| Title: | Cross-sectional associations between central and general adiposity with albuminuria: observations from 400,000 people in UK Biobank |
| Journal: | International Journal of Obesity |
| Published: | 16 Jul 2020 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/32678323/ |
| DOI: | https://doi.org/10.1038/s41366-020-0642-3 |
| URL: | https://www.nature.com/articles/s41366-020-0642-3.pdf |
| Citations: | 10 (6 in last 2 years) as of 8 Aug 2024 |
Publication 4622
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Abstract
BackgroundWhether measures of central adiposity are more or less strongly associated with risk of albuminuria than body mass index (BMI), and by how much diabetes/levels of glycosylated haemoglobin (HbA1c) explain or modify these associations, is uncertain.MethodsOrdinal logistic regression was used to estimate associations between values of central adiposity (waist-to-hip ratio) and, separately, general adiposity (BMI) with categories of urinary albumin-to-creatinine ratio (uACR) in 408,527 UK Biobank participants. Separate central and general adiposity-based models were initially adjusted for potential confounders and measurement error, then sequentially, models were mutually adjusted (e.g. waist-to-hip ratio adjusted for BMI, and vice versa), and finally they were adjusted for potential mediators.ResultsLevels of albuminuria were generally low: 20,425 (5%) had a uACR ≥3 mg/mmol. After adjustment for confounders and measurement error, each 0.06 higher waist-to-hip ratio was associated with a 55% (95%CI 53-57%) increase in the odds of being in a higher uACR category. After adjustment for baseline BMI, this association was reduced to 32% (30-34%). Each 5 kg/m2 higher BMI was associated with a 47% (46-49%) increase in the odds of being in a higher uACR category. Adjustment for baseline waist-to-hip ratio reduced this association to 35% (33-37%). Those with higher HbA1c were at progressively higher odds of albuminuria, but positive associations between both waist-to-hip ratio and BMI were apparent irrespective of HbA1c. Altogether, about 40% of central adiposity associations appeared to be mediated by diabetes, vascular disease and blood pressure.ConclusionsConventional epidemiological approaches suggest that higher waist-to-hip ratio and BMI are independently positively associated with albuminuria. Adiposity-albuminuria associations appear strong among people with normal HbA1c, as well as people with pre-diabetes or diabetes.</p>
10 Authors
- Pengfei Zhu
- Sarah Lewington
- Richard Haynes
- Jonathan Emberson
- Martin J. Landray
- David Cherney
- Mark Woodward
- Colin Baigent
- William G. Herrington
- Natalie Staplin
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