Chronic kidney disease (CKD) risk is inconsistent in the normal-weight, overweight, and obese individuals due to the heterogeneity of metabolic status. This meta-analysis aimed to examine combined effects of body mass index (BMI) and metabolic status on CKD risk.

1. The First International Congress of Iranian Personalized medicine
Combined effects of obesity and metabolic status on the risk of incident
chronic kidney disease events: pooled analysis of longitudinal studies
Presented by: Shahab Alizadeh
Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran,
Iran

2.  Chronic kidney disease is the 18th highest cause of death worldwide and is a worldwide health
problem with increasing incidence and prevalence.
• One of the major risk factors for CKD is obesity
• Most studies, but not all, have shown that obese subjects exhibit lower GFR. These discrepancies
might be due to the heterogeneity of obesity phenotypes.
• Studies demonstrated that not all obese subjects display a clustering of metabolic and
cardiovascular risk factors, and, likewise, not all lean subjects present a healthy metabolic and
disease-free profile.
• Different body size phenotypes were recently defined.
• The role of obesity in kidney disease is depend on the clustering of metabolic and cardiovascular
risk factors.
Introduction: Chronic kidney disease (CKD) and metabolic phenotypes of obesity
The first international congress of Iranian personalized medicine 2 obesity phenotypes and CKD

3.  The subjects were stratified into normal-weight, overweight, and obese categories and
with or without metabolic syndrome to describe different phenotypes of body size as
the following:
 metabolically healthy with normal-weight (MHNW)
 metabolically unhealthy with normal-weight (MUNW)
 metabolically healthy with overweight (MHOW)
 metabolically unhealthy with overweight (MUHOW)
 metabolically healthy with obesity (MHO)
 metabolically unhealthy with obesity (MUHO).
Introduction- Definitions of different metabolic phenotypes of obesity
The first international congress of Iranian personalized medicine 3 obesity phenotypes and CKD
6.0% to 38.4% of obese subjects
higher susceptibility to type 2
diabetes and CVD, and mortality

4. Figure 1. The flow diagram describing the process of screening and excluded articles.
A total of 7 prospective cohort studies , with 3596 cases and 142824 participants
were analyzed using the STATA software
The first international congress of Iranian personalized medicine 4 obesity phenotypes and CKD

5. Introduction- diet and risk of endometrial cancer
The first international congress of Iranian personalized medicine 5 obesity phenotypes and CKD
Figure 2. Pooled estimated risk of chronic kidney disease for metabolically unhealthy normal-weight phenotype
compared with metabolically healthy normal-weight individuals.

6. Figure 3. Pooled estimated risk of chronic kidney disease for metabolically healthy overweight (A) and metabolically
unhealthy overweight (B) phenotypes compared with metabolically healthy normal-weight individuals.
The first international congress of Iranian personalized medicine 6 obesity phenotypes and CKD
(B)(A)

7. .
Figure 4. Pooled estimated risk of CKD for metabolically healthy obese (A) and metabolically unhealthy obese (B)
phenotypes compared with metabolically healthy normal-weight individuals.
The first international congress of Iranian personalized medicine 7 obesity phenotypes and CKD
(A) (B)

8.  metabolically healthy normal-weight individuals 1 (reference)
 metabolically unhealthy normal-weight individuals 45% increased
 metabolically healthy overweight individuals 34% increased
 metabolically unhealthy overweight individuals 31% increased
 metabolically healthy obese individuals 43% increased
 metabolically unhealthy obese individuals 74% increased
 Final Conclusion: Persons with metabolic aberrations, however at normal-weight,
have an increased risk for incident CKD. Healthy overweight and obese individuals
had higher risk; refuting the notion that metabolically healthy overweight and obese
phenotypes are benign conditions.

Conclusions- risk of CKD associated with metabolic phenotypes of body size
The first international congress of Iranian personalized medicine 8 obesity phenotypes and CKD
Compare 45
vs. 43

9. The first international congress of Iranian personalized medicine 9 obesity phenotypes and CKD