Association Between Obesity Indexes and Chronic Kidney Disease Risk: A Double-cohort Prospective Study in the Binhai and UK Biobank

Suhua Gao^1,2Yixi Liu^1,2,3Hongyan Liu^1,2Yao Lin^1,2Pufei Bai^1,2Fang Hou⁴Lu Shan^1,5Saijun Zhou^1,2Haizhen Sun^1,5Guangyang Ma^1,2Hao Liu⁴Mianzhi Zhang⁶Zhuang Cui⁷Pei Yu^1,2*

• ¹NHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin, China
• ²Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, China
• ³Xi'an Honghui Hospital, Xi'an, Shaanxi Province, China
• ⁴Community Health Service Center, Jiefang Road, Tanggu Street, Binhai New District, Tianjin, China
• ⁵Department of Radiology, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
• ⁶Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, Beijing, China
• ⁷Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China

The prevalence of overweight and obesity has increased worldwide, leading to growing concern regarding the impact of visceral adipose deposition on renal function.The aim of this study was to evaluate the predictive value of 10 obesity indexes for the risk of chronic kidney disease (CKD) in both Chinese populations and Western.The Tianjin Chronic Kidney Disease Study (Binhai, primary cohort) included 126,109 participants, while 358,918 adults from the U.K. Biobank (UKB, replication cohort) were included. Cox proportional hazard and restricted cubic spline models were used to assess the relationships between obesity indexes and the risk of CKD.Results: During a median follow-up of 35 months in the Binhai cohort, 14,435 CKD cases were identified, while 358,918 CKD cases were observed in the U.K. Biobank cohort during 161 months of follow-up. The risk of CKD increased with increasing quartile levels of the Chinese Visceral Adiposity Index (CVAI) (P for trend < 0.001).CVAI was associated with increased CKD risk (hazard ratio in comparing the highest to the lowest quintile = 1.22 [95% CI 1.16-1.30]) and its predictive ability was the highest among the 10 obesity indexes, with an AUC value of 0.588 (0.581-0.594) in the female subgroup of the Binhai cohort. All of the obesity indexes were negatively correlated with estimated glomerular filtration rate (eGFR).Conclusions: Findings from two large prospective cohort studies support the notion that obesity indexes, particularly CVAI, are significantly associated with the risk of CKD across diverse ethnic groups.