Sex Differences in Associations Among Obesity, Metabolic Abnormalities, and Chronic Kidney Disease in Japanese Men and Women

J Epidemiol. 2016 Aug 5;26(8):440-6. doi: 10.2188/jea.JE20150208. Epub 2016 Apr 16.

Abstract

Aims: The present study aimed to investigate relationships among abdominal obesity, metabolic abnormalities, and the prevalence of chronic kidney disease (CKD) in relatively lean Japanese men and women.

Participants and methods: The participants included 8133 men and 15 934 women between 40 and 75 years of age recruited from the government health check-up center in Kanazawa City, Japan. The prevalence of abdominal obesity, high blood pressure, dyslipidemia, and high fasting plasma glucose levels were assessed according to the Japanese criteria for metabolic syndrome. The estimated glomerular filtration rate (eGFR) was calculated using the modified Modification of Diet in Renal Disease equation for the Japanese population, and participants with an eGFR <60 mL/min/1.73 m(2) and/or proteinuria were diagnosed with CKD.

Results: Overall, 23% of males and 14% of females met criteria for CKD. Having more numerous complicated metabolic abnormalities was significantly associated with a higher odds ratio (OR) of CKD for men and women, irrespective of abdominal obesity. However, there was a sex difference in the OR of CKD for obese participants without metabolic abnormalities, such that abdominal obesity without metabolic abnormalities was significantly associated with a higher OR for men (multivariate-adjusted OR 1.63; 95% confidence interval [CI], 1.16-2.28) but not for women (OR 1.01; 95% CI, 0.71-1.44).

Conclusions: The present findings demonstrated that obesity without metabolic abnormalities was associated with a higher risk of CKD in men but not women in a relatively lean Japanese population.

目的:: 欧米人と比較し肥満の少ない日本人において、肥満・代謝異常と慢性腎臓病(CKD)との関連を横断的に検討し、その性差を明らかにすることを目的とした。

対象と方法:: 対象はK市の特定健診を受診した40-75歳の男性8,133名、女性15,934名。日本人のメタボリックシンドロームの判定基準を用いて腹部肥満および代謝異常(血圧高値、脂質異常、血糖高値)を判定した。日本人のGFR推算式により求めたeGFR低下(60 ml/min/1.73m2未満)またはタンパク尿陽性をCKDと判定した。ロジスティック回帰分析を用いて、各代謝異常の有無・合併数におけるCKD有病のオッズ比(OR)を求めた。

結果:: 男性の23%、女性の14%にCKDを認めた。男女とも、肥満の有無にかかわらず、代謝異常の合併数が増加するとCKD有病ORは上昇した。代謝異常のない肥満者のCKD有病には性差を認め、男性では肥満のみで有意なCKD有病リスクの増加を認め(多変量調整OR 1.63, 95%信頼区間1.16-2.28)、女性では肥満のみでは有意なCKDリスクの増加は認めなかった(OR 1.01, 95%信頼区間0.71-1.44)。

結論:: 代謝異常を合併しない肥満者において、男性ではCKD有病リスクが有意に高かったが、女性では有意な上昇は認めなかった。

MeSH terms

  • Adult
  • Aged
  • Female
  • Health Status Disparities*
  • Humans
  • Japan / epidemiology
  • Male
  • Metabolic Syndrome / epidemiology*
  • Middle Aged
  • Obesity / epidemiology*
  • Renal Insufficiency, Chronic / epidemiology*
  • Sex Distribution