Waist Circumference and Visceral Fat in CKD: A Cross-sectional Study

• Published in: American journal of kidney diseases Vol. 52; no. 1; pp. 66 - 73
• Main Authors: Sanches, Fabiana M.R., MSc, Avesani, Carla M., PhD, Kamimura, Maria A., PhD, Lemos, Marcelo M., MD, Axelsson, Jonas, MD, PhD, Vasselai, Priscila, MSc, Draibe, Sergio A., MD, PhD, Cuppari, Lilian, PhD
• Format: Journal Article
• Language: English
• Published: Orlando, FL Elsevier Inc 01-07-2008; Elsevier
• Subjects: Abdominal obesity; Adult; Age Distribution; Aged; Biological and medical sciences; Body Composition; Body Mass Index; Brazil - epidemiology; cardiovascular disease; Comorbidity; Cross-Sectional Studies; end-stage renal disease; Female; Humans; Incidence; insulin resistance; Kidney Failure, Chronic - diagnosis; Kidney Failure, Chronic - epidemiology; Linear Models; Male; Medical sciences; Medicin och hälsovetenskap; Metabolic diseases; metabolic syndrome; Middle Aged; Nephrology; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Obesity; Obesity - diagnosis; Obesity - epidemiology; Probability; Prognosis; Renal failure; Risk Assessment; Sex Distribution; Statistics, Nonparametric; Subcutaneous Fat, Abdominal; Tomography, X-Ray Computed; Viscera; Waist-Hip Ratio; Brazil; metabolic syndrome; Abdominal obesity; cardiovascular disease; end-stage renal disease; insulin resistance; Endocrinopathy; Pancreatic hormone; Nephrology; Adipose tissue; Chronic renal failure; Cardiovascular disease; Metabolic syndrome; Urology; Cross sectional study; Nutritional status; Kidney disease; Obesity; Urinary system disease; Nutrition disorder; Metabolic diseases; Terminal stage; Corporal biometry; Insulin; Abdomen; Target tissue resistance; Waist circumference; Renal failure; Insulin resistance; Viscus
• ISSN: 0272-6386; 1523-6838; 1523-6838
• DOI: 10.1053/j.ajkd.2008.02.004

Background In the general population, waist circumference was noted to be a reliable predictor of visceral fat. In addition, increased waist circumference was strongly associated with risk factors for cardiovascular disease. In patients with chronic kidney disease (CKD), the association of waist circumference with visceral fat was never tested. Study Design Cross-sectional study. Setting & Participants 122 patients with CKD not yet on dialysis therapy (75 men; diabetes mellitus, 30%; age, 55.3 ± 11.3 years; body mass index, 27.1 ± 5.2 kg/m2 ; estimated glomerular filtration rate, 35.4 ± 15.2 mL/min/1.73 m2 ) were studied. Predictor Waist circumference. Outcomes & Measurements Anthropometry, abdominal visceral fat measured by means of computed tomography, and cardiovascular disease risk factors. Results Waist circumference strongly correlated with visceral fat ( r = 0.75 for men, r = 0.81 for women; P < 0.01). κ Statistic was 0.56, indicating relatively good agreement between methods. Body mass index showed a lower correlation coefficient ( r = 0.68 for men, r = 0.76 for women; P < 0.01) and poor agreement (0.36) with visceral fat in comparison to waist circumference. In men, waist circumference and visceral fat similarly correlated with high-density lipoprotein cholesterol level, triacylglycerol level, and Homeostasis Model Assessment Index ( P < 0.05). In women, waist circumference correlated with age, C-reactive protein level, and Homeostasis Model Assessment Index, whereas visceral fat also correlated with low-density lipoprotein cholesterol and triacylglycerol levels ( P < 0.05). Limitations Findings are restricted to patients with CKD not yet on dialysis therapy from a single center. Conclusions Waist circumference was strongly associated with visceral fat in patients with CKD. Associations between waist circumference and cardiovascular disease risk factors were similar to those observed for visceral fat, particularly in men. These findings suggest that waist circumference may be a simple and inexpensive tool to be used in epidemiological studies.