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Study assesses obesity-associated CKD risk among African Americans
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Metabolic factors could be fundamental determinants of obesity-associated chronic kidney disease risk in African Americans, according to a study in Nephrology Dialysis Transplantation. Specifically, greater risks were associated with metabolically active visceral adipose and interactions with dietary quality.
Researchers evaluated interactions between obesity and candidate factors in 2,043 African Americans without baseline kidney disease and who were enrolled in the Jackson Heart Study. Obesity was quantified by BMI, sex-normalized waist circumference and visceral adipose.
“In our prospective study of obesity and synergistic risk factors for CKD in African Americans, we found that greater visceral adiposity, assessed by abdominal CT, was associated with an increased risk of incident CKD,” the researchers wrote. “However, this elevated risk was evident only among those with poor dietary quality.”
It was noted that poor dietary quality was prevalent across all levels of adiposity. Poor dietary quality ranged from 45.9% to 55% by tertile of visceral adipose volume. Dietary quality did not account for a difference in associations of BMI and waist circumference with incident CKD. However, the researchers wrote: “dietary quality modified the association of visceral adiposity with incident CKD such that greater visceral adiposity was associated with higher incident CKD risk among patients with poor diet but not intermediate or ideal diet.”
From 2000 to 2004, the Jackson Heart Study enrolled African Americans from the Jackson, Mississippi area who had two subsequent follow-up visits: one exam between 2005 and 2008 and another exam between 2009 and 2013. Researchers discovered after a median of 8 years, incident CKD was not associated with baseline BMI and waist circumference; however, greater visceral adipose volume was independently associated with incident CKD in a nonlinear fashion but was limited to patients with lower dietary quality.
“In additional interaction models, higher waist circumference was associated with greater risk of incident CKD among those with the low-risk APOL1 genotype but not with a high-risk genotype,” the researchers wrote. “Other proposed factors did not modify obesity-CKD associations.” – by Jake Scott
Disclosures: The authors report no relevant financial disclosures.
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