Association Between Central Obesity and Membranous Nephropathy

BACKGROUND The global prevalence of central obesity has increased dramatically. However, the impact of central obesity on membranous nephropathy (MN) remains elusive. This retrospective cross-sectional study investigated the association between central obesity and MN. MATERIAL AND METHODS The study enrolled 255 biopsy-proven MN patients. Central obesity was evaluated with waist-to-hip ratio (WHR). The clinical/pathological phenotypes of MN patients were evaluated via urinary/blood biochemistry and renal pathology examinations. Clinical/pathological phenotypes were compared between patients with and without central obesity. Correlations between the WHR and clinical/pathological phenotypes were explored. The risks of central obesity for massive proteinuria and severe podocyte injury were investigated. RESULTS Patients with central obesity were more likely to have more severe nephrotic syndrome and podocyte injury, as indicated by increased 24 h urine protein (24 h-UPro), total cholesterol (T-CHOL), triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) levels; increased average podocyte foot process width; and decreased serum total protein (TP) and albumin (ALB) levels. They also tended to have poorer renal function and more severe glomerular immunoglobulin and complement deposition and sclerosis. Central obesity was also positively correlated with 24 h-UPro, T-CHOL, TG, HDL, LDL, and the podocyte foot process width, and was negatively correlated with TP and ALB. Central obesity is also a risk factor for massive proteinuria and severe podocyte injury. CONCLUSIONS Central obesity can have adverse effects on MN.