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논문분류	춘계학술대회 초록집
제목	Effect of metabolically healthy obesity on cardiovascular outcomes and progression to end-stage renal disease in chronic kidney disease
저자	Shin Yeong Kang,Soo-young Yoon,Jong Ho Kim,Dae Gyu Kim,Jin Sug Kim,Kyung Hwan Jeong,Hyeon Seok Hwang
출판정보	2022; 2022(1):
키워드
초록	Objectives: Obesity and metabolic dysfunction increases the risk of cardiovascular disease and chronic kidney disease (CKD) progression. However, it is unclear whether metabolically healthy obesity in patients with CKD is associated with higher risk of cardiovascular events and progression to end-stage renal disease (ESRD). Methods: We reviewed the National Health Insurance Service database of Korea for people who received national health screenings between 2009 and 2011. A total of 165,048 CKD patients were identified with consecutive eGFR <60 ml/min per 1.73m2. Obesity was defined as body mass index >23 kg/m2 and metabolic healthy status was considered if less than two of metabolic factors; waist circumference, blood pressure, fasting blood glucose, triglyceride, and high-density lipoprotein cholesterol level. The primary outcomes were cardiovascular events, cardiovascular death, and ESRD progression. Results: Obesity was observed in 110,606 patients (67.01%) and the metabolic dysfunction was more prevalent in non-obese patients than in obese patients (7.58% vs. 34.96%; P < 0.001). Compared to the metabolically healthy non-obese patients, metabolic dysfunction significantly increased the risk of cardiovascular event, death, and ESRD progression, regardless of the presence of obesity. Metabolically unhealthy obese patients revealed the highest risk of cardiovascular event [HR 1.26, 95% confidence interval (CI) 1.19-1.33], cardiovascular death (HR 1.57, 95% CI 1.27-1.95), and progression to ESRD (HR 1.75, 95% CI 1.53-1.99). However, metabolically healthy obese patients were not associated with higher risk of cardiovascular event (HR 1.04, 95% CI 0.97-1.11) and death (HR 0.90, 95% CI 0.67-1.21). In addition, the risk of progression to ESRD was significantly decreased in these patients (HR 0.78, 95% CI 0.65-0.93). Conclusions: Obesity and metabolic dysfunction in CKD patients was significantly associated with worse cardiovascular and renal outcomes. However, metabolically healthy obesity did not increase the risk of cardiovascular event, death, and ESRD progression, suggesting that there is healthy effect of obesity in CKD patients.
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