Body mass index and annual estimated GFR decline in Chinese adults with normal renal function

Abstract

Background/Objectives: The objective of this study was to examine the association between body mass index (BMI) and the annual estimated glomerular filtration rate (eGFR) decline in a rural lean Chinese cohort.Subjects/Methods:A total of 2696 subjects with an eGFR ≥60 ml/min per 1.73 m 2 were followed up for 7 years. Our primary outcome was annual eGFR decline, calculated as (eGFR at baseline-eGFR at revisit)/years of follow-up. Results: During the 7-year follow-up, the mean (s.d.) of annual eGFR decline was 1.7 (1.9) ml/min per 1.73 m 2 per year. Compared with subjects with normal weight (BMI 19-22.9 kg/m 2), overweight subjects (BMI 23-26.9 kg/m 2) had a more rapid annual eGFR decline (β, 0.33; 95% confidence interval (0.18-0.47) ml/min per 1.73 m 2 per year), whereas no significant difference was found when comparing the underweight (<19 kg/m 2) and the obese (≥27 kg/m 2) groups with the normal-weight group. Moreover, in the 19- to 26.9-kg/m 2 range, BMI was positively linearly associated with annual eGFR decline (β2, 0.09 (0.05 to 0.12) ml/min per 1.73 m 2 per year, P<0.001), whereas in the <19 (β1, -0.21(-0.45-0.02), P=0.073; β2 versus β1: P=0.009) and ≥27 kg/m 2 (β3, -0.24 (-0.48-0.00), P=0.053; β3 versus β2: P=0.010) range a negative but statistically insignificant trend of association was detected. Conclusions: Our results suggested a nonlinear S-shaped association between BMI and annual eGFR decline among Chinese adults with normal renal function.