Metabolically Healthy Obesity and Incident Chronic Kidney Disease: The Role of Systemic Inflammation in a Prospective Study

Objective: To investigate the association between the metabolically healthy obesity (MHO) phenotype and incident chronic kidney disease (CKD) in a Chinese population and whether systemic inflammation affects this association. Methods: A cohort study was performed with 2,491 Chinese adults. Body mass index >= 25.0 kg/m(2) was defined as obesity. CKD was defined as estimated glomerular filtration rate< 60 mL/min per 1.73 m(2) or urinary albumin-to-creatinine ratio >= 30 mg/g. High-sensitivity C-reactive protein (hsCRP) was used as a surrogate marker of systemic inflammation. Results: Over a median follow-up period of 3.9 years, 243 of 2,491 participants developed incident CKD (9.8%). Compared with metabolically healthy nonobesity (MHNO), MHO was associated with incident CKD ( odds ratio [ OR] 51.65, 95% confidence interval [CI] 1.01-2.69), but not after adjustment for hsCRP. The MHO/hsCRP >= 0.20 mg/L group, but not the MHO/ hsCRP < 0.20 mg/L group, had an increased OR for incident CKD (OR52.66, 95% CI 1.37-5.14), with the MHNO/hsCRP < 0.20 mg/L group as the reference. Conclusions: MHO was significantly associated with incident CKD, and the level of systemic inflammation partially explained this association.