Skip to main content
Top
Published in: BMC Nephrology 1/2022

Open Access 01-12-2022 | Coronary Heart Disease | Research

Lipid accumulation product, visceral adiposity index and risk of chronic kidney disease

Authors: Alexander L. Bullen, Ronit Katz, Ujjala Kumar, Orlando M. Gutierrez, Mark J. Sarnak, Holly J. Kramer, Michael G. Shlipak, Joachim H. Ix, Suzanne E. Judd, Mary Cushman, Pranav S. Garimella

Published in: BMC Nephrology | Issue 1/2022

Login to get access

Abstract

Background

Lipid accumulation product (LAP) and visceral adiposity index (VAI) are novel, non-imaging markers of visceral adiposity that are calculated by using body mass index (BMI), waist circumference (WC) and serum lipid concentrations. We hypothesized that LAP and VAI are more strongly associated with adverse kidney outcomes than BMI and WC.

Methods

Using data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, we used multivariable logistic regression to evaluate associations of LAP, VAI, BMI and WC with incident chronic kidney disease (CKD), (incident eGFR < 60 ml/min/1.73m2 and > 25% decline).

Results

Among the overall cohort of 27,550 participants, the mean baseline age was 65 years; 54% were women; and 41% were African American. After a median of 9.4 years (IQR 8.6, 9.9) of follow-up, a total of 1127 cases of incident CKD were observed. Each two-fold higher value of VAI (OR 1.12, 95% CI 1.04, 1.20), LAP (OR 1.21, 95% CI 1.13, 1.29), WC (OR 2.10, 95% CI 1.60, 2.76) and BMI (OR: 2.66, 95% CI 1.88, 3.77), was associated with greater odds of incident CKD.

Conclusions

LAP and VAI as measures of visceral adiposity are associated with higher odds of incident CKD but may not provide information beyond WC and BMI.
Appendix
Available only for authorised users
Literature
1.
go back to reference Eknoyan G. Obesity and chronic kidney disease. Nefrologia. 2011;31(4):397–403. Eknoyan G. Obesity and chronic kidney disease. Nefrologia. 2011;31(4):397–403.
2.
go back to reference Fox CS, Larson MG, Leip EP, Culleton B, Wilson PW, Levy D. Predictors of new-onset kidney disease in a community-based population. Jama. 2004;291(7):844–50.CrossRef Fox CS, Larson MG, Leip EP, Culleton B, Wilson PW, Levy D. Predictors of new-onset kidney disease in a community-based population. Jama. 2004;291(7):844–50.CrossRef
3.
go back to reference Forouzanfar MH, Afshin A, Alexander LT. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet (London, England). 2015;386(10010):2287–323. Forouzanfar MH, Afshin A, Alexander LT. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet (London, England). 2015;386(10010):2287–323.
4.
go back to reference Kanasaki K, Kitada M, Kanasaki M, Koya D. The biological consequence of obesity on the kidney. Nephrol Dial Transplant. 2013;28(Suppl 4):iv1–7.CrossRef Kanasaki K, Kitada M, Kanasaki M, Koya D. The biological consequence of obesity on the kidney. Nephrol Dial Transplant. 2013;28(Suppl 4):iv1–7.CrossRef
5.
go back to reference Kramer H. Obesity and chronic kidney disease. Contrib Nephrol. 2006;151:1–18. Kramer H. Obesity and chronic kidney disease. Contrib Nephrol. 2006;151:1–18.
6.
go back to reference Rothman KJ. BMI-related errors in the measurement of obesity. Int J Obes (Lond). 2008;32(Suppl 3):S56–9.CrossRef Rothman KJ. BMI-related errors in the measurement of obesity. Int J Obes (Lond). 2008;32(Suppl 3):S56–9.CrossRef
7.
go back to reference Agarwal R, Bills JE, Light RP. Diagnosing obesity by body mass index in chronic kidney disease: an explanation for the “obesity paradox?”. Hypertension (Dallas, Tex : 1979). 2010;56(5):893–900.CrossRef Agarwal R, Bills JE, Light RP. Diagnosing obesity by body mass index in chronic kidney disease: an explanation for the “obesity paradox?”. Hypertension (Dallas, Tex : 1979). 2010;56(5):893–900.CrossRef
8.
go back to reference Aquina CT, Rickles AS, Probst CP, Kelly KN, Deeb AP, Monson JR, et al. Visceral obesity, not elevated BMI, is strongly associated with incisional hernia after colorectal surgery. Dis Colon Rectum. 2015;58(2):220–7.CrossRef Aquina CT, Rickles AS, Probst CP, Kelly KN, Deeb AP, Monson JR, et al. Visceral obesity, not elevated BMI, is strongly associated with incisional hernia after colorectal surgery. Dis Colon Rectum. 2015;58(2):220–7.CrossRef
9.
go back to reference Rickles AS, Iannuzzi JC, Mironov O, Deeb AP, Sharma A, Fleming FJ, et al. Visceral obesity and colorectal cancer: are we missing the boat with BMI? J Gastrointest Surg. 2013;17(1):133–43 discussion p.43.CrossRef Rickles AS, Iannuzzi JC, Mironov O, Deeb AP, Sharma A, Fleming FJ, et al. Visceral obesity and colorectal cancer: are we missing the boat with BMI? J Gastrointest Surg. 2013;17(1):133–43 discussion p.43.CrossRef
10.
go back to reference Zhai T, Zhang B, Qu Z, Chen C. Elevated visceral obesity quantified by CT is associated with adverse postoperative outcome of laparoscopic radical nephrectomy for renal clear cell carcinoma patients. Int Urol Nephrol. 2018;50(5):845–50.CrossRef Zhai T, Zhang B, Qu Z, Chen C. Elevated visceral obesity quantified by CT is associated with adverse postoperative outcome of laparoscopic radical nephrectomy for renal clear cell carcinoma patients. Int Urol Nephrol. 2018;50(5):845–50.CrossRef
11.
go back to reference Liu J, Fox CS, Hickson DA, May WD, Hairston KG, Carr JJ, et al. Impact of abdominal visceral and subcutaneous adipose tissue on cardiometabolic risk factors: the Jackson Heart Study. J Clin Endocrinol Metab. 2010;95(12):5419–26.CrossRef Liu J, Fox CS, Hickson DA, May WD, Hairston KG, Carr JJ, et al. Impact of abdominal visceral and subcutaneous adipose tissue on cardiometabolic risk factors: the Jackson Heart Study. J Clin Endocrinol Metab. 2010;95(12):5419–26.CrossRef
12.
go back to reference Kramer H, Shoham D, McClure LA, Durazo-Arvizu R, Howard G, Judd S, et al. Association of waist circumference and body mass index with all-cause mortality in CKD: the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study. Am J Kidney Dis. 2011;58(2):177–85.CrossRef Kramer H, Shoham D, McClure LA, Durazo-Arvizu R, Howard G, Judd S, et al. Association of waist circumference and body mass index with all-cause mortality in CKD: the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study. Am J Kidney Dis. 2011;58(2):177–85.CrossRef
13.
go back to reference Teixeira A d CFDA, Salgado JV, et al. Usefulness of visceral adipose tissue estimation in the prevention of chronic kidney disease in hypertensive patients in primary health care. Nutr Hosp. 2018;35(4):948–56.CrossRef Teixeira A d CFDA, Salgado JV, et al. Usefulness of visceral adipose tissue estimation in the prevention of chronic kidney disease in hypertensive patients in primary health care. Nutr Hosp. 2018;35(4):948–56.CrossRef
14.
go back to reference Evans PD, McIntyre NJ, Fluck RJ, McIntyre CW, Taal MW. Anthropomorphic measurements that include central fat distribution are more closely related with key risk factors than BMI in CKD stage 3. PLoS One. 2012;7(4):e34699.CrossRef Evans PD, McIntyre NJ, Fluck RJ, McIntyre CW, Taal MW. Anthropomorphic measurements that include central fat distribution are more closely related with key risk factors than BMI in CKD stage 3. PLoS One. 2012;7(4):e34699.CrossRef
15.
go back to reference Kramer H, Gutiérrez OM, Judd SE, Muntner P, Warnock DG, Tanner RM, et al. Waist circumference, body mass index, and ESRD in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study. Am J Kidney Dis. 2016;67(1):62–9.CrossRef Kramer H, Gutiérrez OM, Judd SE, Muntner P, Warnock DG, Tanner RM, et al. Waist circumference, body mass index, and ESRD in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study. Am J Kidney Dis. 2016;67(1):62–9.CrossRef
16.
go back to reference Sanches FM, Avesani CM, Kamimura MA, Lemos MM, Axelsson J, Vasselai P, et al. Waist circumference and visceral fat in CKD: a cross-sectional study. Am J Kidney Dis. 2008;52(1):66–73.CrossRef Sanches FM, Avesani CM, Kamimura MA, Lemos MM, Axelsson J, Vasselai P, et al. Waist circumference and visceral fat in CKD: a cross-sectional study. Am J Kidney Dis. 2008;52(1):66–73.CrossRef
17.
go back to reference Velludo CM, Kamimura MA, Sanches FM, Lemos MM, Canziani ME, Pupim LB, et al. Prospective evaluation of waist circumference and visceral adipose tissue in patients with chronic kidney disease. Am J Nephrol. 2010;31(2):104–9.CrossRef Velludo CM, Kamimura MA, Sanches FM, Lemos MM, Canziani ME, Pupim LB, et al. Prospective evaluation of waist circumference and visceral adipose tissue in patients with chronic kidney disease. Am J Nephrol. 2010;31(2):104–9.CrossRef
18.
go back to reference Gradmark AM, Rydh A, Renström F, De Lucia-Rolfe E, Sleigh A, Nordström P, et al. Computed tomography-based validation of abdominal adiposity measurements from ultrasonography, dual-energy X-ray absorptiometry and anthropometry. Br J Nutr. 2010;104(4):582–8.CrossRef Gradmark AM, Rydh A, Renström F, De Lucia-Rolfe E, Sleigh A, Nordström P, et al. Computed tomography-based validation of abdominal adiposity measurements from ultrasonography, dual-energy X-ray absorptiometry and anthropometry. Br J Nutr. 2010;104(4):582–8.CrossRef
19.
go back to reference Bonora E, Micciolo R, Ghiatas AA, Lancaster JL, Alyassin A, Muggeo M, et al. Is it possible to derive a reliable estimate of human visceral and subcutaneous abdominal adipose tissue from simple anthropometric measurements? Metabolism. 1995;44(12):1617–25.CrossRef Bonora E, Micciolo R, Ghiatas AA, Lancaster JL, Alyassin A, Muggeo M, et al. Is it possible to derive a reliable estimate of human visceral and subcutaneous abdominal adipose tissue from simple anthropometric measurements? Metabolism. 1995;44(12):1617–25.CrossRef
20.
go back to reference Irlbeck T, Massaro JM, Bamberg F, O'Donnell CJ, Hoffmann U, Fox CS. Association between single-slice measurements of visceral and abdominal subcutaneous adipose tissue with volumetric measurements: the Framingham Heart Study. Int J Obes (Lond). 2010;34(4):781–7.CrossRef Irlbeck T, Massaro JM, Bamberg F, O'Donnell CJ, Hoffmann U, Fox CS. Association between single-slice measurements of visceral and abdominal subcutaneous adipose tissue with volumetric measurements: the Framingham Heart Study. Int J Obes (Lond). 2010;34(4):781–7.CrossRef
21.
go back to reference Mathieu P, Pibarot P, Larose E, Poirier P, Marette A, Després JP. Visceral obesity and the heart. Int J Biochem Cell Biol. 2008;40(5):821–36.CrossRef Mathieu P, Pibarot P, Larose E, Poirier P, Marette A, Després JP. Visceral obesity and the heart. Int J Biochem Cell Biol. 2008;40(5):821–36.CrossRef
22.
go back to reference Kahn HS. The “lipid accumulation product” performs better than the body mass index for recognizing cardiovascular risk: a population-based comparison. BMC Cardiovasc Disord. 2005;5:26.CrossRef Kahn HS. The “lipid accumulation product” performs better than the body mass index for recognizing cardiovascular risk: a population-based comparison. BMC Cardiovasc Disord. 2005;5:26.CrossRef
23.
go back to reference Amato MC, Giordano C, Galia M, Criscimanna A, Vitabile S, Midiri M, et al. Visceral adiposity index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care. 2010;33(4):920–2.CrossRef Amato MC, Giordano C, Galia M, Criscimanna A, Vitabile S, Midiri M, et al. Visceral adiposity index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care. 2010;33(4):920–2.CrossRef
24.
go back to reference Wildman RP, Muntner P, Reynolds K, McGinn AP, Rajpathak S, Wylie-Rosett J, et al. The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999-2004). Arch Intern Med. 2008;168(15):1617–24.CrossRef Wildman RP, Muntner P, Reynolds K, McGinn AP, Rajpathak S, Wylie-Rosett J, et al. The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999-2004). Arch Intern Med. 2008;168(15):1617–24.CrossRef
25.
go back to reference Du T, Yu X, Zhang J, Sun X. Lipid accumulation product and visceral adiposity index are effective markers for identifying the metabolically obese normal-weight phenotype. Acta Diabetol. 2015;52(5):855–63.CrossRef Du T, Yu X, Zhang J, Sun X. Lipid accumulation product and visceral adiposity index are effective markers for identifying the metabolically obese normal-weight phenotype. Acta Diabetol. 2015;52(5):855–63.CrossRef
26.
go back to reference Dai D, Chang Y, Chen Y, Chen S, Yu S, Guo X, et al. Visceral adiposity index and lipid accumulation product index: two alternate body indices to identify chronic kidney disease among the rural population in Northeast China. Int J Environ Res Public Health. 2016;13(12). Dai D, Chang Y, Chen Y, Chen S, Yu S, Guo X, et al. Visceral adiposity index and lipid accumulation product index: two alternate body indices to identify chronic kidney disease among the rural population in Northeast China. Int J Environ Res Public Health. 2016;13(12).
27.
go back to reference Howard VJ, Cushman M, Pulley L, Gomez CR, Go RC, Prineas RJ, et al. The reasons for geographic and racial differences in stroke study: objectives and design. Neuroepidemiology. 2005;25(3):135–43.CrossRef Howard VJ, Cushman M, Pulley L, Gomez CR, Go RC, Prineas RJ, et al. The reasons for geographic and racial differences in stroke study: objectives and design. Neuroepidemiology. 2005;25(3):135–43.CrossRef
28.
go back to reference Stevens LA, Coresh J, Schmid CH, Feldman HI, Froissart M, Kusek J, et al. Estimating GFR using serum cystatin C alone and in combination with serum creatinine: a pooled analysis of 3,418 individuals with CKD. Am J Kidney Dis. 2008;51(3):395–406.CrossRef Stevens LA, Coresh J, Schmid CH, Feldman HI, Froissart M, Kusek J, et al. Estimating GFR using serum cystatin C alone and in combination with serum creatinine: a pooled analysis of 3,418 individuals with CKD. Am J Kidney Dis. 2008;51(3):395–406.CrossRef
29.
go back to reference Zhang KLQ, Chen Y, Wang N, Lu Y. Visceral adiposity and renal function: an observational study from SPECT-China. Lipids Health Dis. 2017;16:Article number: 205.CrossRef Zhang KLQ, Chen Y, Wang N, Lu Y. Visceral adiposity and renal function: an observational study from SPECT-China. Lipids Health Dis. 2017;16:Article number: 205.CrossRef
30.
go back to reference Xu X, Zhao Y, Zhao Z, Zhu S, Liu X, Zhou C, et al. Correlation of visceral adiposity index with chronic kidney disease in the People's Republic of China: to rediscover the new clinical potential of an old indicator for visceral obesity. Ther Clin Risk Manag. 2016;12:489–94. Xu X, Zhao Y, Zhao Z, Zhu S, Liu X, Zhou C, et al. Correlation of visceral adiposity index with chronic kidney disease in the People's Republic of China: to rediscover the new clinical potential of an old indicator for visceral obesity. Ther Clin Risk Manag. 2016;12:489–94.
31.
go back to reference Bozorgmanesh M, Hadaegh F, Azizi F. Diabetes prediction, lipid accumulation product, and adiposity measures; 6-year follow-up: Tehran lipid and glucose study. Lipids Health Dis. 2010;9:45.CrossRef Bozorgmanesh M, Hadaegh F, Azizi F. Diabetes prediction, lipid accumulation product, and adiposity measures; 6-year follow-up: Tehran lipid and glucose study. Lipids Health Dis. 2010;9:45.CrossRef
32.
go back to reference Kahn HS. The lipid accumulation product is better than BMI for identifying diabetes: a population-based comparison. Diabetes Care. 2006;29(1):151–3.CrossRef Kahn HS. The lipid accumulation product is better than BMI for identifying diabetes: a population-based comparison. Diabetes Care. 2006;29(1):151–3.CrossRef
33.
go back to reference Ioachimescu AG, Brennan DM, Hoar BM, Hoogwerf BJ. The lipid accumulation product and all-cause mortality in patients at high cardiovascular risk: a PreCIS database study. Obesity (Silver Spring). 2010;18(9):1836–44.CrossRef Ioachimescu AG, Brennan DM, Hoar BM, Hoogwerf BJ. The lipid accumulation product and all-cause mortality in patients at high cardiovascular risk: a PreCIS database study. Obesity (Silver Spring). 2010;18(9):1836–44.CrossRef
34.
go back to reference Wehr E, Pilz S, Boehm BO, März W, Obermayer-Pietsch B. The lipid accumulation product is associated with increased mortality in normal weight postmenopausal women. Obesity (Silver Spring). 2011;19(9):1873–80.CrossRef Wehr E, Pilz S, Boehm BO, März W, Obermayer-Pietsch B. The lipid accumulation product is associated with increased mortality in normal weight postmenopausal women. Obesity (Silver Spring). 2011;19(9):1873–80.CrossRef
35.
go back to reference Wang Z, Zhang J, Chan S, Cameron A, Healy HG, Venuthurupalli SK, et al. BMI and its association with death and the initiation of renal replacement therapy (RRT) in a cohort of patients with chronic kidney disease (CKD). BMC Nephrol. 2019;20(1):329.CrossRef Wang Z, Zhang J, Chan S, Cameron A, Healy HG, Venuthurupalli SK, et al. BMI and its association with death and the initiation of renal replacement therapy (RRT) in a cohort of patients with chronic kidney disease (CKD). BMC Nephrol. 2019;20(1):329.CrossRef
36.
go back to reference Chang TJ, Zheng CM, Wu MY, Chen TT, Wu YC, Wu YL, et al. Relationship between body mass index and renal function deterioration among the Taiwanese chronic kidney disease population. Sci Rep. 2018;8(1):6908.CrossRef Chang TJ, Zheng CM, Wu MY, Chen TT, Wu YC, Wu YL, et al. Relationship between body mass index and renal function deterioration among the Taiwanese chronic kidney disease population. Sci Rep. 2018;8(1):6908.CrossRef
37.
go back to reference Stefansson VTN, Schei J, Solbu MD, Jenssen TG, Melsom T, Eriksen BO. Metabolic syndrome but not obesity measures are risk factors for accelerated age-related glomerular filtration rate decline in the general population. Kidney Int. 2018;93(5):1183–90.CrossRef Stefansson VTN, Schei J, Solbu MD, Jenssen TG, Melsom T, Eriksen BO. Metabolic syndrome but not obesity measures are risk factors for accelerated age-related glomerular filtration rate decline in the general population. Kidney Int. 2018;93(5):1183–90.CrossRef
38.
go back to reference Lin TY, Liu JS, Hung SC. Obesity and risk of end-stage renal disease in patients with chronic kidney disease: a cohort study. Am J Clin Nutr. 2018;108(5):1145–53.CrossRef Lin TY, Liu JS, Hung SC. Obesity and risk of end-stage renal disease in patients with chronic kidney disease: a cohort study. Am J Clin Nutr. 2018;108(5):1145–53.CrossRef
Metadata
Title
Lipid accumulation product, visceral adiposity index and risk of chronic kidney disease
Authors
Alexander L. Bullen
Ronit Katz
Ujjala Kumar
Orlando M. Gutierrez
Mark J. Sarnak
Holly J. Kramer
Michael G. Shlipak
Joachim H. Ix
Suzanne E. Judd
Mary Cushman
Pranav S. Garimella
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2022
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-022-03026-9

Other articles of this Issue 1/2022

BMC Nephrology 1/2022 Go to the issue