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논문분류	춘계학술대회 초록집
제목	Association between Unintended Weight Loss and Incident Chronic Kidney Disease in People with Metabolic Syndrome: A Community-Based Cohort Study
저자	Hae Ryoung Yun1, Tae Ik Chang2, Hyoungnae Kim1, Seohyun Park1, Jong Hyun Jhee1, Jung Tak Park1, Tae-Hyun Yoo1, Shin-Wook Kang1, Seung Hyeok Han1
출판정보	2018; 2018(1):
키워드	Metabolic syndrome \| Chronic kidney disease \| Body mass index \| Weight reduction \| metabolic profile
초록	Objectives: Obesity is a major component of metabolic syndrome (MeS), which is highly related to chronic kidney disease (CKD). Previous small studies have shown beneficial effects through short-term weight loss intervention in extremely obese subjects. However, it is uncertain whether weight reduction can result in long-term benefits for preventing incident CKD in people with MeS. Methods: Using database from a prospective cohort of the KoGES, 2,938 individuals with MeS were recruited between 2001 and 2002. Subjects were categorized into five groups based on quintiles of percent changes in BMI. The primary outcome was incident CKD, which was defined as an eGFR of < 60 mL/min/1.73 m2 for at least two consecutive measurements. Results: The median (IQR) changes in BMI in each quintile group were -9.3% (-12.4 to -7.6), -4.4% (-5.3 to -3.6), -1.7% (-2.3 to -1.0), 1.1% (-0.3 to 1.8), and 5.5% (-4.0 to 7.8), respectively. During a median follow-up of 11.5 years, CKD occurred in 431 (14.6%) subjects. In multivariable model after adjustment of confounding factors, the lowest quintile was significantly associated with a 67% (HR, 0.329; 95% CI, 0.240-0.451; P < 0.001) decreased risk of incident CKD. The HR in the 2nd quintile was 0.713 (95% CI, 0.541-0.938, P = 0.016), but HRs were not increased in 4th and 5th quintiles with weight gain groups. Changes in BMI positively correlated with changes in blood pressure (γ = 0.121, P < 0.001), fasting glucose (γ = 0.049, P = 0.004), and triglyceride (γ = 0.148, P < 0.001), and, but negatively with HDL-C (γ = -0.151, P < 0.001) and eGFR (γ = -0.079, P < 0.001). Conclusions: We showed that weight loss was associated with reduced risk of incident CKD in participants with MeS. This association may be mediated by the concomitant improvement in BP and metabolic profiles.
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