Índice de conicidade como indicador de obesidade abdominal em indivíduos com doença renal crônica em hemodiálise: uma análise de classes latentes

Abstract

The conicity index is an indicator used as a tool to assess abdominal obesity in individuals on hemodialysis. Objectives: To establish cutoff points for the conicity index according to gender for the diagnosis of abdominal obesity and to verify its association with sociodemographic, clinical and lifestyle variables of individuals with chronic kidney disease undergoing hemodialysis residing in Espírito Santo. Methods: This is a cross-sectional, observational and analytical epidemiological study developed with 953 patients on hemodialysis. Descriptive analysis was stratified by sex, with categorical variables presented through relative and absolute frequencies and tested by Pearson's chi-square test, and continuous variables were presented through means and standard deviations. Latent class analysis was used to determine the cutoff points for the conicity index. The binary logistic regression model was used to test associations between the independent variables and the conicity index, including in the model the variables that presented p-value ≤ 0.10 in the bivariate analysis. For all of them, the assumptions of absence of multicollinearity and outliers were tested. All analyzes were conducted in R software (4.0.3) for Windows®. The significance level adopted was 5%. Results: The cutoff points for the conicity index were similar between the two sexes, resulting in 1.275 (AUC: 0.92 95% CI: 0.88-0.95, p < 0.001) for men and 1.285 (AUC: 0.92 95% CI: 0.89-0.9, p < 0.001) for women. The conicity index was high in 56.54% of men (95% CI: 34.34-70.16) and 43.46% of women (95% CI: 38.45-55.20). We found that both adult men (OR = 3.71; 95% CI: 2.27-6.07) and adult women (OR = 4.06; 95% CI: 2.41-6.84) were more likely to have abdominal obesity, as well as self-declared mixed-raced (OR: 1.74; 95% CI: 1.01-3.00) and single men (OR: 1.64; 95% CI: 1.00-2.68). Conclusion: The conicity index based on the defined cutoff points showed a satisfactory performance. In addition, factors such as age, color and the absence of a partner (a) were associated with abdominal obesity in individuals with chronic kidney disease on hemodialysis.