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Stable Heavy Body Shape Throughout the Life Course Increases the Risk of Chronic Kidney Disease
Han Pang1, Wei Liao1, Huanxiang Zhang1
1Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
Summary
Maintaining a heavy body shape throughout life is linked to a higher risk of chronic kidney disease (CKD). This lifelong obesity pattern also shortens disease-free life expectancy, with genetic factors supporting the causal link.
Area of Science:
- Epidemiology
- Nephrology
- Genetics
Background:
- Chronic kidney disease (CKD) is a significant global health concern.
- The impact of dynamic changes in body weight and shape across the lifespan on CKD development is not well understood.
- Obesity is a known risk factor for various chronic diseases, but its life-course trajectory's specific association with CKD requires investigation.
Purpose of the Study:
- To examine the association between different body shape trajectories from early to middle adulthood and the risk of developing CKD.
- To explore potential causal relationships between body shape patterns and CKD using Mendelian randomization.
- To assess the impact of body shape trajectories on life expectancy and CKD-free life expectancy.
Main Methods:
- Utilized data from the Henan Rural Cohort Study, assessing body shape retrospectively using the Stunkard body diagram.
- Employed group-based trajectory models to identify distinct body shape patterns over the life course.
- Applied logistic regression to analyze associations between body shape trajectories and CKD indicators (eGFR decrease, albuminuria, CKD diagnosis).
- Calculated life expectancy and CKD-free life expectancy using the Sullivan method.
- Conducted two-sample Mendelian randomization (MR) analysis to infer causality.
Main Results:
- Identified five body shape trajectories: lean-stable, lean-marked increase, medium-stable, medium-moderate increase, and heavy-stable among 17,496 participants.
- The heavy-stable body shape group exhibited significantly higher odds of CKD compared to the lean-stable group (OR men: 1.37, 95% CI: 1.01-1.86; OR women: 1.28, 95% CI: 1.02-1.61).
- Individuals in the heavy-stable group had the shortest CKD-free life expectancy.
- Mendelian randomization analysis indicated a causal effect of higher childhood BMI (OR: 1.18, 95% CI: 1.01-1.37) and adult BMI (OR: 1.36, 95% CI: 1.15-1.62) on CKD risk.
Conclusions:
- A stable heavy body shape throughout the life course is associated with the highest prevalence of CKD and reduced CKD-free life expectancy.
- Genetic evidence supports a causal role for both childhood and adult BMI in the development of CKD.
- Lifelong obesity, characterized by a stable heavy body shape, serves as a significant risk marker for chronic kidney disease.
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