Risk of CKD in MHO Phenotype Patients

Clinical Journal of the American Society of Nephrology. 2015;10(4):578-583.

In a recent study conducted by Yoshitaka Hashimoto, MD, and colleagues, there was no association between metabolically healthy obesity (MHO) and increased risk of incident chronic kidney disease (CKD).

MHO is an obesity phenotype that appears to people from the metabolic complications of obesity. Any association between MHO phenotype and incident CKD is not known. The researchers designed this 8-year follow-up cohort study to assess the association between the MHO phenotype and incident CKD.

The 2001 study included 3136 Japanese participants. Common clinical markers, including blood pressure, triglycerides, high-density lipoprotein (HDL) cholesterol, and fasting plasma glucose concentrations were used to assess metabolically healthy status. Obesity was defined as body mass index ≥25.0 kg/m2. CKD was defined by proteinuria or estimated glomerular filtration rate of <60 m:/min/1.73 m2. Logistic regression analyses were performed to calculate the odds ratio for incident CKD.

In participants with the metabolically healthy nonobesity phenotype (n=2122), the crude incidence proportions of CKD were 2.6% (n=56); among participants with the MHP phenotype (n=445), the crude incidence proportions of CKD were 6.7% (n=30); in participants with the metabolically abnormal obesity phenotype (n=267), the crude incidence proportions of CKD were 10.9% (n=29).

Following adjustment for age, sex, smoking status, alcohol use, creatinine, uric acid, systolic blood pressure, HDL cholesterol, and impaired fasting glucose, and diabetes, compared with metabolically healthy nonobesity phenotype, the odds ratios for incident CKD were 0.83 (95% confidence interval [CI], 0.36-1.72; P=.64) for MHO; 1.44 (95% CI, 0.80-2.57; P=.22) for metabolically abnormal obesity; and 2.80 (95% CI, 1./45-5.35; P=.02) for metabolically abnormal obesity.