incidence after adjustment for obesity-associated comorbid conditions and baseline ACR and eGFR. Limitations Short follow-up period (6.3 years) to assess ESRD risk among adults with eGFRs > 60 mL/min/1.73 m2. Conclusions In this cohort of older adults, obesity as measured by waist circumference is associated with higher ESRD risk even with adjustment for BMI, whereas obesity as measured by BMI is not associated with higher ESRD risk after adjustment for waist circumference. However, no significant association is noted between increased waist circumference and ESRD risk after adjustment for obesity-related comorbid conditions, eGFR, and ACR.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26187471</pmid><doi>10.1053/j.ajkd.2015.05.023</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | American journal of kidney diseases, 2016-01, Vol.67 (1), p.62-69 |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Adiposity Aged Body Mass Index body mass index (BMI) chronic kidney disease (CKD) chronic renal failure dialysis end-stage renal disease (ESRD) Female Humans Incidence Kidney Failure, Chronic - complications Kidney Failure, Chronic - epidemiology Longitudinal Studies Male Middle Aged Nephrology obesity Obesity - complications Obesity - epidemiology Racial Groups renal failure Stroke - complications Stroke - epidemiology US Renal Data System (USRDS) Waist Circumference |
| title | Waist Circumference, Body Mass Index, and ESRD in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study |
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