Chang Seong Kim, Tae Ryom Oh, Sang Heon Suh, Hong Sang Choi, Eun Hui Bae, Seong Kwon Ma, Bongseong Kim, Kyung-Do Han, Soo Wan Kim
{"title":"终末期肾病的超重状况和发展：一项全国性的基于人群的研究。","authors":"Chang Seong Kim, Tae Ryom Oh, Sang Heon Suh, Hong Sang Choi, Eun Hui Bae, Seong Kwon Ma, Bongseong Kim, Kyung-Do Han, Soo Wan Kim","doi":"10.1002/jcsm.13297","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Underweight status increases the risk of cardiovascular disease and mortality in the general population. However, whether underweight status is associated with an increased risk of developing end-stage kidney disease is unknown.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A total of 9 845 420 participants aged ≥20 years who underwent health checkups were identified from the Korean National Health Insurance Service database and analysed. Individuals with underweight (body mass index [BMI] < 18.5 kg/m<sup>2</sup>) and obesity (BMI ≥ 25 kg/m<sup>2</sup>) were categorized according to the World Health Organization recommendations for Asian populations.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>During a mean follow-up period of 9.2 ± 1.1 years, 26 406 participants were diagnosed with end-stage kidney disease. After fully adjusting for other potential predictors, the moderate to severe underweight group (<17 kg/m<sup>2</sup>) had a significantly higher risk of end-stage kidney disease than that of the reference (normal) weight group (adjusted hazard ratio, 1.563; 95% confidence interval, 1.337–1.828), and competing risk analysis to address the competing risk of death also showed the similar results (adjusted hazard ratio, 1.228; 95% confidence interval, 1.042–1.448). Compared with that of the reference BMI group (24–25 kg/m<sup>2</sup>), the adjusted hazard ratios for end-stage kidney disease increased as the BMI decreased by 1 kg/m<sup>2</sup>. In the sensitivity analysis, sustained underweight status or progression to underweight status over two repeated health checkups, when compared with normal weight status, had a higher hazard ratio for end-stage kidney disease.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Underweight status is associated with an increased risk of end-stage kidney disease, and this association gradually strengthens as BMI decreases.</p>\n </section>\n </div>","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"14 5","pages":"2184-2195"},"PeriodicalIF":8.9000,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcsm.13297","citationCount":"0","resultStr":"{\"title\":\"Underweight status and development of end-stage kidney disease: A nationwide population-based study\",\"authors\":\"Chang Seong Kim, Tae Ryom Oh, Sang Heon Suh, Hong Sang Choi, Eun Hui Bae, Seong Kwon Ma, Bongseong Kim, Kyung-Do Han, Soo Wan Kim\",\"doi\":\"10.1002/jcsm.13297\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Underweight status increases the risk of cardiovascular disease and mortality in the general population. However, whether underweight status is associated with an increased risk of developing end-stage kidney disease is unknown.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A total of 9 845 420 participants aged ≥20 years who underwent health checkups were identified from the Korean National Health Insurance Service database and analysed. Individuals with underweight (body mass index [BMI] < 18.5 kg/m<sup>2</sup>) and obesity (BMI ≥ 25 kg/m<sup>2</sup>) were categorized according to the World Health Organization recommendations for Asian populations.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>During a mean follow-up period of 9.2 ± 1.1 years, 26 406 participants were diagnosed with end-stage kidney disease. After fully adjusting for other potential predictors, the moderate to severe underweight group (<17 kg/m<sup>2</sup>) had a significantly higher risk of end-stage kidney disease than that of the reference (normal) weight group (adjusted hazard ratio, 1.563; 95% confidence interval, 1.337–1.828), and competing risk analysis to address the competing risk of death also showed the similar results (adjusted hazard ratio, 1.228; 95% confidence interval, 1.042–1.448). Compared with that of the reference BMI group (24–25 kg/m<sup>2</sup>), the adjusted hazard ratios for end-stage kidney disease increased as the BMI decreased by 1 kg/m<sup>2</sup>. 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Underweight status and development of end-stage kidney disease: A nationwide population-based study
Background
Underweight status increases the risk of cardiovascular disease and mortality in the general population. However, whether underweight status is associated with an increased risk of developing end-stage kidney disease is unknown.
Methods
A total of 9 845 420 participants aged ≥20 years who underwent health checkups were identified from the Korean National Health Insurance Service database and analysed. Individuals with underweight (body mass index [BMI] < 18.5 kg/m2) and obesity (BMI ≥ 25 kg/m2) were categorized according to the World Health Organization recommendations for Asian populations.
Results
During a mean follow-up period of 9.2 ± 1.1 years, 26 406 participants were diagnosed with end-stage kidney disease. After fully adjusting for other potential predictors, the moderate to severe underweight group (<17 kg/m2) had a significantly higher risk of end-stage kidney disease than that of the reference (normal) weight group (adjusted hazard ratio, 1.563; 95% confidence interval, 1.337–1.828), and competing risk analysis to address the competing risk of death also showed the similar results (adjusted hazard ratio, 1.228; 95% confidence interval, 1.042–1.448). Compared with that of the reference BMI group (24–25 kg/m2), the adjusted hazard ratios for end-stage kidney disease increased as the BMI decreased by 1 kg/m2. In the sensitivity analysis, sustained underweight status or progression to underweight status over two repeated health checkups, when compared with normal weight status, had a higher hazard ratio for end-stage kidney disease.
Conclusions
Underweight status is associated with an increased risk of end-stage kidney disease, and this association gradually strengthens as BMI decreases.
期刊介绍：
The Journal of Cachexia, Sarcopenia, and Muscle is a prestigious, peer-reviewed international publication committed to disseminating research and clinical insights pertaining to cachexia, sarcopenia, body composition, and the physiological and pathophysiological alterations occurring throughout the lifespan and in various illnesses across the spectrum of life sciences. This journal serves as a valuable resource for physicians, biochemists, biologists, dieticians, pharmacologists, and students alike.
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