Skip to main content
SpringerLink
Log in

Associations between metabolic profiles and incident CKD in the Chinese population aged 45–85 years

  • Nephrology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Purpose

The roles of metabolic indices in predicting chronic kidney disease (CKD) were lacking. This study aimed to examine the concomitant impact of metabolic and novel anthropometric indices on incident CKD in the Chinese populations.

Methods

This prospective cohort study included 1825 males and 2218 females aged between 45 and 85 years, derived from the ongoing prospectively cohort of China Health and Retirement Longitudinal Study (CHARLS), from 2011 to 2015. The outcome was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2.

Results

During the 5-years follow-up period, 3.0% (55/1825) of males and 4.1% (90/2218) of the females developed CKD. After multivariable adjustment, elevated triglyceride (TG), low high-density lipoprotein cholesterol (HDL-C), serum uric acid (sUA), elevated visceral fat index (VFI), elevated body shape index (BSI) and elevated body roundness index (BRI) in males, and sUA, and BRI in females were the independent predictors for CKD. Composite scores, composed of sUA, history of cardiovascular disease (CVD), waist circumstance (WC), HDL-C, and BRI in males and sUA, hypertension, and BRI in females were constructed that could accurately predict CKD.

Conclusion

Our study found that elevated levels of TG, sUA, BSI, BRI, and diminished HDL in males and elevated levels of sUA, and BRI in females, are indicative of the incident CKD. The composite score, integrating a history of disease, metabolic indices, and noval anthropometric indices, could accurately differentiate individuals with and without incident CKD, proving useful for CKD care and management.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data Availability

The data underlying this article will be shared on reasonable request to the corresponding author.

References

  1. Jha V, Garcia-Garcia G, Iseki K, Li Z, Naicker S, Plattner B, Saran R, Wang AY, Yang CW (2013) Chronic kidney disease: global dimension and perspectives. Lancet 382(9888):260–272. https://doi.org/10.1016/S0140-6736(13)60687-X

    Article  PubMed  Google Scholar 

  2. Huh JH, Yadav D, Kim JS, Son JW, Choi E, Kim SH, Shin C, Sung KC, Kim JY (2017) An association of metabolic syndrome and chronic kidney disease from a 10-year prospective cohort study. Metabolism 67:54–61. https://doi.org/10.1016/j.metabol.2016.11.003

    Article  CAS  PubMed  Google Scholar 

  3. Wang F, He K, Wang J et al (2018) Prevalence and risk factors for CKD: a comparison between the adult populations in China and the United States. Kidney Int Rep 3(5):1135–1143. https://doi.org/10.1016/j.ekir.2018.05.011

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Li Y, Ning Y, Shen Bo, Shi Y, Song N, Fang Yi, Ding X, Temporal trends in prevalence and mortality for chronic kidney disease in China from, et al (1990) to 2019: an analysis for the Global Burden of Disease Study 2019. Clin kKdney J. https://doi.org/10.1093/ckj/sfac218

    Article  Google Scholar 

  5. Oluwo O, Scialla JJ (2021) Uric Acid and CKD Progression Matures with Lessons for CKD Risk Factor Discovery. Clin J Am Soc Nephrol 16(3):476–478. https://doi.org/10.2215/CJN.10650620

    Article  CAS  PubMed  Google Scholar 

  6. Srivastava A, Kaze AD, McMullan CJ, Isakova T, Waikar SS (2018) Uric Acid and the Risks of Kidney Failure and Death in Individuals With CKD. Am J Kidney Dis 71(3):362–370. https://doi.org/10.1053/j.ajkd.2017.08.017

    Article  CAS  PubMed  Google Scholar 

  7. Wu N, Qin Y, Chen S, Yu C, Xu Y, Zhao J, Yang X, Li N, Pan XF (2021) Association between metabolic syndrome and incident chronic kidney disease among Chinese: A nation-wide cohort study and updated meta-analysis. Diabetes Metab Res Rev 37(7):e3437. https://doi.org/10.1002/dmrr.3437

    Article  CAS  PubMed  Google Scholar 

  8. Yan P, Xu Y, Miao Y, Tang Q, Wu Y, Bai X, Zhang Z, Li Q, Wan Q (2021) Association of lipid accumulation product with chronic kidney disease in Chinese community adults: a report from the REACTION study. Lipids Health Dis 20(1):131. https://doi.org/10.1186/s12944-021-01569-8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Huang J, Zhou C, Li Y, Zhu S, Liu A, Shao X, Liu X, Holthfer H, Zou H (2015) Visceral adiposity index, hypertriglyceridemic waist phenotype and chronic kidney disease in a southern Chinese population: a cross-sectional study. Int Urol Nephrol 47(8):1387–1396. https://doi.org/10.1007/s11255-015-1040-y

    Article  CAS  PubMed  Google Scholar 

  10. Dong Y, Wang Z, Chen Z, Wang X, Zhang L, Nie J, Zheng C, Wang J, Shao L, Tian Y, Gao R (2018) Comparison of visceral, body fat indices and anthropometric measures in relation to chronic kidney disease among Chinese adults from a large scale cross-sectional study. BMC Nephrol 19(1):40. https://doi.org/10.1186/s12882-018-0837-1

    Article  PubMed  PubMed Central  Google Scholar 

  11. Zhao Y, Hu Y, Smith JP, Strauss J, Yang G (2014) Cohort profile: the China Health and Retirement Longitudinal Study (CHARLS). Int J Epidemiol 43(1):61–68. https://doi.org/10.1093/ije/dys203

    Article  PubMed  Google Scholar 

  12. Nishida C, Ko GT, Kumanyika S (2010) Body fat distribution and noncommunicable diseases in populations: overview of the 2008 WHO Expert Consultation on Waist Circumference and Waist-Hip Ratio. Eur J Clin Nutr 64(1):2–5. https://doi.org/10.1038/ejcn.2009.139

    Article  CAS  PubMed  Google Scholar 

  13. Liu LS. Writing Group of 2010 Chinese Guidelines for the Management of Hypertension. [2010 Chinese guidelines for the management of hypertension]. Zhonghua Xin Xue Guan Bing Za Zhi. 2011, 39(7):579–615.

  14. Diabetes branch of Chinese Medical Association. Guidelines for the prevention and treatment of type 2 diabetes in China (2013 Edition). Chinese Journal of Endocrinology and metabolism 2014, 30(10): 893–942.

  15. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001; 285(19): 2486–97. doi: https://doi.org/10.1001/jama.285.19.2486.

  16. Krakauer NY, Krakauer JC (2012) A new body shape index predicts mortality hazard independently of body mass index. PLoS ONE 7(7):e39504. https://doi.org/10.1371/journal.pone.0039504

    Article  ADS  CAS  PubMed  PubMed Central  Google Scholar 

  17. Thomas DM, Bredlau C, Bosy-Westphal A, Mueller M, Shen W, Gallagher D, Maeda Y, McDougall A, Peterson CM, Ravussin E, Heymsfield SB (2013) Relationships between body roundness with body fat and visceral adipose tissue emerging from a new geometrical model. Obesity (Silver Spring) 21(11):2264–2271. https://doi.org/10.1002/oby.20408

    Article  PubMed  Google Scholar 

  18. Adejumo EN, Adejumo AO, Azenabor A, Ekun AO, Enitan SS, Adebola OK, Ogundahunsi OA (2019) Anthropometric parameter that best predict metabolic syndrome in South west Nigeria. Diabetes Metab Syndr 13(1):48–54. https://doi.org/10.1016/j.dsx.2018.08.009

    Article  PubMed  Google Scholar 

  19. Inker LA, Schmid CH, Tighiouart H, Eckfeldt JH, Feldman HI, Greene T, Kusek JW, Manzi J, Van Lente F, Zhang YL, Coresh J, Levey AS; CKD-EPI Investigators. Estimating glomerular filtration rate from serum creatinine and cystatin C. N Engl J Med 2012; 367(1): 20–9. doi: https://doi.org/10.1056/NEJMoa1114248.

  20. Stevens PE, Levin A. Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med 2013; 158(11): 825–30. doi: https://doi.org/10.7326/0003-4819-158-11-201306040-00007.

  21. Duan JW, Li YL, Li SX, Yang YP, Li F, Li Y, Wang J, Deng PZ, Wu JJ, Wang W, Meng CJ, Miao RJ, Chen ZH, Zou B, Yuan H, Cai JJ, Lu Y. Association of Long-term Ambient Fine Particulate Matter (PM2.5) and Incident CKD: A Prospective Cohort Study in China. Am J Kidney Dis 2022: S0272–6386(22)00623–0. doi: https://doi.org/10.1053/j.ajkd.2022.03.009.

  22. Wu M, Shu Y, Wang L, Song L, Chen S, Liu Y, Bi J, Li D, Yang Y, Hu Y, Wang Y, Wu S, Tian Y (2022) Metabolic syndrome severity score and the progression of CKD. Eur J Clin Invest 52(1):e13646. https://doi.org/10.1111/eci.13646

    Article  CAS  PubMed  Google Scholar 

  23. Lin L, Tan W, Pan X, Tian E, Wu Z, Yang J (2022) Metabolic Syndrome-Related Kidney Injury: A Review and Update. Front Endocrinol (Lausanne) 13:904001. https://doi.org/10.3389/fendo.2022.904001

    Article  PubMed  Google Scholar 

  24. Wisse BE (2004) The inflammatory syndrome: the role of adipose tissue cytokines in metabolic disorders linked to obesity. J Am Soc Nephrol 15(11):2792–2800. https://doi.org/10.1097/01.ASN.0000141966.69934.21

    Article  CAS  PubMed  Google Scholar 

  25. Muntner P, Coresh J, Smith JC, Eckfeldt J, Klag MJ (2000) Plasma lipids and risk of developing renal dysfunction: the atherosclerosis risk in communities study. Kidney Int 58(1):293–301. https://doi.org/10.1046/j.1523-1755.2000.00165.x

    Article  CAS  PubMed  Google Scholar 

  26. Yang S, Cao C, Deng T, Zhou Z (2020) Obesity-Related Glomerulopathy: A Latent Change in Obesity Requiring More Attention. Kidney Blood Press Res 45(4):510–522. https://doi.org/10.1159/000507784

    Article  CAS  PubMed  Google Scholar 

  27. Li L, Yang C, Zhao Y, Zeng X, Liu F, Fu P (2014) Is hyperuricemia an independent risk factor for new-onset chronic kidney disease?: A systematic review and meta-analysis based on observational cohort studies. BMC Nephrol 15:122. https://doi.org/10.1186/1471-2369-15-122

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Li Y, He Y, Yang L, Liu Q, Li C, Wang Y, Yang P, Wang J, Chen Z, Huang X (2022) Body Roundness Index and Waist-Hip Ratio Result in Better Cardiovascular Disease Risk Stratification: Results From a Large Chinese Cross-Sectional Study. Front Nutr 9:801582. https://doi.org/10.3389/fnut.2022.801582

    Article  PubMed  PubMed Central  Google Scholar 

  29. Chang Y, Guo X, Chen Y, Guo L, Li Z, Yu S, Yang H, Sun Y (2015) A body shape index and body roundness index: two new body indices to identify diabetes mellitus among rural populations in northeast China. BMC Public Health 15:794. https://doi.org/10.1186/s12889-015-2150-2

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Kawarazaki W, Fujita T (2021) Kidney and epigenetic mechanisms of salt-sensitive hypertension. Nat Rev Nephrol 17(5):350–363. https://doi.org/10.1038/s41581-021-00399-2

    Article  CAS  PubMed  Google Scholar 

  31. Cho KH, Kang DJ, Nam HS, Kim JH, Kim SY, Lee JO, Kim BJ (2021) Ozonated sunflower oil exerted protective effect for embryo and cell survival via potent reduction power and antioxidant activity in hdl with strong antimicrobial activity. Antioxidants (Basel) 10(11):1651. https://doi.org/10.3390/antiox10111651

    Article  CAS  PubMed  Google Scholar 

  32. Chen JS, Wang MX, Wang MM, Zhang YK, Guo X, Chen YY, Zhang MQ, Sun JY, Liu YF, Liu C (2022) Synthesis and biological evaluation of geniposide derivatives as inhibitors of hyperuricemia, inflammatory and fibrosis. Eur J Med Chem 237:114379. https://doi.org/10.1016/j.ejmech.2022.114379

    Article  CAS  PubMed  Google Scholar 

  33. Wang F, He K, Wang J, Zhao MH, Li Y, Zhang L, Saran R, Bragg-Gresham JL (2018) Prevalence and Risk Factors for CKD: A Comparison Between the Adult Populations in China and the United States. Kidney Int Rep 3(5):1135–1143. https://doi.org/10.1016/j.ekir.2018.05.011

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Yang C, Wang H, Zhao X, Matsushita K, Coresh J, Zhang L, Zhao MH (2020) CKD in China: Evolving Spectrum and Public Health Implications. Am J Kidney Dis 76(2):258–264. https://doi.org/10.1053/j.ajkd.2019.05.032. (Epub 2019 Sep 3)

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank the CHARLS team for their hard work and unselfish sharing of survey data.

Funding

Apart from the original grants to the CHARLS, this study was sponsored by the Natural Science Foundation of Shanghai (21ZR1412400), Shanghai Key Laboratory of Kidney and Blood Purification (14DZ2260200), Shanghai Science and Technology Commission (18411960800), Shanghai Municipal Key Clinical Specialty (shslczdzk02501), Shanghai Three-year Action Plan to Strengthen the Public Health System (GWVI-11.2-YQ10), and Youth Fund of Zhongshan Hospital (2022ZSQN10).

Author information

Authors and Affiliations

  1. Department of Nephrology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, Shanghai, 200032, China

    Bowen Zhu, Yiqin Shi, Nana Song, Shuan Zhao, Bo Shen, Jialin Wang, Weidong Zhang, Yufei Lu, Yi Fang, Xiaoqiang Ding & Yang Li

  2. Shanghai Medical Center of Kidney, Shanghai, China

    Bowen Zhu, Yiqin Shi, Nana Song, Shuan Zhao, Bo Shen, Jialin Wang, Weidong Zhang, Yufei Lu, Yi Fang, Xiaoqiang Ding & Yang Li

  3. Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China

    Bowen Zhu, Yiqin Shi, Nana Song, Shuan Zhao, Bo Shen, Jialin Wang, Weidong Zhang, Yufei Lu, Yi Fang, Xiaoqiang Ding & Yang Li

Authors
  1. Bowen Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yiqin Shi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nana Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shuan Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Bo Shen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jialin Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Weidong Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yufei Lu
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yi Fang
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Xiaoqiang Ding
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Yang Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

BZ and YL contributed to the conception or design of the work. YS, NS, SZ and BS contributed to the acquisition, analysis, or interpretation of data for the work. BZ and YL drafted the manuscript. XD and YL critically revised the manuscript. YF, JW, and WZ contribute to analysis, or interpretation of the work. All gave final approval and agree to be accountable for all aspects of work ensuring integrity and accuracy.

Corresponding authors

Correspondence to Xiaoqiang Ding or Yang Li.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 1548 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhu, B., Shi, Y., Song, N. et al. Associations between metabolic profiles and incident CKD in the Chinese population aged 45–85 years. Int Urol Nephrol (2024). https://doi.org/10.1007/s11255-023-03916-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11255-023-03916-3

Keywords

Search

Navigation