Waist Circumference and Visceral Fat in CKD: A Cross-sectional Study

Background

In the general population, waist circumference was noted to be a reliable predictor of visceral fat. In addition, increased waist circumference was strongly associated with risk factors for cardiovascular disease. In patients with chronic kidney disease (CKD), the association of waist circumference with visceral fat was never tested.

Study Design

Cross-sectional study.

Setting & Participants

122 patients with CKD not yet on dialysis therapy (75 men; diabetes mellitus, 30%; age, 55.3 ± 11.3 years; body mass index, 27.1 ± 5.2 kg/m²; estimated glomerular filtration rate, 35.4 ± 15.2 mL/min/1.73 m²) were studied.

Predictor

Waist circumference.

Outcomes & Measurements

Anthropometry, abdominal visceral fat measured by means of computed tomography, and cardiovascular disease risk factors.

Results

Waist circumference strongly correlated with visceral fat (r = 0.75 for men, r = 0.81 for women; P < 0.01). κ Statistic was 0.56, indicating relatively good agreement between methods. Body mass index showed a lower correlation coefficient (r = 0.68 for men, r = 0.76 for women; P < 0.01) and poor agreement (0.36) with visceral fat in comparison to waist circumference. In men, waist circumference and visceral fat similarly correlated with high-density lipoprotein cholesterol level, triacylglycerol level, and Homeostasis Model Assessment Index (P < 0.05). In women, waist circumference correlated with age, C-reactive protein level, and Homeostasis Model Assessment Index, whereas visceral fat also correlated with low-density lipoprotein cholesterol and triacylglycerol levels (P < 0.05).

Limitations

Findings are restricted to patients with CKD not yet on dialysis therapy from a single center.

Conclusions

Waist circumference was strongly associated with visceral fat in patients with CKD. Associations between waist circumference and cardiovascular disease risk factors were similar to those observed for visceral fat, particularly in men. These findings suggest that waist circumference may be a simple and inexpensive tool to be used in epidemiological studies.

Index Words: Abdominal obesity, insulin resistance, metabolic syndrome, cardiovascular disease, end-stage renal disease