Four-year changes in visceral fat mass and the risk of developing proteinuria in the general population

Abstract

Background: Previous cross-sectional studies demonstrated the close relationship between visceral obesity and the increased prevalence of proteinuria. But, little is known about the role of changes in visceral fat mass (ΔVFM) over several years in the development of proteinuria. In this longitudinal cohort study with the general population, the changes in ΔVFM as well as baseline VFM on proteinuria development were evaluated. Methods: Healthy individuals (n = 2393) who participated in two health screening exams were analyzed. Subjects were divided into three groups based on gender-specific tertiles of baseline VFM and ΔVFM. Each patient was tested for proteinuria using a dipstick, and proteinuria was defined as 1+ or greater. Results: The mean age was 51.9±7.7 years, and the incidence of proteinuria was 3.9% (n = 93). During the 4 years, 52.5%of the subjects experienced a decline in ΔVFM. However, subjects who developed proteinuria exhibited a significant increase in ΔVFM. Even after adjustment for age, smoking, systolic and diastolic BP, serum creatinine, and hs-CRP levels, the highest tertiles for baseline VFM [men, odds ratio (OR) 3.43, 95% confidence interval (CI) 1.22-9.67; women, OR 2.01, 95% CI 1.05-4.15] and ΔVFM (men, OR 2.92, 95% CI 1.22-6.99; women, OR 3.16, 95% CI 1.56-6.39) were independent predictors of proteinuria development. Following adjustment of both parameters, subjects in the highest baseline VFM and ΔVFM tertiles exhibited the greatest risk of proteinuria development, which suggested the additive harmful effects of the two factors. Conclusions: Baseline VFM and greater increase in ΔVFM were both important risk factors for developing proteinuria in the general population. Appropriate education and interventions to prevent accumulation of VFM should be the major focus of preemptive strategies. Copyright: