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タイトル: | Body mass index change and estimated glomerular filtration rate decline in a middle-aged population: health check-based cohort in Japan |
著者: | Fukuma, Shingo ![]() ![]() Ikenoue, Tatsuyoshi Bragg-Gresham, Jennifer Norton, Edward Yamada, Yukari ![]() ![]() ![]() Kohmoto, Daichi Saran, Rajiv |
著者名の別形: | 福間, 真悟 池之上, 辰義 山田, ゆかり 河本, 大知 |
発行日: | Aug-2020 |
出版者: | BMJ |
誌名: | BMJ Open |
巻: | 10 |
号: | 9 |
論文番号: | e037247 |
抄録: | Background: Obesity is a growing public health problem worldwide. We evaluated the mediators and association between changes in obesity metrics and renal outcomes in the general population. Methods: Using the Japanese nationwide health check-based cohort from April 2011 to March 2019, we selected individuals aged 40–74 years, with a baseline estimated glomerular filtration rate (eGFR) ≥45 mL/min/1.73 m2, whose body mass index (BMI) change was assessed. The primary outcome was combined 30% decline in eGFR, eGFR <15 mL/min/1.73 m2 and end-stage renal disease. Results: During 245 147 person-years’ follow-up among 50 604 participants (mean eGFR, 83.7 mL/min/1.73 m2; mean BMI, 24.1 kg/m2), 645 demonstrated eGFR decline (incidence rate 2.6/1000 person-years, 95% CI: 2.4 to 2.8). We observed continued initial changes in BMI for over 6 years and a U-shaped association between BMI change and eGFR decline. Compared with 0% change in BMI, adjusted HRs for changes of −10%, −4%, 4% and 10% were 1.53 (95% CI: 1.15 to 2.04), 1.14 (95% CI: 1.01 to 1.30), 1.16 (95% CI: 1.02 to 1.32) and 1.87 (95% CI: 1.25 to 2.80), respectively. The percentage of excess risk of BMI increase (>4%) mediated by three risk factors (blood pressure, haemoglobin A1c and total cholesterol), was 13.3%. Conclusion: In the middle-aged Japanese population, both, increase and decrease in BMI were associated with subsequent eGFR decline. Changes in risk factors mediated a small proportion of the association between BMI increase and eGFR decline. Our findings support the clinical significance of monitoring BMI as a renal risk factor. |
著作権等: | © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
URI: | http://hdl.handle.net/2433/255276 |
DOI(出版社版): | 10.1136/bmjopen-2020-037247 |
PubMed ID: | 32895282 |
出現コレクション: | 学術雑誌掲載論文等 |

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