Obesity Without Metabolic Abnormality and Incident CKD: A Population-Based British Cohort Study
Abstract
RATIONALE & OBJECTIVE
Metabolically healthy obesity (obesity without any metabolic abnormality) is considered not to be associated with increased risk of morbidity and mortality. We aimed to examine and quantify the association between metabolically healthy overweight/obesity and the risk of incident chronic kidney disease (CKD) in a British primary care population.
DESIGN
Retrospective population-based cohort study.
SETTING & PARTICIPANTS
4,447,955 of the 5,182,908 adults in The Health Improvement Network (THIN) database (United Kingdom, 1995-2015) with a recorded body mass index (BMI) at the time of registration date who were free of CKD and cardiovascular disease.
EXPOSURES
11 body size phenotypes were created, defined by body mass index categories (underweight, normal weight, overweight, and obesity) and 3 metabolic abnormalities (diabetes, hypertension, and dyslipidemia).
OUTCOMES
Incident CKD defined as a recorded diagnosis of kidney replacement therapy (KRT), a recorded diagnosis of CKD, or by an estimated glomerular filtration rate 3 mg/mmol for ≥90 days.
RESULTS
Of the 4.5 million individuals, 1,040,921 (23.4%) and 588,909 (13.2%) were metabolically healthy overweight and metabolically healthy obese, respectively. During a mean follow-up of 5.4 (SD 4.3) years, compared to individuals with metabolically healthy normal weight (n=1,656,231), those who had metabolically healthy overweight (adjusted HR = 1.30, 95% CI 1.28 to 1.33) and metabolically healthy obesity…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 5,182,908 participants or records.
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