Insulin resistance mediates the association between adiposity markers and incident chronic kidney disease: Findings from the UK Biobank prospective cohort study
Authors' conclusion
Elevated WHR was linked to increased risks of CKD and ESKD. The mediating effect of IR indexes between WHR and CKD was more significant than BMI.
Study context
- Population
- Adults without baseline chronic kidney disease (CKD), UK Biobank
- Participants
- 398,307 adults
- Exposure
- High vs lower waist circumference and waist-to-hip ratio (WHR); Insulin resistance (IR) indices as mediators
- Outcome
- Incident CKD and ESKD
- Follow-up
- 13.62 years
Methodological detailsUK Biobank, Cox regression, mediation analysis
- UK Biobank
- Cox regression
- Mediation analysis
Main finding
As reported in the abstract
Incident CKD and ESKD with high waist circumference and WHR (BMI-adjusted)
- CKD cases
- 17,583 (3.37 per 1000 person-years)
- End-stage kidney disease (ESKD) cases
- 1,509 (0.29 per 1000 person-years)
- High waist circumference, CKD: HR
- 1.23 (1.19-1.27) (95% CI)
- High WHR, CKD: HR
- 1.17 (1.12-1.22) (95% CI)
- High waist circumference, ESKD: HR
- 1.37 (1.22-1.54) (95% CI)
- High WHR, ESKD: HR
- 1.39 (1.29-1.49) (95% CI)
Observational data: associations, not effects.
Further findings
Mediation: proportion of TyG index–CKD association accounted for by BMI, waist circumference, WHR
%
- BMI
- 12
- Waist circumference
- 44.4
- WHR
- 23.8
Mediation: proportion of TG/HDL-C ratio–CKD association accounted for by BMI, waist circumference, WHR
%
- BMI
- 7.4
- Waist circumference
- 26.7
- WHR
- 13.9
Original publication
Insulin resistance mediates the association between adiposity markers and incident chronic kidney disease: Findings from the UK Biobank prospective cohort study. Diabetes Res Clin Pract. Published 15 May 2025. doi:10.
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