Obesity, Anion Accumulation, and Anion Gap Metabolic Acidosis: A Cohort Study

Obesity is associated with low serum bicarbonate, an indicator of metabolic acidosis and a CKD risk factor. To further characterize acid-base disturbance and subclinical metabolic acidosis in this population, we examined prospective associations of body mass index (BMI) with elevated anion gap and w...

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Bibliographic Details
Published in:Kidney360 2021-11, Vol.2 (11), p.1706-1715
Main Authors: Lambert, Douglas C, Abramowitz, Matthew K
Format: Article
Language:English
Subjects:
Acid-Base Equilibrium
Acidosis - epidemiology
Adult
Bicarbonates
Cohort Studies
Humans
Obesity - complications
Original Investigation
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Summary:Obesity is associated with low serum bicarbonate, an indicator of metabolic acidosis and a CKD risk factor. To further characterize acid-base disturbance and subclinical metabolic acidosis in this population, we examined prospective associations of body mass index (BMI) with elevated anion gap and whether anion gap values in obesity associate with low bicarbonate. Data from adult outpatients ( =94,448) in the Bronx, New York were collected from 2010 to 2018. Mixed effects models and Cox proportional hazards models were used to examine associations of BMI with elevated anion gap and anion gap metabolic acidosis and of baseline anion gap with incident low bicarbonate and anion gap metabolic acidosis. Anion gap was defined using traditional and albumin-corrected calculations. Greater BMI was associated with higher anion gap over time and with progressively greater risk of developing an elevated anion gap (hazard ratio [HR] for body mass index [BMI]≥40 kg/m versus 18 to
ISSN:2641-7650
2641-7650
DOI:10.34067/KID.0003562021