肥胖表型与中国中老年人慢性肾脏病发病风险关联研究——基于CHARLS数据

Association between obesity phenotype and risk of chronic kidney disease among middle-aged and older adults in China:Based on CHARLS data

目的:探讨肥胖表型及其转变与中国中老年人慢性肾脏病(CKD)发病风险的关联。方法:基于中国健康与养老追踪调查(CHARLS),纳入参加2011年和2015年两次调查的4538名[基线时(58.75±8.56)岁]研究对象。根据体质量指数和代谢状态将肥胖表型分为:代谢正常非超重/肥胖组(MHNO)、代谢正常超重/肥胖组(MHO)、代谢异常非超重/肥胖组(MANO)和代谢异常超重/肥胖组(MAO)。采用多因素Cox比例风险回归模型分析肥胖表型及其转变与CKD的发病风险。结果:与MHNO组相比,基线MHO、MANO和MAO组CKD发病风险显著上升,HR(95%CI)分别为:1.42(1.01~2.02)、1.55(1.01~2.36)和1.49(1.06~2.09)。随访期间,631人(62.85%)仍为MHO表型;148人(14.74%)转变为MHNO表型;10人(1.00%)转变成MANO表型;215人(21.41%)转变成MAO表型。以稳定的MHO组作为参比,MHO表型转变与CKD发病风险关联没有统计学意义(P>0.05)。结论:MHO和代谢异常表型(MANO、MAO)均会增加中国中老年人CKD发病风险。

Objective:To investigate the relationship of obesity phenotype and its change with risk of chronic kidney disease(CKD)among Chinese middle-aged and older adults.Methods:The data were obtained from the China Health and Retirement Longitudinal Survey(CHARLS)2011 and 2015 waves.A total of 4538(58.75±8.56 years at baseline)participants were included.Obesity phenotypes were grouped according to body mass index and metabolic status as metabolically healthy non-overweight/obese(MHNO),metabolically healthy overweight/obese(MHO),metabolically abnormal non-overweight/obese(MANO),and metabolically abnormal overweight/obese(MAO).Multifactorial Cox proportional hazards regression models were used to analyze the association between obesity phenotype or its transformation and CKD risk.Results:There was an increased risk of CKD for participants with MHO,MANO,and MAO at baseline as compared with MHNO participants.The HRs(95%CI)were 1.42(1.01-2.02),1.55(1.01-2.36),and 1.49(1.06-2.09),respectively.Over half(62.85%)of participants classified as MHO at baseline remained MHO during the follow-up period,whereas 148(14.74%),10(1.00%),and 215(21.41%)participants changed to MHNO,MANO,and MAO phenotypes,respectively.Compared with those with stable MHO,the transformation of MHO phenotype was not statistically associated with the risk of CKD(P>0.05).Conclusion:Both MHO and metabolic abnormal phenotypes(MANO and MAO)increased the risk of CKD among Chinese middle-aged and older adults.