계명대학교 의학도서관 Repository

Sex-Specific Obesity Paradox in Critically Ill Patients With Severe Acute Kidney Injury: A Retrospective Analysis

Metadata Downloads
Author(s)
Hyo Jin JungYu Jin SeoJiyun JungJangwook LeeJae Yoon ParkYong Chul KimSung Woo LeeTae Hyun BanWoo Yeong ParkKipyo KimHyosang KimKyeongmin KimHee-Yeon JungJi-Young ChoiJang-Hee ChoSun-Hee ParkChan-Duck KimJeong-Hoon LimYong-Lim Kim
Keimyung Author(s)
Park, Woo Yeong
Department
Dept. of Internal Medicine (내과학)
Journal Title
Crit Care Med
Issued Date
2025
Volume
53
Issue
2
Keyword
acute kidney injurybody mass indexcontinuous renal replacement therapycritical illnessintensive care unitmortalityobesity paradoxsex difference
Abstract
OBJECTIVES:
Although obesity is typically correlated with adverse outcomes in various diseases, certain acute critical illnesses exhibit a phenomenon known as the obesity paradox. This study evaluated sex-specific differences in the prognostic implications of the body mass index (BMI) of patients with severe acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT).

DESIGN:
A multicenter retrospective cohort study.

SETTING:
Data from eight tertiary hospitals in Korea.

PATIENTS:
A total of 3805 critically ill patients receiving CRRT. Patients were categorized into four BMI groups: underweight, normal weight, overweight, and obese.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
There were 2308 male and 1497 female patients. The 90-day mortality risk significantly differed among BMI groups in the overall patient population and the male subpopulation but not the female subpopulation. Following adjustment for confounding variables, the 90-day mortality risk was higher in the underweight group than in the obese group (hazard ratio [HR], 1.20; 95% CI, 1.05–1.36; p = 0.006). Among male patients, the 90-day mortality risk was higher in both the underweight and normal weight groups than in the obese group (underweight: HR, 1.30; 95% CI, 1.10–1.53; p = 0.002 and normal weight: HR, 1.18; 95% CI, 1.04–1.35; p = 0.010); however, no such association was observed among female patients. Subgroup analysis demonstrated the obesity paradox in male patients of old age, with septic AKI, or with low albumin levels.

CONCLUSIONS:
There were sex differences in the association between BMI and mortality in critically ill patients with severe AKI. Although the precise distribution of fat mass and muscle mass was not identified, obese male patients had a more favorable prognosis, which was not evident among female patients. These findings highlight the importance of considering sex-specific factors in understanding the complex relationship between obesity and mortality in critically ill patients with AKI.
Keimyung Author(s)(Kor)
박우영
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1530-0293
Source
https://journals.lww.com/ccmjournal/fulltext/2025/02000/sex_specific_obesity_paradox_in_critically_ill.10.aspx
DOI
10.1097/CCM.0000000000006538
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/46006
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
공개 및 라이선스
  • 공개 구분공개
  • 엠바고Forever
파일 목록
  • 관련 파일이 존재하지 않습니다.

Items in Repository are protected by copyright, with all rights reserved, unless otherwise indicated.