Socioeconomic status and reduced kidney function in the Whitehall II Study: role of obesity and metabolic syndrome

Autor: Daniel R. Witte, Talal M. Al-Qaoud, Dorothea Nitsch, Eric J. Brunner, Jonathan C. K. Wells
Rok vydání: 2010
Předmět:
Male
obesity
estimated glomerular filtration rate
Cross-sectional study
030232 urology & nephrology
Comorbidity
lean body mass
Body Mass Index
Cohort Studies
Pathogenesis and Treatment of Kidney Disease
0302 clinical medicine
Medicine
030212 general & internal medicine
Original Investigation
2. Zero hunger
Metabolic Syndrome
education.field_of_study
Age Factors
Middle Aged
3. Good health
serum lipids
Nephrology
Obesity
Abdominal
Reduced kidney function
Female
Cohort study
Glomerular Filtration Rate
Adult
medicine.medical_specialty
Population
Renal function
socioeconomic status
03 medical and health sciences
Internal medicine
Humans
Renal Insufficiency
Chronic
education
Aged
Dyslipidemias
business.industry
Administrative Personnel
medicine.disease
Endocrinology
Cross-Sectional Studies
Social Class
Lean body mass
Metabolic syndrome
business
Body mass index
Kidney disease
Zdroj: American Journal of Kidney Diseases
ISSN: 1523-6838
0272-6386
Popis: Background Previous US-based studies have found that chronic kidney disease (CKD) disproportionately affects those of more adverse social circumstances. Our aim was to show the association between socioeconomic status (SES) and decreased kidney function in a European context and explore the role of obesity and metabolic syndrome. We consider the potential confounding effect of lean muscle mass. Study Design Cross-sectional. Setting & Participants White participants in the follow-up of the Whitehall II cohort: UK-based European population (age, 55-79 years; n=5,533), of whom 4,066 men (73%) and 1,467 women (27%) with complete data were analyzed. Predictors Self-reported occupational grade/salary range. Outcomes Estimated glomerular filtration rate (GFR) using the CKD-EPI (CKD Epidemiology Collaboration) equation. Measurements Body mass index (BMI), serum lipid levels, blood pressure, Tanita TBF-300 body composition analyzer, impedance-derived lean mass index (LMI). Results Participants in a lower compared with higher occupational grade were at increased odds of having decreased GFR (age- and sex-adjusted OR, 1.31; 95% CI, 1.12-1.53; P = 0.001). Socioeconomic disparity in LMI was evident in women, but not men. After further adjustment for BMI and components of metabolic syndrome, the odds of decreased GFR in whites with a lower compared with higher occupational grade was attenuated by 23.3% (OR, 1.23; 95% CI, 1.06-1.45; P = 0.008). Adjustment for LMI explained 15% of the association between SES and estimated GFR. Limitations Cross-sectional design, missing data for subset of participants, no urinary data. Conclusions BMI and components of metabolic syndrome may explain up to a quarter of the association between low SES and decreased GFR, suggesting potential modifiable factors.
Databáze: OpenAIRE
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