Association between waist-to-hip ratio and chronic kidney disease in the elderly

To compare the anthropometric indices of obesity and identify which index serves as a better discriminator in the chronic kidney disease (CKD) for the elderly.

Participants of a 1-day health check, older than 60 years, in our hospital from 2003 to 2005 were enrolled. CKD was defined as estimated glomerular filtration rate by modification of diet in renal disease formula less than 60 mL/min per 1.73 m(2). Indices of obesity include body mass index, waist circumference, waist-to-hip ratio (WHR) and waist-to-height ratio. Traditional risk factors including diabetes, hypertension and metabolic syndrome were also taken into consideration. The accuracy of indices of obesity in predicting CKD was measured by area under the receiver operating characteristic curve (AUC). Association between risk factors was estimated by multivariate logistic regression.

We studied 984 participants (537 men and 447 women) with a mean age of 66.7 +/- 5.3 years. A total of 161 (16.4%) participants was found having CKD. In the indices of obesity, WHR showed best diagnostic accuracy in predicting CKD (AUC: 0.58). A WHR cut-off value of 0.88 had a sensitivity of 68.9% and a specificity of 45.4%. The odds ratios were significant for WHR, hypertension and diabetes (P = 0.025, P < 0.001 and P = 0.033).

In indices of obesity, WHR is better than body mass index, bodyweight and waist circumferences in predicting CKD in elder Taiwanese. Furthermore, the association of WHR and CKD is independent of hypertension and diabetes.