Central Body Fat Distribution Associates with Unfavorable Renal Hemodynamics Independent of Body Mass Index

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Figure 1.
Univariate associations between WHR and BMI with renal hemodynamics measures. Scatter plots showing the univariate associations between WHR (upper panel) and BMI (lower panel), respectively, with BSA-indexed GFR and ERPF and with FF.
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Figure 2.
Mean FF per median WHR and BMI. Three-dimensional bar graph showing the combined effects of WHR and BMI on FF, with mean FF (y-axis) per sex-stratified median of WHR (x-axis) and median BMI (z-axis). Median WHR was 0.86 and median BMI was 24.6 kg/m².

Table 1.

Participant characteristics (n=315)

Variable	Data
Men, n (%)	167 (53)
Age (yr)	39±15
WHR	0.87±0.09
Waist circumference (cm)	86±11
Hip circumference (cm)	99±9
Weight (kg)	78±14
Height (cm)	176±10
BMI (kg/m²)	24.9±3.9
BSA (m²)	1.94±0.20
Overweight, n (%)	109 (35)
Obesity, n (%)	31 (10)
Fasting plasma glucose (mmol/L)	4.7±0.5
Systolic BP (mmHg)	123±12
Diastolic BP (mmHg)	75±8
MAP (mmHg)	89±9
GFR/BSA (ml/min per 1.73 m²)	109±15
ERPF/BSA (ml/min per 1.73 m²)	415±92
GFR (ml/min)	122±20
ERPF (ml/min)	464±112
FF (%)	27±5
Albuminuria (mg/d) (n=198)	5 (3–8)
Urinary sodium excretion (mmol/d) (n=192)	205±79

Overweight and obesity are defined as BMI 25–29.9 and ≥30 kg/m², respectively. Unless otherwise noted, data are shown as mean ± SD or median (interquartile range).

Table 2.

Multivariate data for WHR and BMI with renal hemodynamic measures, indexed for BSA

Variable	GFR/BSA		ERPF/BSA		FF
Variable	β (95% CI)	P Value	β (95% CI)	P Value	β (95% CI)	P Value
WHR
Model 1	−2.95 (−4.67 to −1.23)	0.001	−38.7 (−48.2 to −29.2)	<0.001	1.72 (1.19 to 2.24)	<0.001
Model 2	−3.48 (−5.26 to −1.70)	<0.001	−46.0 (−55.5 to −36.5)	<0.001	2.05 (1.52 to 2.57)	<0.001
Model 3	−3.39 (−5.18 to −1.61)	<0.001	−45.7 (−55.2 to −36.2)	<0.001	2.05 (1.51 to 2.58)	<0.001
Model 4	−3.13 (−4.99 to −1.28)	0.001	−43.0 (−52.8 to −33.2)	<0.001	1.93 (1.38 to 2.48)	<0.001
Model 5	−4.01 (−6.17 to −1.85)	<0.001	−46.6 (−58.0 to −35.1)	<0.001	2.05 (1.41 to 2.70)	<0.001
BMI
Model 1	−0.78 (−2.52 to 0.96)	0.38	−20.8 (−31.0 to −10.7)	<0.001	0.98 (0.43 to 1.52)	<0.001
Model 2	−0.70 (−2.45 to 1.04)	0.43	−19.8 (−29.9 to −9.7)	<0.001	0.93 (0.39 to 1.48)	0.001
Model 3	−0.69 (−2.43 to 1.05)	0.44	−19.8 (−29.8 to −9.7)	<0.001	0.93 (0.39 to 1.48)	0.001
Model 4	−0.34 (−2.12 to 1.44)	0.71	−16.2 (−26.3 to −6.0)	0.002	0.78 (0.22 to 1.33)	0.006
Model 5	1.61 (−0.42 to 3.64)	0.12	6.5 (−4.3 to 17.3)	0.24	−0.22 (−0.83 to 0.38)	0.47

In models of WHR, sex, age, MAP, and BMI are entered as independent values; BSA-indexed GFR and ERPF and FF are entered as dependent variables. In models of BMI, sex, age, MAP, and WHR are entered as independent values. Regression coefficients and confidence intervals are reported as standardized values. Model 1: crude; model 2: model 1 plus adjustment for sex; model 3: model 2 plus adjustment for age; model 4: model 3 plus adjustment for MAP; model 5: model 4 plus adjustment for BMI in model of WHR or adjustment for WHR in model of BMI.

Table 3.

Multivariate data for WHR and BMI with renal hemodynamic measures, unindexed

Variable	GFR		ERPF		FF
Variable	β (95% CI)	P Value	β (95% CI)	P Value	β (95% CI)	P Value
WHR
Model 1	2.21 (−0.09 to 4.51)	0.06	−22.8 (−35.3 to −10.4)	<0.001	1.72 (1.19 to 2.24)	<0.001
Model 2	−3.41 (−5.53 to −1.29)	0.002	−53.5 (−64.9 to −42.1)	<0.001	2.29 (1.72 to 2.85)	<0.001
Model 3	−3.46 (−5.57 to −1.35)	0.001	−54.0 (−65.0 to −42.9)	<0.001	2.30 (1.74 to 2.86)	<0.001
Model 4	−3.34 (−5.45 to −1.23)	0.002	−53.6 (−64.7 to −42.4)	<0.001	2.30 (1.74 to 2.87)	<0.001
Model 5	−3.11 (−5.28 to −0.94)	0.005	−51.0 (−62.4 to −39.7)	<0.001	2.19 (1.61 to 2.76)	<0.001
Model 6	−4.53 (−6.90 to −2.16)	<0.001	−52.7 (−65.2 to −40.1)	<0.001	2.03 (1.39 to 2.67)	<0.001
BMI
Model 1	5.06 (2.82 to 7.29)	<0.001	−1.2 (−13.9 to 11.4)	0.85	0.98 (0.43 to 1.52)	<0.001
Model 2	−0.44 (−2.64 to 1.76)	0.69	−30.4 (−43.0 to −17.7)	<0.001	1.45 (0.84 to 2.06)	<0.001
Model 3	1.30 (−1.29 to 3.88)	0.32	−25.4 (−40.4 to −10.4)	0.001	1.59 (0.87 to 2.32)	<0.001
Model 4	1.35 (−1.23 to 3.93)	0.30	−25.1 (−40.1 to −10.1)	0.001	1.59 (0.86 to 2.31)	<0.001
Model 5	1.63 (−0.96 to 4.23)	0.22	−22.0 (−36.9 to −7.2)	0.004	1.46 (0.74 to 2.18)	<0.001
Model 6	3.92 (1.11 to 6.72)	0.006	4.5 (−10.4 to 19.4)	0.55	0.44 (−0.32 to 1.19)	0.26

In models of WHR, BSA, sex, age, MAP, and BMI are entered as independent values; unindexed GFR and ERPF, and FF are entered as dependent variables. In models of BMI, BSA, sex, age, MAP, and WHR are entered as independent values. Regression coefficients and confidence intervals are reported as standardized values. Model 1: crude; model 2: model 1 plus adjustment for BSA; model 3: model 2 plus adjustment for sex; model 4: model 3 plus adjustment for age; model 5: model 4 plus adjustment for MAP; model 6: model 5 plus adjustment for BMI in model of WHR or adjustment for WHR in model of BMI.