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Combination of Thigh Circumference and Indices of Central Obesity Helps Predict Incident Chronic Kidney Disease: A 14-Year Prospective Cohort Study Using a Three-Dimensional Body Laser Scanner.

OBJECTIVE
Obesity, high body mass index, and visceral fat accumulation are associated with renal diseases. However, the association between body measurements and chronic kidney disease (CKD) is still unclear.


METHODS
A cohort of 7,825 participants scheduled for follow-up of CKD was recruited from 2000 to 2008 in Taiwan. A questionnaire was developed to collect the basic demographics, lifestyle variables, personal disease history, and family disease history of the participants. A 3-dimensional body surface scanning system was used to take their body measurements. The participants underwent an average follow-up of 14.3 years for evaluation of the incidence of CKD. A multiple Cox regression model was built.


RESULTS
Three body measurements, namely chest width (hazard ratio [HR] 1.059, 95% confidence interval [CI] 1.011-1.110), waist circumference (HR 1.017, 95% CI 1.006-1.029), and thigh circumference (HR 0.941, 95% CI 0.922-0.961), were significantly associated with CKD. Two combinations of body measurements, namely the waist-to-thigh ratio and chest-to-thigh ratio, were derived to predict the occurrence of CKD. Participants with the highest quartile of waist-to-thigh ratio and chest-to-thigh ratio had a 2.175-fold and 2.182-fold risk of developing CKD, respectively.


CONCLUSIONS
This study suggests that along with central obesity, body limb measurements can be used as an indicator to predict the occurrence of CKD. The effects of limb measurements on CKD could help provide an innovative perspective regarding the intervention to be developed for the treatment of CKD and a preventive medicine for high-risk individuals. The association of thigh circumference with CKD warrants further investigation.