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논문분류	춘계학술대회 초록집
제목	Neck Circumference Predicts Renal Function Decline in Overweight Men and Women: A Community-based Prospective Cohort Study
저자	Chang-Yun Yoon* 1, Jong Hyun Jhee1, Youn Kyung Kee1, Changhwan Seo1, Misol Lee1, Min-Uk Cha1, Hyoungnae Kim1, Seohyun Park1, Hae-Ryong Yun1, Su-Young Jung1, Young Eun Kwon1, Seung Hyeok Han1, Tae-Hyun Yoo1, 2, Shin-Wook Kang1, Jung Tak Park1
출판정보	2016; 2016(1):
키워드	chronic kidney disease, Neck Circumference, Renal Function
초록	Background: Chronic kidney disease (CKD) markedly increases the risks of mortality and morbidity. Upper body subcutaneous fat, commonly estimated by neck circumference (NC), has recently been noticed as the main determinator of systemic free fatty acid concentrations in overweight patients. In spite of the relationships found with metabolic complications, the impact of upper body subcutaneous fat on renal function has not been fully elucidated. Therefore, the association between upper body subcutaneous fat, represented by NC, and incident CKD was explored. Methods: The data was retrieved from the Korean Genome and Epidemiology Study (KoGES) cohort. Overweight was defined as body mass index ≥ 23 kg/m2, and subjects were followed at a 2-year interval from 2003 to 2012. Incident CKD was defined as the composites of estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2 or development of proteinuria. A total of 35,709 cohort subjects were screened. After exclusion, 2,268 overweight subjects were eligible for final analysis. Results: The mean age was 36.3 ± 3.0 years, and 1,285 patients (56.7%) were male. The subjects were divided into two groups according to the median value of NC in male and female subjects, respectively. High NC showed significantly high prevalence of hypertension (male; 63 [10.3%] vs 108 [17.7%], P < 0.001, female; 56 [11.0%] vs 73 [16.9%], P = 0.009) and diabetes (male; 41 [6.7%] vs 72 [11.8%], P = 0.002, female; 12 [2.4%] vs 41 [9.5%], P < 0.001), while eGFR was significantly low only in male subjects with high NC (male; 74.0 ± 8.2 vs 71.9 ± 7.3 ml/min/1.73m2, P < 0.001, female; 71.2 ± 7.5 vs 70.5 ± 7.5 ml/min/1.73m2, P = 0.167). In multiple Cox analysis, higher NC values were independently associated with incident CKD development in female subject after adjusting for multiple confounding factors (NC, 1 cm increase, male; hazard ratio [95% confidence interval] = 0.989 [0.887-1.103], P = 0.841, female; 1.159 [1.024-1.310], P = 0.019). However, a significant relationship was not found in male subjects. Conclusion: NC is independently associated with the incidence of CKD in overweight female subjects. Upper body subcutaneous fat, chiefly represented by NC, could be considered as a practical risk factor for CKD.
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