Four-Year Changes in Visceral Fat Mass and the Risk of Developing Proteinuria in the General Population

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 (Delta VFM) over several years in the development of proteinuria. In this longitudinal cohort study with the general population, the changes in Delta VFM 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 Delta VFM. 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 Delta VFM. However, subjects who developed proteinuria exhibited a significant increase in Delta VFM. 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) 1.229.67; women, OR 2.01, 95% CI 1.05-4.15] and Delta VFM (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.VFM 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 Delta VFM 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.