ABSTRACT
BACKGROUND: studies have shown an association between obesity and a reduction in estimated glomerular filtration rate (eGFR). However, little is known regarding whether this association is related to total fat or, more specifically, to central or visceral fat. OBJECTIVE: this study evaluated the correlations among the nutritional indices that measure total, central and visceral obesity with eGFR. METHODS: a cross-sectional study, involving 288 hypertensive patients. Kidney function was estimated by GFR, using the Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. Explanatory variables included body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), waist stature ratio (WSR), estimated visceral adipose tissue (eVAT) and body fat percentage (BF%). RESULTS: the mean BMI was 27.8 ± 4.7 kg/m². Most of the patients (68.1%) were in the normal range of BF%, but regarding WC and eVAT, they were at very high risk (58.3% and 64.6%, respectively). In men, there were no correlations between nutritional indices and eGFR. In women, only eVAT remained negatively correlated with eGFR, estimated by MDRD and CKD-EPI equations, independent of BMI, smoking, physical inactivity, blood pressure, glycated hemoglobin, LDL and HDL cholesterol, uric acid and microalbuminuria. CONCLUSIONS: the majority of obesity indices were not associated with eGFR. Only eVAT was negatively associated with eGFR by MDRD and CKDEPI equations in hypertensive women. In primary health care, visceral adipose tissue estimation could support the identification of hypertensive women at increased risk for developing chronic kidney disease.
Subject(s)
Hypertension/complications , Intra-Abdominal Fat , Primary Health Care , Renal Insufficiency, Chronic/etiology , Renal Insufficiency, Chronic/prevention & control , Aged , Anthropometry , Body Composition , Body Mass Index , Cross-Sectional Studies , Female , Humans , Kidney Function Tests , Male , Middle Aged , Risk AssessmentABSTRACT
Background: studies have shown an association between obesity and a reduction in estimated glomerular filtration rate (eGFR). However, little is known regarding whether this association is related to total fat or, more specifically, to central or visceral fat. Objective: this study evaluated the correlations among the nutritional indices that measure total, central and visceral obesity with eGFR. Methods: a cross-sectional study, involving 288 hypertensive patients. Kidney function was estimated by GFR, using the Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. Explanatory variables included body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), waist stature ratio (WSR), estimated visceral adipose tissue (eVAT) and body fat percentage (BF%).Results: the mean BMI was 27.8 ± 4.7 kg/m². Most of the patients (68.1%) were in the normal range of BF%, but regarding WC and eVAT, they were at very high risk (58.3% and 64.6%, respectively). In men, there were no correlations between nutritional indices and eGFR. In women, only eVAT remained negatively correlated with eGFR, estimated by MDRD and CKD-EPI equations, independent of BMI, smoking, physical inactivity, blood pressure, glycated hemoglobin, LDL and HDL cholesterol, uric acid and microalbuminuria. Conclusions: the majority of obesity indices were not associated with eGFR. Only eVAT was negatively associated with eGFR by MDRD and CKDEPI equations in hypertensive women. In primary health care, visceral adipose tissue estimation could support the identification of hypertensive women at increased risk for developing chronic kidney disease
Antecedentes: los estudios han demostrado una asociación entre la obesidad y una reducción en la tasa de filtración glomerular estimada (eGFR). Sin embargo, poco se sabe sobre si esta asociación está relacionada con la grasa total o, más específicamente, con la grasa central o visceral. Objetivo: este estudio evaluó las correlaciones entre los índices nutricionales que miden la obesidad total, central y visceral con eGFR. Métodos: estudio transversal con 288 pacientes hipertensos. La función renal se estimó mediante TFG, utilizando las ecuaciones de Modificación de la Dieta en la Enfermedad Renal (MDRD) y la Colaboración en Epidemiología de la Enfermedad Renal Crónica (CKD-EPI). Las variables explicativas incluyeron el índice de masa corporal (IMC), la circunferencia de cintura (WC), la relación cintura-cadera (WHR), la proporción cintura-estatura (WSR), el tejido adiposo visceral estimado (eVAT) y el porcentaje de grasa corporal (% BF). Resultados: el IMC medio fue de 27,8 ± 4,7 kg/m². La mayoría de los pacientes (68,1%) se encontraban en el rango normal de BF%, pero en cuanto a WC y eVAT, presentaban un riesgo muy alto (58,3% y 64,6%, respectivamente). En los hombres, no hubo correlaciones entre los índices nutricionales y eGFR. En las mujeres, solo el eVAT permaneció correlacionado negativamente con el eGFR, estimado por las ecuaciones MDRD y CKD-EPI, independiente del IMC, el tabaquismo, la inactividad física, la presión arterial, la hemoglobina glicosilada, el colesterol LDL y HDL, el ácido úrico y la microalbuminuria. Conclusiones: la mayoría de los índices de obesidad no se asociaron con el eGFR. Solo eVAT se asoció negativamente con eGFR por las ecuaciones MDRD y CKD-EPI en mujeres hipertensas. En la Atención Primaria, la estimación del tejido adiposo visceral podría apoyar la identificación de las mujeres hipertensas con mayor riesgo de desarrollar enfermedad renal crónica
