Normal weight and waist obesity indicated by increased total body fat associated with all-cause mortality in stage 3–5 chronic kidney disease
Patients with chronic kidney disease (CKD) demonstrate a survival benefit with a high body mass index (BMI); this is the obesity paradox. Central obesity has a higher prognostic value than BMI, even in those with normal weight. Whether total body fat percentage (TBF%) provides more information than...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2022.982519/full |
| _version_ | 1818022974951784448 |
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| author | Feng-Ching Shen Mei-En Chen Wei-Tsung Wu Wei-Tsung Wu I-Ching Kuo Sheng-Wen Niu Jia-Jung Lee Jia-Jung Lee Chi-Chih Hung Chi-Chih Hung Jer-Ming Chang Jer-Ming Chang Shang-Jyh Hwang Shang-Jyh Hwang |
| author_facet | Feng-Ching Shen Mei-En Chen Wei-Tsung Wu Wei-Tsung Wu I-Ching Kuo Sheng-Wen Niu Jia-Jung Lee Jia-Jung Lee Chi-Chih Hung Chi-Chih Hung Jer-Ming Chang Jer-Ming Chang Shang-Jyh Hwang Shang-Jyh Hwang |
| author_sort | Feng-Ching Shen |
| collection | DOAJ |
| description | Patients with chronic kidney disease (CKD) demonstrate a survival benefit with a high body mass index (BMI); this is the obesity paradox. Central obesity has a higher prognostic value than BMI, even in those with normal weight. Whether total body fat percentage (TBF%) provides more information than BMI and waist circumference (WC) remains unknown. We included 3,262 Asian patients with stage 3–5 CKD and divided these patients by TBF% and waist-to-height ratio (WHtR) quartiles (Q1–Q4). TBF% was associated with BMI, WC, nutritional markers, and C-reactive protein. In all patients, BMI but not TBF% or WHtR demonstrated a survival paradox. In patients with BMI <25 kg/m2, but not in those with BMI ≥ 25 kg/m2, TBF% Q4 and WHtR Q4 were associated with all-cause mortality, with hazard ratios [HRs; 95% confidence intervals (CIs)] of 2.35 (1.31–4.22) and 1.38 (1.06–1.80), respectively. The HRs of TBF% Q4 for all-cause mortality were 2.90 (1.50–5.58) in patients with a normal WC and 3.81 (1.93–7.50) in patients with normal weight and normal WC (All P for interaction < 0.05). In conclusion, TBF% can predict all-cause mortality in patients with advanced CKD and a normal weight, normal WC, or both. |
| first_indexed | 2024-12-10T03:36:57Z |
| format | Article |
| id | doaj.art-0fadef9e6a5a44988bea0005b6a12576 |
| institution | Directory Open Access Journal |
| issn | 2296-861X |
| language | English |
| last_indexed | 2024-12-10T03:36:57Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Nutrition |
| spelling | doaj.art-0fadef9e6a5a44988bea0005b6a125762022-12-22T02:03:41ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2022-09-01910.3389/fnut.2022.982519982519Normal weight and waist obesity indicated by increased total body fat associated with all-cause mortality in stage 3–5 chronic kidney diseaseFeng-Ching Shen0Mei-En Chen1Wei-Tsung Wu2Wei-Tsung Wu3I-Ching Kuo4Sheng-Wen Niu5Jia-Jung Lee6Jia-Jung Lee7Chi-Chih Hung8Chi-Chih Hung9Jer-Ming Chang10Jer-Ming Chang11Shang-Jyh Hwang12Shang-Jyh Hwang13Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Nutrition and Dietetics, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDivision of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanGraduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanRegenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, TaiwanDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanRegenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, TaiwanDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanFaculty of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanFaculty of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanPatients with chronic kidney disease (CKD) demonstrate a survival benefit with a high body mass index (BMI); this is the obesity paradox. Central obesity has a higher prognostic value than BMI, even in those with normal weight. Whether total body fat percentage (TBF%) provides more information than BMI and waist circumference (WC) remains unknown. We included 3,262 Asian patients with stage 3–5 CKD and divided these patients by TBF% and waist-to-height ratio (WHtR) quartiles (Q1–Q4). TBF% was associated with BMI, WC, nutritional markers, and C-reactive protein. In all patients, BMI but not TBF% or WHtR demonstrated a survival paradox. In patients with BMI <25 kg/m2, but not in those with BMI ≥ 25 kg/m2, TBF% Q4 and WHtR Q4 were associated with all-cause mortality, with hazard ratios [HRs; 95% confidence intervals (CIs)] of 2.35 (1.31–4.22) and 1.38 (1.06–1.80), respectively. The HRs of TBF% Q4 for all-cause mortality were 2.90 (1.50–5.58) in patients with a normal WC and 3.81 (1.93–7.50) in patients with normal weight and normal WC (All P for interaction < 0.05). In conclusion, TBF% can predict all-cause mortality in patients with advanced CKD and a normal weight, normal WC, or both.https://www.frontiersin.org/articles/10.3389/fnut.2022.982519/fullobesity paradoxall-cause mortalitychronic kidney diseasesnormal weightnormal waisttotal body fat |
| spellingShingle | Feng-Ching Shen Mei-En Chen Wei-Tsung Wu Wei-Tsung Wu I-Ching Kuo Sheng-Wen Niu Jia-Jung Lee Jia-Jung Lee Chi-Chih Hung Chi-Chih Hung Jer-Ming Chang Jer-Ming Chang Shang-Jyh Hwang Shang-Jyh Hwang Normal weight and waist obesity indicated by increased total body fat associated with all-cause mortality in stage 3–5 chronic kidney disease Frontiers in Nutrition obesity paradox all-cause mortality chronic kidney diseases normal weight normal waist total body fat |
| title | Normal weight and waist obesity indicated by increased total body fat associated with all-cause mortality in stage 3–5 chronic kidney disease |
| title_full | Normal weight and waist obesity indicated by increased total body fat associated with all-cause mortality in stage 3–5 chronic kidney disease |
| title_fullStr | Normal weight and waist obesity indicated by increased total body fat associated with all-cause mortality in stage 3–5 chronic kidney disease |
| title_full_unstemmed | Normal weight and waist obesity indicated by increased total body fat associated with all-cause mortality in stage 3–5 chronic kidney disease |
| title_short | Normal weight and waist obesity indicated by increased total body fat associated with all-cause mortality in stage 3–5 chronic kidney disease |
| title_sort | normal weight and waist obesity indicated by increased total body fat associated with all cause mortality in stage 3 5 chronic kidney disease |
| topic | obesity paradox all-cause mortality chronic kidney diseases normal weight normal waist total body fat |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2022.982519/full |
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