Comparação do desempenho entre índices de adiposidade abdominal e global como discriminadores da doença renal crônica
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Publicado
Dec 27, 2023
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Resumo
Objetivo: Avaliar o desempenho dos índices de adiposidade - índice de massa corporal (IMC), circunferência da cintura (CC), razão cintura estatura (RCE) e a body shape index (ABSI) - para discriminação da doença renal crônica (DRC). Métodos: Estudo transversal realizado com dados obtidos da Pesquisa Nacional de Saúde 2013, considerando medidas laboratoriais e índices antropométricos aferidos. Dentre os parâmetros avaliados para testar o desempenho dos índices de adiposidade na discriminação da DRC (taxa de filtração glomerular < 60 ml/min/1,73 m²) estão áreas sob a curva (AUC) ROC com respectivos intervalos de confiança (IC 95%) e índices de Youden. As análises foram feitas na amostra total e estratificadas por sexo e faixa etária. Resultados: Os índices de adiposidade (IMC, CC, RCE e ABSI) mostraram poder discriminatório na aleatório para DRC na amostra total e quando estratificado por sexo e faixa etária, mas a RCE demonstrou melhor desempenho em relação a AUC em todas as análises (0,653 na amostra total, 0,663 no sexo masculino, 0,649 no sexo feminino, 0,606 nos adultos e 0,549 nos idosos). Conclusão: Este estudo demonstrou que os índices de adiposidade apresentam baixo poder discriminatório para DRC, embora significativo.
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Como Citar
CarvalhoW. do N., TonacoL. A. B., MoreiraA. D., & Velasquez-MelendezG. (2023). Comparação do desempenho entre índices de adiposidade abdominal e global como discriminadores da doença renal crônica. Revista Eletrônica Acervo Saúde, 23(12), e14721. https://doi.org/10.25248/reas.e14721.2023
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2. Betzler BK, et al. Association between Body Mass Index and Chronic Kidney Disease in Asian Populations: A Participant-level Meta-Analysis. Maturitas, 2021;154: 46 - 54.
3. BIKBOV B, et al. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 2020; 395 (10225): 709 - 733.
4. CAI H, et al. Body mass index combined with waist circumference can predict moderate chronic kidney disease: A retrospective study. Medicine, 2021; 100(12): 1 - 7.
5. CHANG Y, et al. Metabolically healthy obesity and development of chronic kidney disease: A cohort study. Annals of Internal Medicine, 2016; 164 (5) 305 - 312.
6. DONG Y, et al. 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 nephrology, 2018; 19 (1): 1 - 7.
7. DUONG TV, et al. Associations of Waist Circumference, Socioeconomic, Environmental, and Behavioral Factors with Chronic Kidney Disease in Normal Weight, Overweight, and Obese People. Int J Environ Res Public Heal, 2019; 16 (5093): 1 - 18.
8. FOREMAN KJ, et al. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016-40 for 195 countries and territories. Lancet, 2018; 392 (10159): 2052 - 2090.
9. GOUVEA E, et al. Self-report of medical diagnosis of chronic kidney disease: prevalence and characteristics in the Brazilian adult population, National Health Survey 2013 and 2019. Epidemiol. Serv. Saúde, 2022; 31 (1): 1 - 12.
10. HE Y, et al. Association Between Body Mass Index and Mildly Decreased Estimated Glomerular Filtration Rate in Chinese Adults With Early Chronic Kidney Disease. J Ren Nutr, 2016; 26 (6): 367 - 72.
11. HUNG C, et al. Association between Body Mass Index and Renal Outcomes Modified by Chronic Kidney Disease and Anemia: The Obesity Paradox for Renal Outcomes. J Clin Med, 2022; 11 (10): 1 - 13.
12. HUNLEY TE, et al. Scope and mechanisms of obesity-related renal disease. Current Opinion in Nephrology and Hypertension, 2010; 19 (3): 227- 234.
13. IBGE. Instituto Brasileiro de Geografia E Estatística. Pesquisa Nacional de Saúde 2013: acesso e utilização dos serviços de saúde, acidentes e violências: Brasil, Grandes Regiões e Unidades da Federação. Rio de Janeiro: IBGE; 2015.
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16. KOTSIS V, et al. Impact of Obesity in Kidney Diseases. Nutrients, 2021; 13 (12): 1 - 16.
17. KOVESDY CP, et al. Obesity and kidney disease: hidden consequences of the epidemic. Jornal Brasileiro de Nefrologia, 2017; 39 (1): 1 - 10.
18. KRAKAUER NY e KRAKAUER JC. A new body shape index predicts mortality hazard independently of body mass index. PLOS ONE, 2012; 7 (7): 1 - 10.
19. LAVIE CJ, et al. Obesity and Prevalence of Cardiovascular Diseases and Prognosis—The Obesity Paradox Updated. Progress in Cardiovascular Diseases, 2016; 58 (5): 537 - 547.
20. LEVEY AS, et al. A new equation to estimate glomerular filtration rate. Annals of Internal Medicine, 2009; 150 (9): 604 - 612.
21. LIU L, et al. Waist height ratio predicts chronic kidney disease: A systematic review and meta-analysis, 1998-2019. Archives of Public Health, 2019; 77 (1): 1 - 9.
22. MALTA DC, et al. Evaluation of renal function in the Brazilian adult population, according to laboratory criteria from the National Health Survey Avaliação da função renal na população adulta brasileira, segundo critérios laboratoriais da Pesquisa Nacional de Saúde. Rev Bras Epidemiol, 2019; 22 (2): 1 - 13.
23. MALTA D, et al. Underreporting of chronic kidney disease according to laboratory criteria of Brazilian adults. European Journal of Public Health, 2020; 30 (5): 953 - 954.
24. MOREIRA AD, et al. Association between Adiposity Indexes and Kidney Disease: Findings from the Longitudinal Study of Adult Health (Elsa-Brazil). Journal of the American Nutrition Association, 2021; 41 (3): 275 - 280.
25. ODAGIRI K, et al. Waist to Height Ratio Is an Independent Predictor for the Incidence of Chronic Kidney Disease. PLOS ONE, 2014; 9 (2): 1 – 9.
26. QIAN X, et al. Changes in distributions of waist circumference, waist-to-hip ratio and waist-to-height ratio over an 18-year period among Chinese adults: A longitudinal study using quantile regression. BMC Public Health, 2019; 19 (1):1 - 10.
27. RICO-MARTÍN S, et al. Effectiveness of body roundness index in predicting metabolic syndrome: A systematic review and meta-analysis. Obes Ver, 2020; 21 (7): 1 - 23.
28. SOUZA-JÚNIOR PRB, et al. Sampling Design for the National Health Survey, Brazil 2013. Epidemiol. Serv. Saúde, 2015; 24 (2): 207 - 216.
29. SILVA LESD, et al. Temporal trend of overweight and obesity prevalence among Brazilian adults, according to sociodemographic characteristics, 2006-2019. Epidemiologia e Serviços de Saúde, 2021; 30 (1): 1 - 12.
30. SONG Y, et al. Waist-hip ratio measured by bioelectrical impedance analysis as a valuable predictor of chronic kidney disease development. BMC nephrology, 2022; 23 (1): 1 - 9.
31. SZWARCWALD CL, et al. Laboratory exams of the National Health Survey: methodology of sampling, data collection and analysis. Revista Brasileira de Epidemiologia, 2019; 22 (2): 1 - 9.
32. TEUFEL F, et al. Body-mass index and diabetes risk in 57 low-income and middle-income countries: a cross-sectional study of nationally representative, individual-level data in 685 616 adults. The Lancet, 2021; 398 (10296): 238 - 248.
33. THETHI T, et al. The link between the renin-angiotensin-aldosterone system and renal injury in obesity and the metabolic syndrome. Current Hypertension Reports, 2012; 14 (2): 1 - 16.
34. VRIES APJ, et al. Fatty kidney: Emerging role of ectopic lipid in obesity-related renal disease. The Lancet Diabetes and Endocrinology, 2014; 2 (5): 417 - 26.
35. WORLD HEALTH ORGANIZATION. Physical status: the use of and interpretation of anthropometry, report of a WHO expert committee. Genebra: World Health Organization; 1995.
36. WORLD HEALTH ORGANIZATION. Waist Circumference and Waist-Hip Ratio Report of a WHO Expert Consultation. Geneva: World Health Organization, 2008.
37. XUE R, et al. Abdominal obesity and risk of CVD: a dose–response meta-analysis of thirty-one prospective studies. British Journal of Nutrition, 2021; 126 (9) 1420 - 1430.
38. YANG S, et al. Comparison of the Correlates Between Body Mass Index, Waist Circumference, Waist-to-Height Ratio, and Chronic Kidney Disease in a Rural Chinese Adult Population. Journal of Renal Nutrition, 2019; 29 (4): 302 - 309.
39. ZENG Q, et al. Optimal cut-off values of BMI, waist circumference and waist: height ratio for defining obesity in Chinese adults. Br J Nutr, 2014; 112 (10): 1735 - 44.