目的 · 研究中国中老年社区人群肥胖与慢性肾脏疾病（CKD）的相关性。方法 · 采取整群抽样的方法对上海市嘉定区 10 375 名 40 岁及以上的常住居民进行调查。每位受试者均接受标准化问卷调查、体格检查，同时采集空腹血和晨尿标本检测血糖、血脂、 肝功能、肾功能、尿白蛋白、尿肌酐等生化指标。肥胖程度的判断采用世界卫生组织（WHO）的诊断标准，将男性和女性按照体质量 指数（BMI）分为正常体质量组（BMI<25 kg/m2）、超重组（25 kg/m2 ≤ BMI<30 kg/m2）、肥胖组（BMI ≥ 30 kg/m2）。依据美国 CKD 流行病学合作研究组（CKD-EPI）方程计算获得估算的肾小球滤过率。采用Logistic 回归分析不同BMI 水平人群CKD 的患病风险。
 结果 · 研究对象各项代谢指标均随着 BMI 水平的升高而趋向恶化。在校正多种因素后，BMI 每增加 1 kg/m2，CKD 患病风险增加 9%， 其比值比（OR）为 1.09（95% CI：1.07 ～ 1.12）。多元 Logistic 回归分析结果显示，超重组和肥胖组的 CKD 患病风险较正常体质量组 分别增加 51%（OR=1.51, 95% CI：1.27 ～ 1.78）和 181%（OR=2.81, 95%CI：2.20 ～ 3.61）。 结论 · 在中国中老年社区人群中，超重和 肥胖者 CKD 患病风险显著升高。

 Objective · To investigate the relationship between obesity and chronic kidney disease (CKD) in a community-based study among a middle-aged and elderly Chinese population.  Methods · A survey of 10 375 inhabitants aged 40 years or older in Jiading District of Shanghai was performed using cluster sampling. All the subjects were recruited to undergo questionnaire interview, anthropometric measurements, and biochemical measurements. Blood and urine samples were collected to measure biochemical features, including plasma glucose, lipid profiles, liver and renal function, as well as urinary albumin and creatinine. Obesity status was diagnosed according to the World Health Organization (WHO) criteria. According to body mass index (BMI) levels, the subjects were divided into normal weight group (BMI<25 kg/m2), overweight group
 (25 kg/m2 ≤ BMI<30 kg/m2) and obesity group (BMI ≥ 30 kg/m2). The estimated glomerular filtration rate (eGFR) was calculated based on American Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation. Logistic regression analysis was used to analyze the risk of CKD among people with different BMI levels.  Results · Increased BMI levels were associated with more unfavorable metabolic profiles. After a variety of factors were adjusted, each 1 kg/m2 increment of BMI was associated with a 9% higher risk of prevalent CKD, and the odds ratio (OR) was 1.09 (95% CI：1.07-1.12). Results from multivariate Logistic regression analysis showed that in the total population, compared with individuals in the normal weight group, those in the overweight and obesity groups had 51% (OR=1.51, 95% CI: 1.27-1.78) and 181% (OR=2.81, 95% CI: 2.20-3.61) higher risk of prevalent CKD.  Conclusion · In the middle-aged and elderly community population in China, overweight and obesity are associated with an increased risk of prevalent CKD.