Cross-sectional associations between central and general adiposity with albuminuria: observations from 400,000 people in UK Biobank
| Autor: | Pengfei Zhu, Sarah Lewington, Natalie Staplin, Jonathan Emberson, David Z.I. Cherney, William G. Herrington, Colin Baigent, Mark Woodward, Martin J Landray, Richard Haynes |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Epidemiology Endocrinology Diabetes and Metabolism Medicine (miscellaneous) Blood Pressure 030204 cardiovascular system & hematology Article Odds Body Mass Index 03 medical and health sciences 0302 clinical medicine Diabetes mellitus medicine Diabetes Mellitus Albuminuria Humans 030212 general & internal medicine Prospective Studies Adiposity Biological Specimen Banks Glycated Hemoglobin Nutrition and Dietetics business.industry Waist-Hip Ratio Confounding nutritional and metabolic diseases Middle Aged medicine.disease United Kingdom Blood pressure Cross-Sectional Studies Risk factors Obesity Abdominal Female Ordered logit medicine.symptom business Body mass index Demography |
| Zdroj: | International Journal of Obesity (2005) |
| ISSN: | 1476-5497 0307-0565 |
| Popis: | Background Whether 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. Methods Ordinal 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. Results Levels 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. Conclusions Conventional 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. |
| Databáze: | OpenAIRE |
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