Key result
Higher waist-to-hip ratio was independently associated with albuminuria, with each 0.06 higher waist-to-hip ratio increasing the odds of being in a higher uACR category by 55%.
Why the study?
It was uncertain whether central adiposity is more or less strongly associated with albuminuria risk than BMI, and how much diabetes or HbA1c levels explain or modify these associations.
Does higher central and general adiposity increase the odds of albuminuria in a general adult population?
Cross-Sectional (n=408,527)
Yes
Does higher central and general adiposity increase the odds of albuminuria in a general adult population?
Odds Ratio: 1.55 (95% CI 1.53–1.57)
p-value: p=<0.0001
Higher central and general adiposity are independently associated with increased odds of albuminuria, irrespective of diabetes status.
Supports adiposity assessment in albuminuria evaluation; leaves open causal effects and intervention benefits in prospective studies.
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/m 2 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.
No takes yet. Share an insight, caveat, or question.
Zhu et al. (2020) conducted a cross-sectional in Albuminuria (n=408,527). Central adiposity (waist-to-hip ratio) vs. Lower categories of waist-to-hip ratio was evaluated on Higher urinary albumin-to-creatinine ratio (uACR) category (OR 1.55, 95% CI 1.53-1.57, p=<0.0001). Higher waist-to-hip ratio was independently associated with albuminuria, with each 0.06 higher waist-to-hip ratio increasing the odds of being in a higher uACR category by 55%.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: