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Obesity is linked to poor health-related quality of life (HRQOL) in the general population, but its role in chronic kidney disease (CKD) is uncertain.
We conducted a cross-sectional study that investigated 1880 participants from the KoreaN cohort study for Outcome in patients With CKD (KNOW-CKD) who underwent complete baseline laboratory tests, health questionnaires, and HRQOL. HRQOL was assessed by physical component summary (PCS) and mental component summary (MCS) of the SF-36 questionnaire. We used multivariable linear regression models to examine the relationship between Body Mass Index (BMI) and sex-specific waist circumference (WC) with HRQOL.
Adults with higher BMI and greater WC showed lower PCS. After adjusting for age, sex, socioeconomic state, comorbidities, and laboratory findings, we found that WC, but not BMI, was associated with PCS. Greater WC quintiles were associated with lower PCS [WC-4th quintile (β, − 2.63, 95% CI − 5.19 to − 0.06) and WC-5th quintile (β, − 3.71, 95% CI − 6.28 to − 1.15)]. The association between WC and PCS was more pronounced in older adults, woman, patients with diabetes, cardiovascular disease, or lower eGFR. The relationship between BMI and WC with MCS was not significant.
In adults with CKD, WC is a better indicator of poor physical HRQOL than BMI. The association between WC and physical HRQOL is modified by age, sex, eGFR, and comorbidities such as diabetes and cardiovascular disease.
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Supplementary material 1 (DOCX 682 KB)11136_2018_2084_MOESM1_ESM.docx
Mills, K. T., Xu, Y., Zhang, W., Bundy, J. D., Chen, C. S., Kelly, T. N., et al. (2015). A systematic analysis of worldwide population-based data on the global burden of chronic kidney disease in 2010. Kidney International, 88(5), 950–957. CrossRef
Finkelstein, F. O., Wuerth, D., & Finkelstein, S. H. (2009). Health related quality of life and the CKD patient: Challenges for the nephrology community. Kidney International, 76(9), 946–952. CrossRef
Abdel-Kader, K., Unruh, M. L., & Weisbord, S. D. (2009). Symptom burden, depression, and quality of life in chronic and end-stage kidney disease. Clinical Journal of the American Society of Nephrology: CJASN, 4(6), 1057–1064. CrossRef
Chong, K., & Unruh, M. (2017). Why does quality of life remain an under-investigated issue in chronic kidney disease and why is it rarely set as an outcome measure in trials in this population? Nephrology, Dialysis, Transplantation, 32(suppl_2), ii47–ii52. CrossRef
Ng, M., Fleming, T., Robinson, M., Thomson, B., Graetz, N., Margono, C., et al. (2014). Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet, 384(9945), 766–781. CrossRef
Afshin, A., Forouzanfar, M. H., Reitsma, M. B., Sur, P., Estep, K., Lee, A., et al. (2017). Health effects of overweight and obesity in 195 countries over 25 years. The New England Journal of Medicine, 377(1), 13–27. CrossRef
Ahmadi, S. F., Zahmatkesh, G., Ahmadi, E., Streja, E., Rhee, C. M., Gillen, D. L., et al. (2015). Association of Body Mass Index with clinical outcomes in non-dialysis-dependent chronic kidney disease: A systematic review and meta-analysis. Cardiorenal Medicine, 6(1), 37–49. CrossRef
Navaneethan, S. D., Schold, J. D., Arrigain, S., Kirwan, J. P., & Nally, J. V. Jr. (2016). Body Mass Index and causes of death in chronic kidney disease. Kidney International, 89(3), 675–682. CrossRef
Lu, J. L., Kalantar-Zadeh, K., Ma, J. Z., Quarles, L. D., & Kovesdy, C. P. (2014). Association of Body Mass Index with outcomes in patients with CKD. Journal of the American Society of Nephrology: JASN, 25(9), 2088–2096. CrossRef
Muller, M. J., Braun, W., Enderle, J., & Bosy-Westphal, A. (2016). Beyond BMI: Conceptual issues related to overweight and obese patients. Obesity Facts, 9(3), 193–205. CrossRef
Global, B. M. I. M. C., Di Angelantonio, E., Bhupathiraju Sh, N., Wormser, D., Gao, P., Kaptoge, S., et al. (2016). Body-mass index and all-cause mortality: Individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet, 388(10046), 776–786. CrossRef
Kalantar-Zadeh, K., Rhee, C. M., Chou, J., Ahmadi, S. F., Park, J., Chen, J. L., et al. (2017). The obesity paradox in kidney disease: How to reconcile it with obesity management. Kidney International Reports, 2(2), 271–281. CrossRef
Kramer, H., Shoham, D., McClure, L. A., Durazo-Arvizu, R., Howard, G., Judd, S., et al. (2011). Association of waist circumference and Body Mass Index with all-cause mortality in CKD: The REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study. American Journal of Kidney Diseases, 58(2), 177–185. CrossRef
Kramer, H., Gutierrez, O. M., Judd, S. E., Muntner, P., Warnock, D. G., Tanner, R. M., et al. (2016). Waist circumference, Body Mass Index, and ESRD in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study. American Journal of Kidney Diseases, 67(1), 62–69. CrossRef
Ul-Haq, Z., Mackay, D. F., Fenwick, E., & Pell, J. P. (2013). Meta-analysis of the association between Body Mass Index and health-related quality of life among adults, assessed by the SF-36. Obesity, 21(3), E322–E327. CrossRef
Oh, K. H., Park, S. K., Park, H. C., Chin, H. J., Chae, D. W., Choi, K. H., et al. (2014). KNOW-CKD (KoreaN cohort study for outcome in patients with chronic kidney disease): Design and methods. BMC Nephrology, 15, 80. CrossRef
Levin, A., & Stevens, P. E. (2014). Summary of KDIGO 2012 CKD guideline: Behind the scenes, need for guidance, and a framework for moving forward. Kidney International, 85(1), 49–61. CrossRef
WHO Expert Consultation. (2004). Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet, 363(9403), 157–163. CrossRef
World Health Organization. (2008). Pacific physical activity guidelines for adults: Framework for accelerating the communication of physical activity guidelines. Geneva: World Health Organization.
Ware, J. E. Jr., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30(6), 473–483. CrossRef
Han, C. W., Lee, E. J., Iwaya, T., Kataoka, H., & Kohzuki, M. (2004). Development of the Korean version of short-form 36-item health survey: Health related QOL of healthy elderly people and elderly patients in Korea. Tohoku Journal of Experimental Medicine, 203(3), 189–194. CrossRef
Okorodudu, D. O., Jumean, M. F., Montori, V. M., Romero-Corral, A., Somers, V. K., Erwin, P. J., et al. (2010). Diagnostic performance of Body Mass Index to identify obesity as defined by body adiposity: A systematic review and meta-analysis. International Journal of Obesity (2005), 34(5), 791–799. CrossRef
Kittiskulnam, P., Chertow, G. M., Kaysen, G. A., Delgado, C., Dalrymple, L. S., & Johansen, K. L. (2016). Misclassification of obesity by Body Mass Index among patients receiving hemodialysis. American Journal of Kidney Diseases, 67(4), 709–711. CrossRef
Lin, T. Y., Peng, C. H., Hung, S. C., & Tarng, D. C. (2018). Body composition is associated with clinical outcomes in patients with non-dialysis-dependent chronic kidney disease. Kidney International, 93(3), 733–740. CrossRef
Lee, C. M., Huxley, R. R., Wildman, R. P., & Woodward, M. (2008). Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: A meta-analysis. Journal of Clinical Epidemiology, 61(7), 646–653. CrossRef
Hu, J., Yang, S., Zhang, A., Yang, P., Cao, X., Li, X., et al. (2016). Abdominal obesity is more closely associated with diabetic kidney disease than general obesity. Diabetes Care, 39(10), e179–e180. CrossRef
Postorino, M., Marino, C., Tripepi, G., & Zoccali, C. (2009). Abdominal obesity and all-cause and cardiovascular mortality in end-stage renal disease. Journal of the American College of Cardiology, 53(15), 1265–1272. CrossRef
Klein, S., Allison, D. B., Heymsfield, S. B., Kelley, D. E., Leibel, R. L., Nonas, C., et al. (2007). Waist circumference and cardiometabolic risk: A consensus statement from shaping America’s health: Association for Weight Management and Obesity Prevention; NAASO, the Obesity Society; the American Society for Nutrition; and the American Diabetes Association. Diabetes Care, 30(6), 1647–1652. CrossRef
Xu, Y., Zhou, Z., Li, Y., Yang, J., Guo, X., Gao, J., et al. (2015). Exploring the nonlinear relationship between Body Mass Index and health-related quality of life among adults: A cross-sectional study in Shaanxi Province, China. Health and Quality of Life Outcomes, 13, 153. CrossRef
Laxy, M., Teuner, C., Holle, R., & Kurz, C. (2018). The association between BMI and health-related quality of life in the US population: Sex, age and ethnicity matters. International Journal of Obesity (2005), 42(3), 318–326. CrossRef
Antonopoulos, A. S., Oikonomou, E. K., Antoniades, C., & Tousoulis, D. (2016). From the BMI paradox to the obesity paradox: The obesity-mortality association in coronary heart disease. Obesity Reviews, 17(10), 989–1000. CrossRef
Prado, C. M., Gonzalez, M. C., & Heymsfield, S. B. (2015). Body composition phenotypes and obesity paradox. Current Opinion in Clinical Nutrition and Metabolic Care, 18(6), 535–551. CrossRef
Sharma, D., Hawkins, M., & Abramowitz, M. K. (2014). Association of sarcopenia with eGFR and misclassification of obesity in adults with CKD in the United States. Clinical Journal of the American Society of Nephrology: CJASN, 9(12), 2079–2088. CrossRef
Androga, L., Sharma, D., Amodu, A., & Abramowitz, M. K. (2017). Sarcopenia, obesity, and mortality in US adults with and without chronic kidney disease. Kidney International Reports, 2(2), 201–211. CrossRef
- Body Mass Index, waist circumference, and health-related quality of life in adults with chronic kidney disease
Young Youl Hyun
Seung Hyeok Han
Yun Kyu Oh
Sue Kyung Park
the KNOW-CKD Study Investigator
- Springer International Publishing
Quality of Life Research
An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation - An Official Journal of the International Society of Quality of Life Research
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649