Metabolically Healthy Obese Still At Increased Risk of Chronic Kidney Disease Interview with:
Yoosoo Chang MD PhD

Kangbuk Samsung Hospital
Sungkyunkwan University School of Medicine
Seoul, Korea

Medical Research: What is the background for this study? What are the main findings?

Response: There is substantial controversy and a lot of interest on the health implications of metabolically healthy obesity, that is, subjects who are obese but do not have metabolic abnormalities in spite of their high body mass index. The risk for chronic kidney disease (CKD) among obese patients without metabolic abnormalities is unknown.

In this cohort study of South Korean men and women, metabolically healthy overweight and obese participants had increased incidence of Chronic Kidney Disease (CKD) compared with normal-weight participants.

Medical Research: What should clinicians and patients take away from your report?

Response: Physicians should monitor metabolically healthy obese and overweight patients for  Chronic Kidney Disease and counsel them about maintaining a healthy weight and lifestyle.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Adipocytokines or adipose tissue-derived factors such as leptin, adiponectin, tumor-necrosis factor-alpha, interleukin-6 etc may be involved in the pathogenesis of development of chronic kidney disease. The measures of these markers associated with excessive adiposity will benefit future research efforts.

Also, in our study, we used a single assessment of BMI at baseline and did not incorporate changes in BMI or other changes in metabolic health status during the follow-up. Incorporation of the change of BMI and metabolic health during follow-up time will benefit future research efforts. 

Medical Research: Is there anything else you would like to add?

Response: Our study suggests that metabolically healthy obese individuals are at an increased risk of chronic kidney disease.  In prior studies,  metabolically healthy overweight has been reported to be associated with the development of type 2 diabetes and cardiovascular disease, indicating that  metabolically healthy overweight is not a harmless condition and that the obese phenotype, regardless of metabolic abnormalities, can adversely affect health outcome.


:Chang Y, Ryu S, Choi Y, Zhang Y, Cho J, Kwon M, et al. Metabolically Healthy Obesity and Development of Chronic Kidney Disease: A Cohort Study. Ann Intern Med. [Epub ahead of print 9 February 2016] doi:10.7326/M15-1323

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Dr. Yoosoo Chang (2016). Metabolically Healthy Obese Still At Increased Risk of Chronic Kidney Disease