High weight in adolescents has been linked to a high risk of developing chronic kidney disease
High body mass index in adolescence is associated with early development of chronic kidney disease, with the risk increasing with the severity of obesity. These conclusions were reached by Israeli scientists who conducted a cohort study involving almost 600,000 adolescents. The results are published in the journal JAMA Pediatrics.
According to the American Academy of Pediatrics, the prevalence of obesity among children and adolescents can be as high as 30 percent, depending on ethnic group and family income level, and it will be getting higher in the near future. And while the association between obesity and chronic kidney disease (CKD) in adults is well established, data on such an association in adolescents and young adults are limited. In addition, it is unclear whether this association can be considered independent of other obesity-related comorbidities, such as diabetes and hypertension.
To address this gap, Avishai Tsur and colleagues at the Hebrew University of Jerusalem examined data from a representative cohort of adolescents in Israel who underwent a medical examination before mandatory military service. The cohort numbered 593660 adolescents (323293 males and 270367 females). It included 209485 children with an elevated body mass index (BMI), 60516 overweight, 25304 moderately obese, and 6331 severely obese. The mean age at the time of the study was 17.2 years.
Researchers found a consistent relationship between high BMI and the development of chronic kidney disease. Among men, the adjusted relative risk for early development of CKD was 1.8 for those with high normal BMI, 4.0 for overweight, 6.7 for moderately obese, and 9.4 for severely obese. In women, the adjusted relative risk was 1.4 for high normal BMI, 2.3 for overweight, 2.7 for moderately obese, and 4.3 for severely obese.
In addition, the researchers calculated the risk of developing CKD in people without diabetes or arterial hypertension. Although the relative risk of CKD was lower for them, it was still statistically significant: it was 2.7 for severely obese men and 2.3 for women.
These results indicate that obesity in adolescence has a similar effect on the risk of developing CKD as it does in adulthood and old age. These are important findings, as CVD is significantly associated with decreased life expectancy, so the issue of obesity prevention, including protection against CVD, becomes even more important.
However, there is good news: trials of monoclonal antibodies that activate the leptin receptor have shown them to be effective in treating obesity and lipodystrophy.