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U-shaped association between body mass index and proteinuria in a large Japanese general population sample |
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| Authors: | Yuji Sato Shouichi Fujimoto Tsuneo Konta Kunitoshi Iseki Toshiki Moriyama Kunihiro Yamagata Kazuhiko Tsuruya Hideaki Yoshida Koichi Asahi Issei Kurahashi Yasuo Ohashi Tsuyoshi Watanabe |
| Affiliation: | 1. Dialysis Division, University of Miyazaki Hospital, Miyazaki, Japan 2. Department of Hemovascular Medicine and Artificial Organs, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan 3. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan 4. Steering Committee for the “Examination of the Positioning of CKD in Specific Health Check and Guidance”, Tokyo, Japan 5. Department of Planning, Information, and Management, University of Tokyo Hospital, Tokyo, Japan 6. Department of Biostatistics/Epidemiology and Preventive Health Sciences, School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan |
| Abstract: | BackgroundThere is little data on the association between body mass index (BMI) and proteinuria.MethodsThis was a cross-sectional cohort study assessing the association between BMI and proteinuria in a large Japanese population. Using a nationwide health check-up database of 212,251 Japanese aged >20 years with no pre-existing cardiovascular diseases (185,183 men, median age 66 years; 127,068 women, median age 65 years), we examined the association between BMI and proteinuria (≥1+ on dipstick).ResultsSubjects were divided into 11 subgroups by BMI grading in 1 kg/m2 intervals from 18.5?27.5 kg/m2. A BMI of approximately 22 ± 0.5 kg/m2 was considered optimal for Japanese; therefore, this subgroup was set as a reference when logistic analysis was applied. Age, waist circumference, height, weight, smoking and drinking habits, use of medications such as antihypertensive, antidiabetic, or antihyperlipidemic, as well as proteinuria, estimated glomerular filtration rate (eGFR), chemistry data, and blood pressure levels were significantly different between subgroups in both genders. The odds ratio for proteinuria showed a U-shape in men and women, even after adjustment for significant covariates such as age, waist circumference, systolic blood pressure, eGFR, fasting plasma glucose, triglyceride, low-density lipoprotein, antihypertensive use, antidiabetic use, antihyperlipidemic use, and lifestyle factors (smoking and drinking). Gender differences were also prominent—a BMI <20.4 kg/m2 was significantly associated with proteinuria in men compared to a BMI <18.4 kg/m2 in women. On the other hand, a BMI ≥ 25.5 kg/m2 was also significantly associated with proteinuria in men compared to a BMI ≥ 22.5 kg/m2 in women.ConclusionsWe found that BMI levels were associated with proteinuria in a U-shaped manner and showed marked gender differences. Health guidance should not only focus on higher BMI subjects, but also on thin subjects, in terms of the prevention of chronic kidney disease. |
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