책임저자

유승호 교수

(의과대학 직업환경의학과, SAIHST겸직)

Eliseo Guallar 교수

(존스홉킨스대 보건대학원, SAIHST초빙교수)

 제1저자





장유수 교수

(의과대학 직업환경의학과, SAIHST겸직)

 

Impact Factor ('14) = 17.81

Ann Intern Med. 2016 Mar 1;164(5):305-12. doi: 10.7326/M15-1323. Epub 2016 Feb 9.

Metabolically Healthy Obesity and Development of Chronic Kidney Disease: A Cohort Study.

Chang Y, Ryu S, Choi Y, Zhang Y, Cho J, Kwon MJ, Hyun YY, Lee KB, Kim H, Jung HS, Yun KE, Ahn J, Rampal S, Zhao D, Suh BS, Chung EC, Shin H, Pastor-Barriuso R, Guallar E.

 

Abstract

BACKGROUND:

The risk for chronic kidney disease (CKD) among obese persons without obesity-related metabolic abnormalities, called metabolically healthy obesity, is largely unexplored.

OBJECTIVE:

To investigate the risk for incident CKD across categories of body mass index in a large cohort of metabolically healthy men and women.

DESIGN:

Prospective cohort study.

SETTING:

Kangbuk Samsung Health Study, Kangbuk Samsung Hospital, Seoul, South Korea.

PARTICIPANTS:

62 249 metabolically healthy, young and middle-aged men and women without CKD or proteinuria at baseline.

MEASUREMENTS:

Metabolic health was defined as a homeostasis model assessment of insulin resistance less than 2.5 and absence of any component of the metabolic syndrome. Underweight, normal weight, overweight, and obesity were defined as a body mass index less than 18.5 kg/m2, 18.5 to 22.9 kg/m2, 23 to 24.9 kg/m2, and 25 kg/m2 or greater, respectively. The outcome was incident CKD, defined as an estimated glomerular filtration rate less than 60 mL/min/1.73 m2.

RESULTS:

During 369 088 person-years of follow-up, 906 incident CKD cases were identified. The multivariable-adjusted differences in 5-year cumulative incidence of CKD in underweight, overweight, and obese participants compared with normal-weight participants were -4.0 (95% CI, -7.8 to -0.3), 3.5 (CI, 0.9 to 6.1), and 6.7 (CI, 3.0 to 10.4) cases per 1000 persons, respectively. These associations were consistently seen in all clinically relevant subgroups.

LIMITATION:

Chronic kidney disease was identified by a single measurement at each visit.

CONCLUSION:

Overweight and obesity are associated with an increased incidence of CKD in metabolically healthy young and middle-aged participants. These findings show that metabolically healthy obesity is not a harmless condition and that the obese phenotype, regardless of metabolic abnormalities, can adversely affect renal function.

PRIMARY FUNDING SOURCE: None.

PMID:26857595[PubMed - in process]

 

(출처_PubMed)

유승호 교수 연구소개    [프로필 보기]

미국의 존스홉킨스 보건대학(Johns Hopkins Bloomberg School of Public Health)의 연구자들과 공동으로 강북삼성 코호트 연구 진행하고 있다. 「강북삼성 코호트 연구」는 만성질환, 심혈관계 질환 등의 예방과 치료에 도움이 되는 정보를 얻고자 광범위한 인구집단의 질병과 건강 상태의 자연 경과, 예후, 질병 결정 인자를 평가하기 위한 대규모의 장기 연구조사 사업입니다.   

엘리세오와이아르 교수 연구소개    [프로필 보기]

본 연구실은 미국의 존스홉킨스 보건대학(Johns Hopkins Bloomberg School of Public Health)의 연구자들과 공동으로 역학적 방법론을 통해 임상 현장의 문제들을 해결하기 위한 근거를 창출하는 연구실로서, 병원 기반 자료를 바탕으로 질병과 건강 상태의 자연 경과, 예후, 질병 결정 인자를 평가하는 건강증진측면의 연구들을 수행해 오고 있음. 또한 국제적으로 표준화된 도구 및 측정 적용을 통한 연구 인프라 구축을 통해 다양한 임상 역학 연구를 설계하고, 진행하고 있음.  

장유수 교수 연구소개    [프로필 보기]

강북삼성병원 종합건진센터 데이터를 기반으로 한 후향적 코호트 구축 및 자료관리에 있어 코호트 연구소팀과 존스홉킨스 보건대학원 교수진과 주도적인 역할을 하였으며, 이를 이용한 건강증진측면의 연구들을 수행해 오고 있다. 국제적으로 표준화된 도구 및 측정 적용을 건진센터에 도입하고 연구데이타 구축에 있어 역할을 수행하고 있다.