Objective  To evaluate the predictive value of different anthropometric indices in assessing body fat content in patients with chronic kidney disease (CKD).

Methods  Bioelectrical impedance analysis was used to measure body fat percentage and visceral fat area in 279 non-dialysis CKD patients. Height and body mass were measured to calculate body mass index (BMI). Waist and hip circumferences were measured to calculate waist-to-hip ratio. Skinfold thickness (triceps skinfold thickness and subscapular skinfold thickness) was also measured. Pearson correlation analysis was employed to explore the correlations between anthropometric indices and body fat percentage as well as visceral fat area. Receiver operating characteristic (ROC) curves were plotted, and the DeLong test was conducted to compare the differences in the area under the curve (AUC) of the ROC curves.

Results  Pearson correlation analysis revealed significant correlations between body fat percentage and BMI (r=0.419, P < 0.001), hip circumference (r=0.450, P < 0.001), triceps skinfold thickness (r=0.229, P < 0.001), and subscapular skinfold thickness (r=0.324, P < 0.001). Significant correlations were also observed between visceral fat area and BMI (r=0.658, P < 0.001), hip circumference (r=0.648, P < 0.001), triceps skinfold thickness (r=0.194, P=0.001), and subscapular skinfold thickness (r=0.333, P < 0.001). ROC curve analysis demonstrated that the triceps skinfold thickness had the largest AUC value (0.732) for diagnosing obesity in CKD patients, with a sensitivity of 62.1% and specificity of 78.8%, indicating a moderate diagnostic performance. BMI and hip circumference had AUC values of 0.806 and 0.804, respectively, for assessing visceral obesity in CKD patients, showing good diagnostic performance. In contrast, the waist-to-hip ratio exhibited poor diagnostic value for both overall obesity and visceral obesity.

Conclusion  Measuring BMI and hip circumference is valuable for diagnosing visceral fat accumulation in CKD patients. However, when assessing overall obesity in CKD patients, multiple anthropometric indices should be combined for comprehensive evaluation. Additionally, our results indicate that different anthropometric indices have varying diagnostic values for different types of obesity, necessitating appropriate selection based on actual circumstances.