الفهرس 
OBESITY: EPIDEMIOLOGY AND NEW ADVANCES IN MANAGEMENTOnly 14 pages are availabe for public view
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Abstract
T
he rapid increase in obesity rates worldwide remains a serious public health problem. Metabolically healthy obesity (MHO) is a type of obesity characterized by the absence of metabolic syndrome. It is considered a transitional state, meaning that certain metabolic effects may further complicate the disease. Yet, the relationship between chronic kidney disease (CKD) and MHO has not been established. This review investigates the relationship between the metabolic healthy phenotype of obesity and the development or progression of chronic kidney disease.
This study aim to determine the causal relationship between obesity and the development of CKD.
A comprehensive literature search was carried out in five main databases, namely Web of Science (Elsevier), PubMed/Medline (https://pubmed.ncbi.nlm.nih.gov/), Science Direct (www.sciencedirect.com), Scopus (Elsevier), and Google Scholar for published studies up to December 2022 using the following search strategy (”chronic kidney disease” OR ”end-stage renal disease” OR ”estimated glomerular filtration rate” OR ”kidney function”) AND (“obesity” OR ”metabolic syndrome” OR ”metabolically healthy” OR ”metabolically healthy obesity” OR ”overweight” OR ”metabolically healthy overweight ”OR ”metabolic parameters” OR ”metabolic profile” OR ”obesity without metabolic abnormality” OR ”healthy obesity”) and A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Metanalyses (PRISMA) for reporting.
This review included 15 cohort studies published between 2015 – 2022 with a total of 5,039,394 participants and 647,609 metabolic healthy obese adults, the mean follow-up period was seven years. Compared to healthy normal-weight individuals (MHNW), metabolic healthy obese (MHO) individuals had a 42% higher risk of development or progression of CKD and 2% of the MHO population developed CKD with a pooled risk ratio (RR) = 1.42, 95% CI (1.25-1.61) by random effects model.
This study found that metabolic healthy obese adults have a significantly higher risk of development or progression of CKD compared to healthy normal - weight individuals.
CONCLUSION
1- This analysis found that metabolic healthy obesity has a significant association with developing chronic kidney disease as it increases risk by about 1.42 folds.
2- Early detection of obesity-related glomerulopathy (ORG) can be performed through the detection of GFR or proteinuria.
3- Measures should also be taken to prevent and manage obesity and metabolic disorders to reduce the prevalence of obesity and the associated risk of chronic kidney disease.
RECOMMENDATIONS
1) Chronic kidney disease (CKD) screening should be offered to MHO individuals and health education related to lifestyle modifications should be widely available to reduce the burden of MHO and related disorders.
2) Different metabolic phenotypes as well as BMI estimates should be considered when evaluating obese individuals.
3) The emergence of the concept of the metabolic healthy obesity phenotype requires awareness of the health issues involved, as it is not a benign disease as it was previously known.