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Cross-sectional associations between central and general adiposity with albuminuria: observations from 400,000 people in UK Biobank

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...

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Autores principales: Zhu, Pengfei, Lewington, Sarah, Haynes, Richard, Emberson, Jonathan, Landray, Martin J., Cherney, David, Woodward, Mark, Baigent, Colin, Herrington, William G., Staplin, Natalie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7577847/
https://www.ncbi.nlm.nih.gov/pubmed/32678323
http://dx.doi.org/10.1038/s41366-020-0642-3
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author Zhu, Pengfei
Lewington, Sarah
Haynes, Richard
Emberson, Jonathan
Landray, Martin J.
Cherney, David
Woodward, Mark
Baigent, Colin
Herrington, William G.
Staplin, Natalie
author_facet Zhu, Pengfei
Lewington, Sarah
Haynes, Richard
Emberson, Jonathan
Landray, Martin J.
Cherney, David
Woodward, Mark
Baigent, Colin
Herrington, William G.
Staplin, Natalie
author_sort Zhu, Pengfei
collection PubMed
description 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.
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spelling pubmed-75778472020-11-02 Cross-sectional associations between central and general adiposity with albuminuria: observations from 400,000 people in UK Biobank Zhu, Pengfei Lewington, Sarah Haynes, Richard Emberson, Jonathan Landray, Martin J. Cherney, David Woodward, Mark Baigent, Colin Herrington, William G. Staplin, Natalie Int J Obes (Lond) Article 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. Nature Publishing Group UK 2020-07-16 2020 /pmc/articles/PMC7577847/ /pubmed/32678323 http://dx.doi.org/10.1038/s41366-020-0642-3 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Zhu, Pengfei
Lewington, Sarah
Haynes, Richard
Emberson, Jonathan
Landray, Martin J.
Cherney, David
Woodward, Mark
Baigent, Colin
Herrington, William G.
Staplin, Natalie
Cross-sectional associations between central and general adiposity with albuminuria: observations from 400,000 people in UK Biobank
title Cross-sectional associations between central and general adiposity with albuminuria: observations from 400,000 people in UK Biobank
title_full Cross-sectional associations between central and general adiposity with albuminuria: observations from 400,000 people in UK Biobank
title_fullStr Cross-sectional associations between central and general adiposity with albuminuria: observations from 400,000 people in UK Biobank
title_full_unstemmed Cross-sectional associations between central and general adiposity with albuminuria: observations from 400,000 people in UK Biobank
title_short Cross-sectional associations between central and general adiposity with albuminuria: observations from 400,000 people in UK Biobank
title_sort cross-sectional associations between central and general adiposity with albuminuria: observations from 400,000 people in uk biobank
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7577847/
https://www.ncbi.nlm.nih.gov/pubmed/32678323
http://dx.doi.org/10.1038/s41366-020-0642-3
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