Comparison of the Correlates Between Body Mass Index, Waist Circumference, Waist-to-Height Ratio, and Chronic Kidney Disease in a Rural Chinese Adult Population

Objective The aim of the article was to evaluate and compare the correlates of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with chronic kidney disease (CKD) among a rural Chinese adult population. Design This was a case–control study. Methods A total of 4,221 adults, aged 27 to 95 years, were divided into different groups based on the standard of CKD stages. A receiver operating characteristic curve was performed to evaluate and compare the predictive values of BMI, WC, and WHtR for CKD. Multiple logistic regression model and ordinal logistic regression model were used to estimate the association between BMI, WC, WHtR, and CKD. Main Outcome Measures The main outcome variable was stage of CKD. Results The abnormality in BMI, WC, and WHtR was associated with the cumulative risk of CKD after adjusting for age, gender, smoking, and drinking, and corresponding odds ratios (ORs) (95% confidence intervals [CIs]) were 1.154 (1.009-1.319), 1.240 (1.077-1.428), and 1.191 (1.030-1.378). After further adjustment for blood lipid, hypertension, type 2 diabetes mellitus, and use of antihypertensive and antidiabetic agents, the association of WC and CKD remained statistically significant (adjusted OR = 1.220, 95% CI: 1.052-1.415). Both WC and WHtR were significantly associated with the risk of CKD in females, crude ORs (95% CIs) of cumulative effect of WC and WHtR with CKD were 1.534 (1.296-1.816) and 1.981 (1.683-2.331), respectively. The area under the curves of BMI, WC ,and WHtR for CKD Stage 3 were 0.531, 0.579, and 0.614, and pairwise comparisons showed the area under the curve of WHtR was significantly higher than BMI and WC ( P P  = .002). Conclusion Our findings suggested that abnormality in BMI, WC, and WHtR was associated with CKD in rural population, and WHtR was better in CKD prediction, especially in female.