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논문분류	춘계학술대회 초록집
제목	Decrease in waist-to-hip ratio significantly reduced the risk of incident chronic kidney disease even in non-obese non-alcoholic fatty liver disease
저자	Mi Jung Lee, Young Eun Chon, Hyung Jong Kim, Yu Bum Choi, Seong Gyu Hwang, Kyu Sung Rim, Mi Na Kim, Hana Park, Joo Ho Lee, Yeonjung Ha
출판정보	2019; 2019(1):
키워드	Non-alcoholic fatty liver disea \| Waist-to-hip ratio \| Chronic kidney disease \| Obesity
초록	Weight loss is regarded as a pivotal treatment strategy in both obese and non-obese non-alcoholic fatty liver disease (NAFLD). However, there is a lack of data evaluating whether changes in central obesity affects long-term kidney function in this population. Therefore, we investigated the impact of changes in waist-to-hip ratio (WHR) on adverse kidney outcomes in NAFLD patients using a community-based, prospective cohort with a 12-year follow-up. Among 10,030 participants from the Korean Genome Epidemiology Study, 1,774 NAFLD patients were included in this study. Patients were categorized into three groups according to time-averaged percent changes of WHR (TA-%WHR change), respectively; ≥-5%, <-5% to <5%, ≥5%. Study outcomes were development of chronic kidney disease (CKD). The independent association of TA-%WHR change with CKD development was evaluated in both non-obese NAFLD (body mass index [BMI] <25 kg/m2) and obese NAFLD (BMI ≥25 kg/m2). During a mean follow-up of 108.7 ± 44.5 months, CKD developed in 510 patients (28.7%). In 1,774 NAFLD patients, compared to patients with minimal changes of WHR (<-5% to <5%), patients with reduced WHR of more than 5% had a significantly decreased risk of CKD development (HR=0.300; 95% CI=0.194-0.464; P<0.001). Furthermore, significant risk reduction from decreased WHR (≥-5%) for developing CKD remained still in non-obese NAFLD patients (HR=0.290; 95% CI=0.114-0.736; P=0.01), as well as obese NAFLD patients (HR=0.289; 95% CI=0.175-0.476; P<0.001). This study demonstrated that more than an average of 5% decrease in WHR, a useful anthropometric index of central obesity, significantly reduced the risk of CKD development even in NAFLD patients who are non-obese. It suggests that significant and sustained reduction of central obesity may improve long-term kidney outcomes in patients with NAFLD.
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