Korean J Fam Pract 2020; 10(2): 129-135  https://doi.org/10.21215/kjfp.2020.10.2.129
Association between Cardiometabolic Risk Factors and Decreased Glomerular Filtration Rate in Korean Women
Jina Kim, Jiwon Lee, Seo Young Kang, Hye Soon Park*
Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Hye Soon Park
Tel: +82-2-3010-3813, Fax: +82-2-3010-3815
E-mail: hyesoon@amc.seoul.kr
ORCID: http://orcid.org/0000-0002-9514-2401
Received: October 1, 2019; Revised: February 16, 2020; Accepted: March 1, 2020; Published online: April 20, 2020.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Decreased glomerular filtration rate (GFR) was associated with increased mortality and decreased quality of life in previous studies. In Korean adults, the prevalence rates of cardiometabolic risk factors are higher in women than in men after middle age. We evaluated the association between cardiometabolic risk factors and decreased GFR in Korean women.
Methods: We evaluated 2,339 subjects using data from the Korea National Health and Nutrition Examination Survey VII-1 (2016) after excluding participants with GFRs of <15 mL/min/1.73 m2. Normal GFR was ≥60 mL/min/1.73 m2, and decreased GFR was 15–59 mL/min/1.73 m2. Socioeconomic status, lifestyle factors, body mass index, waist circumference, and comorbidities were evaluated to analyze the association between cardiometabolic risk factors and decreased GFR. The odds ratio (OR) and 95% confidence interval (CI) were calculated using multivariate logistic regression analyses.
Results: As age increased, the OR for decreased GFR increased. In comparison with women with waist circumferences of <85 cm, the women with waist circumferences of ≥85 cm (OR, 1.94; 95% CI, 1.22–3.10) had a significant increase in the OR for decreased GFR. In women with diabetes mellitus, the OR for decreased GFR significantly increased (OR, 3.14; 95% CI, 1.70–5.81).
Conclusion: Decreased GFR was associated with age, abdominal obesity, and diabetes mellitus in Korean women. Control of abdominal obesity and appropriate management of diabetes mellitus are needed to prevent chronic kidney disease in Korean women.
Keywords: Decreased Glomerular Filtration Rate; Abdominal Obesity; Diabetes Mellitus; Korean Women
References
  1. Mills KT, Xu Y, Zhang W, Bundy JD, Chen CS, Kelly TN, et al. A systematic analysis of worldwide population-based data on the global burden of chronic kidney disease in 2010. Kidney Int 2015; 88: 950-7.
    Pubmed KoreaMed CrossRef
  2. Coresh J, Selvin E, Stevens LA, Manzi J, Kusek JW, Eggers P, et al. Prevalence of chronic kidney disease in the United States. JAMA 2007; 298: 2038-47.
    Pubmed CrossRef
  3. Lee SW, Park GH, Lee SY, Song JH, Kim MJ. Comparison of anthropometric data between end-stage renal disease patients undergoing hemodialysis and healthy adults in Korea. Yonsei Med J 2005; 46: 658-66.
    Pubmed KoreaMed CrossRef
  4. Brodsky J. International comparisons. Am J Kidney Dis 2008; 51 (1 Supplement 1): S239-54.
    CrossRef
  5. Kim S, Lim CS, Han DC, Kim GS, Chin HJ, Kim SJ, et al. The prevalence of chronic kidney disease (CKD) and the associated factors to CKD in urban Korea: a population-based cross-sectional epidemiologic study. J Korean Med Sci 2009; 24 Suppl: S11-21.
    Pubmed KoreaMed CrossRef
  6. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 2004; 351: 1296-305.
    Pubmed CrossRef
  7. Awuah KT, Finkelstein SH, Finkelstein FO. Quality of life of chronic kidney disease patients in developing countries. Kidney Int Suppl (2011) 2013; 3:227-9.
    Pubmed KoreaMed CrossRef
  8. Stevens LA, Coresh J, Greene T, Levey AS. Assessing kidney function--measured and estimated glomerular filtration rate. N Engl J Med 2006; 354:2473-83.
    Pubmed CrossRef
  9. Smith HW. The kidney: structure and function in health and disease. New York (NY): Oxford University Press; 1951.
  10. Michels WM, Grootendorst DC, Verduijn M, Elliott EG, Dekker FW, Krediet RT. Performance of the Cockcroft-Gault, MDRD, and new CKD-EPI formulas in relation to GFR, age, and body size. Clin J Am Soc Nephrol 2010; 5:1003-9.
    Pubmed KoreaMed CrossRef
  11. Coppolino G, Bolignano D, Gareri P, Ruberto C, Andreucci M, Ruotolo G, et al. Kidney function and cognitive decline in frail elderly: two faces of the same coin? Int Urol Nephrol 2018; 50: 1505-10.
    Pubmed CrossRef
  12. Isomaa B, Almgren P, Tuomi T, Forsén B, Lahti K, Nissén M, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001; 24: 683-9.
    Pubmed CrossRef
  13. Cai Q, Wang X, Ye J, Zhuo L, Song H, Liu C, et al. Metabolic syndrome does not always play a critical role in decreased GFR. Ren Fail 2016; 38: 383-9.
    Pubmed CrossRef
  14. Tozawa M, Iseki C, Tokashiki K, Chinen S, Kohagura K, Kinjo K, et al. Metabolic syndrome and risk of developing chronic kidney disease in Japanese adults. Hypertens Res 2007; 30: 937-43.
    Pubmed CrossRef
  15. Mendy VL, Azevedo MJ, Sarpong DF, Rosas SE, Ekundayo OT, Sung JH, et al. The association between individual and combined components of metabolic syndrome and chronic kidney disease among African Americans: the Jackson Heart Study. PLoS One 2014; 9: e101610.
    Pubmed KoreaMed CrossRef
  16. Regitz-Zagrosek V, Lehmkuhl E, Weickert MO. Gender differences in the metabolic syndrome and their role for cardiovascular disease. Clin Res Cardiol 2006; 95: 136-47.
    Pubmed CrossRef
  17. Davies DF, Shock NW. Age changes in glomerular filtration rate, effective renal plasma flow, and tubular excretory capacity in adult males. J Clin Invest 1950; 29: 496-507.
    Pubmed KoreaMed CrossRef
  18. Denic A, Glassock RJ, Rule AD. Structural and functional changes with the aging kidney. Adv Chronic Kidney Dis 2016; 23: 19-28.
    Pubmed KoreaMed CrossRef
  19. Glassock RJ, Rule AD. The implications of anatomical and functional changes of the aging kidney: with an emphasis on the glomeruli. Kidney Int 2012; 82: 270-7.
    Pubmed KoreaMed CrossRef
  20. de Boer IH, Katz R, Fried LF, Ix JH, Luchsinger J, Sarnak MJ, et al. Obesity and change in estimated GFR among older adults. Am J Kidney Dis 2009;54: 1043-51.
    Pubmed KoreaMed CrossRef
  21. Mathew AV, Okada S, Sharma K. Obesity related kidney disease. Curr Diabetes Rev 2011; 7: 41-9.
    Pubmed CrossRef
  22. Chagnac A, Weinstein T, Herman M, Hirsh J, Gafter U, Ori Y. The effects of weight loss on renal function in patients with severe obesity. J Am Soc Nephrol 2003; 14: 1480-6.
    Pubmed CrossRef
  23. Chang A, Greene TH, Wang X, Kendrick C, Kramer H, Wright J, et al. The effects of weight change on glomerular filtration rate. Nephrol Dial Transplant 2015; 30: 1870-7.
    Pubmed KoreaMed CrossRef
  24. Wajchenberg BL. Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome. Endocr Rev 2000; 21: 697-738.
    Pubmed CrossRef
  25. Dias RSC, Calado IL, Alencar JD, Hortegal EV, Santos EJF, Brito DJA, et al. Abdominal obesity and reduction of glomerular filtration. Rev Assoc Med Bras (1992) 2018; 64: 346-53.
    Pubmed CrossRef
  26. Hahr AJ, Molitch ME. Management of diabetes mellitus in patients with chronic kidney disease. Clin Diabetes Endocrinol 2015; 1: 2.
    Pubmed KoreaMed CrossRef
  27. DCCT/EDIC Research Group, de Boer IH, Sun W, Cleary PA, Lachin JM, Molitch ME, et al. Intensive diabetes therapy and glomerular filtration rate in type 1 diabetes. N Engl J Med 2011; 365: 2366-76.
    Pubmed KoreaMed CrossRef

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