Metabolic Obesity Phenotypes and Risk of Chronic Kidney Disease: A Cross-Sectional Study from Communities in the Center Region of Cameroun

Background and Aims: Obesity is a risk factor for chronic kidney disease (CKD). Prior studies have identified two subtypes of obesity: metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO), the latter being associated with an increased risk of CKD, while the condition of the former is contradictory and largely uninvestigated in Africa. Methodology: A cross-sectional study was conducted involving 317 obese participants (n = 201 metabolically healthy subjects and 116 metabolically unhealthy subjects) in two areas of the center region of Cameroon. Obesity was defined as a body mass index (BMI) of 27.0 kg/m2 or greater. Chronic kidney disease (CKD) was evaluated using the estimated glomerular filtration rate (GFR) of less than 60 ml/min per 1.73 m2, as per the CKD-EPI definition. Results: The prevalence of CKD was significantly higher in urban areas (28%) compared to peri-urban/rural areas (14.6%). Individuals with MUO phenotype had higher rates of CKD compared to participants with MHO phenotype; however, there was a difference in the prevalence of CKD between the metabolically healthy subjects in urban areas (24.6%) and in peri-urban/rural areas (14.3%). After adjustment for confounding factors, the risk factors for CKD in urban areas were: age over 50 years (OR: 7.54; 95% CI = 3.09 - 7.45), a high Total Cholesterol/HDL cholesterol ratio (TC/HDL ratio) (OR: 2.06; 95% CI = 0.97 - 4.41), and a high atherogenic index of plasma (AIP) (OR: 2.94; 95% CI = 1.16 - 7.45). MUO phenotype also had a higher risk of CKD, but the P-value was of borderline significance. The risk factors in peri-urban and rural areas were a high TC/HDL ratio (OR: 4.73; 95% CI: 1.33 - 16.86) and high visceral fat (OR: 4.94; 95% CI: 1.33 - 16.86). Conclusion: The MUO phenotype was associated with a higher prevalence of CKD. Furthermore, this prevalence was lower in peri-urban/rural areas compared to urban areas.