Bidirectional Relationship between Obesity, Psychiatric Disorders, and Renal Disease: A Systematic Review

Main Article Content

Okelue Edwards Okobi, MD, MS Joy Chinaza Okorie, MD, MPH Zimakor Donatus Douglas Ewuzie, MD Oluwatosin B Iyun, MD, MPH Ifelunwa M Osanakpo, MD Evelyn Omowunmi Fatoye, MD Uvieroghene Peter Ogbebor, MBBS/MBA Rita Okobi

Abstract

The rapid growth of obesity worldwide has made it a significant health problem. In contrast, the dramatic increase in the prevalence of obesity has had a significant impact on the magnitude of chronic kidney disease (CKD), especially in developing countries. A vast number of researchers have reported a strong relationship between obesity and chronic kidney disease, and obesity can serve as an independent risk factor for kidney disease. The histological changes of kidneys in obesity-induced renal injury include glomerular or tubular hypertrophy, focal segmental glomerulosclerosis, or bulbous sclerosis. Furthermore, inflammation, renal hemodynamic changes, insulin resistance, and lipid metabolism disorders are all involved in developing and progressing obesity-induced nephropathy. However, there is no targeted treatment for obesity-related kidney disease.


Despite the apt acknowledgment of the physical comorbidity burden in obesity, its correlation to both mental health and renal health has received relatively less research attention. However, in the last 20 years, there has been a progressive collection of evidence concerning the correlation between obesity, renal disorders, and different psychiatric disorders, especially in individuals who have sought treatment for the conditions. Regardless of this, there are still significant knowledge gaps linked to the strengths as well as directions of the correlations between obesity, psychiatric disorders, and renal disorders. Moreover, owing to the methodological variances between different studies, it is essential to synthesize the existing evidence in these areas to enable researchers and clinicians to have improved comprehension of the extant correlations between obesity, psychiatric disorders, and renal disorders. This will positively impact the clinical assessment and identification of additional research targets in these areas, including the potential neurobiological correlations between psychiatric disorders and obesity. From the management point of view, it has been indicated that early identification and subsequent management of both widespread psychiatric challenges and renal disorders may optimize the outcomes in obese and overweight patients presenting for treatments. As such, there is a need for practicing politicians to have a better understanding of the bidirectional correlations between obesity, psychiatric disorders, and renal disorders. With this background, the present systematic review and meta-analysis have been performed to review and synthesize the extant data and evidence on the bidirectional correlations between obesity, psychiatric disorders, and renal disorders.


The positive bidirectional relationship between body weight and depression is found. The effect of depression on body weight is significant among both males and females in a randomized population, and females who experience depression are most likely to be obese and less likely to have normal weight compared to females without depression. The risks of overweight and obesity are high among people who are less educated or unable, who have poor health statuses, and who had high blood pressure.

Keywords: Obesity, Psychiatric Disorders, Chronic Kidney Disease (CKD), Bidirectional Relationship, Nephropathy, Inflammation, Insulin Resistance, Lipid Metabolism, Mental Health, Meta-Analysis

Article Details

How to Cite
OKOBI, Okelue Edwards et al. Bidirectional Relationship between Obesity, Psychiatric Disorders, and Renal Disease: A Systematic Review. Medical Research Archives, [S.l.], v. 12, n. 7, july 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5497>. Date accessed: 21 dec. 2024. doi: https://doi.org/10.18103/mra.v12i7.5497.
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Review Articles

References

1. Min J, Zhao Y, Slivka L, et al. : Double burden of diseases worldwide: Coexistence of undernutrition and overnutrition‐related non‐communicable chronic diseases. Obes Rev. 2018, 19:49-61. 10.1111/obr.12605

2. Chooi YC, Ding C, Magkos F: The epidemiology of obesity. Metabolism. 2019, 92:6-10. 10.1016 /j.metabol.2018.09.005

3. James WPT: The epidemiology. J Intern Med. 2008, 263:336-352. 10.1111/j.1365-2796.2008.01922.x

4. Żukiewicz-Sobczak W, Wróblewska P, Zwoliński J, et al.: Obesity and poverty paradox in developed countries. Ann Agric Environ Med. 2014, 21:590-594. 10.5604/12321966.1120608

5. Forouzanfar MH, Afshin A, Alexander LT, et al.: global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters. Lancet. 2016, 388:1659-1724. 10.1016/S0140-6736(15)00128-2

6. Flegal KM, Kruszon-Moran D, Carroll MD, et al.: Trends in obesity among adults in the United States, 2005 to 2014. JAMA. 2016, 315:2284-2291. 10.1001/jama.2016.6458.

7. Patist CM, Stapelberg NJ, Du Toit EF, et al.: The brain-adipocyte-gut network: Linking obesity and depression subtypes. Cogn Affect Behav Neurosci. 2018, 18:1121-1144. 10.3758/s13415-018-0626-0

8. Gordon‐Larsen P, Wang H, Popkin BM: Overweight dynamics in Chinese children and adults. Obes Rev. 2014, 15:37-48. 10.1111 /obr.12121

9. Subramanian SV, Perkins JM, Özaltin E, et al.: Weight of nations: a socioeconomic analysis of women in low-to middle-income countries. Am J Clin Nutr. 2011, 93:413-421. 10.3945/ajcn.110.004820

10. Tsujimoto T, Sairenchi T, Iso H, et al.: The dose-response relationship between body mass index and the risk of incident stage≥ 3 chronic kidney disease in a general Japanese population: The Ibaraki prefectural health study (IPHS). J Epidemiol. 2014, 24:444-451. 10.2188/jea.je20140028

11. Elsayed EF, Sarnak MJ, Tighiouart H, et al.: Waist-to-hip ratio, body mass index, and subsequent kidney disease and death. Am J Kidney Dis. 2008, 52:29-38. 10.1053/j.ajkd.2008.02.363

12. Ahuja M, Sathiyaseelan T, Wani RJ, et al.: Obesity, food insecurity, and depression among females. Arch Public Health. 2020, 78:1-6. 10.1186/s13690-020-00463-6

13. Johnston E, Johnson S, McLeod P, et al.: The relation of body mass index to depressive symptoms. Can J Public Health. 2004, 95:179-183. 10.1007/BF03403643

14. Paulitsch RG, Demenech LM, Dumith SC: Association of depression and obesity is mediated by weight perception. J Health Psychol. 2021, 26:2020-2030. 10.1177/1359105319897778

15. Yu M, Shi Y, Gu L, Wang W: “Jolly fat” or “sad fat”: a systematic review and meta-analysis of the association between obesity and depression among community-dwelling older adults. Aging Ment Health. 20222, 26:13-25. 10.1080/13607863. 2020.1857687

16. Darimont T, Karavasiloglou N, Hysaj O, et al.: Body weight and self-perception are associated with depression: Results from the National Health and Nutrition Examination Survey (NHANES) 2005-2016. J Affect Disord. 2020, 274:929-934. 10.1016/ j.jad.2020.05.130

17. Heo M, Pietrobelli A, Fontaine KR, et al.: Depressive mood and obesity in US adults: comparison and moderation by sex, age, and race. Int J Obes (Lond). 2006, 30:513-519. 10.1038/ sj.ijo.0803122

18. Moonajilin MS, Rahman ME, Islam MS: Relationship between overweight/obesity and mental health disorders among Bangladeshi adolescents: a cross-sectional survey. Obes. Med. 2020, 1:100216. 10.1016/j.obmed.2020.100216

19. Wang X, Hu Y, Qin LQ, et al.: Combined association of central obesity and depressive symptoms with risk of heart disease: A prospective cohort study. J Affect Disord. 2022, 15:360-365. 10.1016/j.jad.2021.10.096

20. Pape M, Herpertz S, Schroeder S, et al.: Food addiction and its relationship to weight-and addiction-related psychological parameters in individuals with overweight and obesity. Front Psychol. 2021, 21:736454. 10.3389/fpsyg.2021.736454

21. Freire CC, Zanella MT, Segal A, et al.: Associations between binge eating, depressive symptoms and anxiety and weight regain after Roux-en-Y gastric bypass surgery. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity. Eat Weight Disord. 2021, 26:191-199. 10.1007/s40519-019-00839-w

22. Sharafi SE, Garmaroudi G, Ghafouri M, et al.: Prevalence of anxiety and depression in patients with overweight and obesity. Obes. Med. 20201, 17:100169. 10.1016/j.obmed.2019.100169

23. Cilli M, De Rosa R, Pandolfi C, et al.: Quantification of sub-clinical anxiety and depression in essentially obese patients and normal-weight healthy subjects. Eat Weight Disord. 2003, 8:319-320. 10.1007/BF03325033

24. John U, Meyer C, Rumpf HJ, Hapke U: Relationships of psychiatric disorders with overweight and obesity in an adult general population. Obes Res. 2005, 13:101-109. 10.1038/oby.2005.13

25. Simon GE, Von Korff M, Saunders K, et al.: Association between obesity and psychiatric disorders in the US adult population. Arch Gen Psychiatry. 20061, 63:824-830. 10.1001/archpsyc. 63.7.824

26. Liu J, Jia F, Li C, et al.: Association between body mass index and suicide attempts in Chinese patients of a hospital in Shanxi district with first-episode drug-naïve major depressive disorder. J Affect Disord. 2023, 15:377-383. 10.1016/j.jad.202 3.06.064

27. Liao W, Luo Z, Hou Y, et al.: Age and gender-specific association between obesity and depressive symptoms: a large-scale cross-sectional study. BMC Public Health. 2020, 20:1-10. 10.1186 /s12889-020-09664-8

28. Hasler G, Pine DS, Gamma A, et al.: The associations between psychopathology and being overweight: a 20-year prospective study. Psychol Med. 2004, 34:1047-1057. 10.1017/s0033291703 001697

29. Thaker VV, Osganian SK, deFerranti SD, et al.: Psychosocial, behavioral and clinical correlates of children with overweight and obesity. BMC Pediatr. 2020, 20:1-1. 10.1186/s12887-020-02145-2

30. Roberts RE, Deleger S, Strawbridge WJ, Kaplan GA: Prospective association between obesity and depression: evidence from the Alameda County study. Int J Obes Relat Metab Disord. 2003, 27:514-521. 10.1038/sj.ijo.0802204

31. Labad J, Price JF, Strachan MW, et al.: Symptoms of depression but not anxiety is associated with central obesity and cardiovascular disease in people with type 2 diabetes: The Edinburgh Type 2 Diabetes Study. Diabetologia. 2010, 53:467-471. 10.1007/s00125-009-1628-9

32. Sacco WP, Wells KJ, Vaughan CA, et al.: Depression in adults with type 2 diabetes: the role of adherence, body mass index, and self-efficacy. Health Psychol. 2005, 24:630-634. 10.1037/0278-6133.24.6.630

33. The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. (2011). Accessed: 10/04/2024: https://www.ohri.ca/programs/clinical_epidemiology/oxford.asp

34. Jüni P, Altman DG, Egger M: Assessing the quality of controlled clinical trials. BMJ. 2001, 7:42-46. 10.1136/bmj.323.7303.42

35. Wong WC, Cheung CS, Hart GJ: Development of a quality assessment tool for systematic reviews of observational studies (QATSO) of HIV prevalence in men having sex with men and associated risk behaviours. Emerging themes in epidemiology. Emerg Themes Epidemiol. 2008, 5:5-23. 10.1186/1742-7622-5-23

36. Fulton S, Décarie-Spain L, Fioramonti X, et al.: The menace of obesity to depression and anxiety prevalence. Trends Endocrinol Metab. 2022, 33:18-35. 10.1016/j.tem.2021.10.005

37. Milano W, Ambrosio P, Carizzone F, et al.: Depression and obesity: analysis of common biomarkers. Diseases. 2020, 14:23. 10.3390/ diseases8020023

38. Kim E, Song JH, Hwang JY, et al.: Obesity and depressive symptoms in elderly Koreans: evidence for the “Jolly Fat” hypothesis from the Ansan Geriatric (AGE) Study. Geriatrics (Basel). 2010, 1:231-234. 10.3390/geriatrics4010014

39. Polanka BM, Vrany EA, Patel J, Stewart JC: Depressive disorder subtypes as predictors of incident obesity in US adults: moderation by race/ethnicity. Am J Epidemiol. 2017, 185:734-742. 10.1093/aje/kwx030

40. Taylor VH, Forhan M, Vigod SN, et al.: The impact of obesity on quality of life. Best Pract Res Clin Endocrinol Metab. 2013, 27:139-146. 10.1016/j.beem.2013.04.004

41. Zhang L, Liu K, Li H, et al.: Relationship between body mass index and depressive symptoms: the “fat and jolly” hypothesis for the middle-aged and elderly in China. BMC Public Health. 2016, 16:1-5. 10.1186/s12889-016-3864-5

42. Clum GA, Rice JC, Broussard M, et al.: Associations between depressive symptoms, self-efficacy, eating styles, exercise and body mass index in women. J Behav Med. 2014, 37:577-586. 10.1007/s10865-013-9526-5

43. Pickering RP, Goldstein RB, Hasin DS, et al.: Temporal relationships between overweight and obesity and DSM-IV substance use, mood, and anxiety disorders: results from a prospective study, the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2011, 8:1494-1502. 10.4088/JCP.10m06077gry

44. Sanderson K, Patton GC, McKercher C, et al.: Overweight and obesity in childhood and risk of mental disorder: a 20-year cohort study. Aust N Z J Psychiatry. 2011, 45:384-392. 10.3109/00048674 .2011.570309

45. Nazar G, Alcover CM, Concha-Cisternas Y, et al.: Risk factors and gender differences for depression in Chilean older adults: a cross-sectional analysis from the National Health Survey 2016-2017. IJMHP. 2022, 5:679-697. 10.32604/ijm hp.2022.020105

46. Fruh SM, Graves RJ, Hauff C, et al.: Weight bias and stigma: Impact on health. Nurs Clin North Am. 2021, 56:479-493. 10.1016/j.cnur.2021.07.001

47. Opel N, Thalamuthu A, Milaneschi Y, et al.: Brain structural abnormalities in obesity: relation to age, genetic risk, and common psychiatric disorders: evidence through univariate and multivariate mega-analysis including 6420 participants from the ENIGMA MDD working group. Molecular psychiatry. Mol Psychiatry. 2021, 26:4839-4852. 10.1038/s41380-020-0774-9

48. Gubata ME, Urban N, Cowan DN, Niebuhr DW: A prospective study of physical fitness, obesity, and the subsequent risk of mental disorders among healthy young adults in army training. J Psychosom Res. 2013, 1:43-48. 10.1016/j.jpsychores.2013.04.003

49. Sutin AR, Ferrucci L, Zonderman AB, Terracciano A: Personality and obesity across the adult life span. J Pers Soc Psychol. 2011, 101:579-592. 10.1037/a0024286

50. Peterhänsel C, Wagner B, Dietrich A, Kersting A: Obesity and comorbid psychiatric disorders as contraindications for bariatric surgery? —A case study. Int J Surg Case Rep. 2014, 5:1268-1270. 10.1016/j.ijscr.2014.11.023

51. Sansone RA, Sansone LA: The relationship between borderline personality and obesity. Innov Clin Neurosci. 2013, 10:36-40.

52. Camacho-Barcia L, Giel KE, Jiménez-Murcia S, et al.: Eating disorders and obesity: bridging clinical, neurobiological, and therapeutic perspectives. Trends. Mol. Med. 2024, 30:361-380. 10.1016/j.molmed.2024.02.007

53. Da Luz FQ, Hay P, Touyz S, Sainsbury A: Obesity with comorbid eating disorders: associated health risks and treatment approaches. Nutrients. 2018, 27:829. 10.3390/nu10070829

54. Cortese S, Ramos Olazagasti MA, Klein RG, et al.: Obesity in men with childhood ADHD: a 33-year controlled, prospective, follow-up study. Pediatrics. 2013, 1:1731-1738. 10.1542/peds.2012-0540

55. Boswell RG, Potenza MN, Grilo CM: The neurobiology of binge-eating disorder compared with obesity: implications for differential therapeutics. Clinical Therapeutics. Clin Ther. 2021, 43:50-69. 10.1016/j.clinthera.2020.10.014

56. McCarty CA, Kosterman R, Mason WA, et al.: Longitudinal associations among depression, obesity and alcohol use disorders in young adulthood. Gen Hosp Psychiatry. 2009, 31:442-450. 10.1016/j.genhosppsych.2009.05.013

57. Than WH, Chan GC, Ng JK, Szeto CC: The role of obesity on chronic kidney disease development, progression, and cardiovascular complications. ABST. 2020, 2:24-34. 10.1016/j.abst.2020.09.001

58. Miyasato Y, Oba K, Yasuno S, et al.: Associations between visceral obesity and renal impairment in health checkup participants: a retrospective cohort study. Clin Exp Nephrol. 2020, 24:935-945. 10.1007/s10157-020-01921-9

59. Khan RN, Kinra P, Kumar N, et al.: Association of body mass index with coronary artery disease and chronic kidney disease: An autopsy study. Med J Armed Forces India. 2024, 6:24-35. 10.1016 /j.mjafi.2023.12.009

60. Munkhaugen J, Lydersen S, Widerøe TE, et al.: Prehypertension, obesity, and risk of kidney disease: 20-year follow-up of the HUNT I study in Norway. Am J Kidney Dis. 2009, 1:638-646. 10.10 53/j.ajkd.2009.03.023

61. Lew QL, Jafar TH, Talaei M, et al.: Increased body mass index is a risk factor for end-stage renal disease in the Chinese Singapore population. Kidney Int. 2017, 92:979-987. 10.1016/j.kint.2017. 03.019

62. Kotsis V, Martinez F, Trakatelli C, Redon J: Impact of obesity in kidney diseases. Nutrients. 2021, 15:4482. 10.3390/nu13124482

63. Koch VH: Obesity facts and their influence on renal function across the life span. Front Med (Lausanne). 2021, 12:704409. 10.3389/fmed.2021. 704409

64. Shen FC, Chen ME, Wu WT, et al.: Normal weight and waist obesity indicated by increased total body fat associated with all-cause mortality in stage 3-5 chronic kidney disease. Front Nutr. 2022, 16:982519. 10.3389/fnut.2022.982519

65. Kramer H, Gutiérrez OM, Judd SE, et al.: Waist circumference, body mass index, and ESRD in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study. Am J Kidney Dis. 2016, 67:62-69. 10.1053/j.ajkd.2015.05.023

66. Postorino M, Marino C, Tripepi G, et al.: CREDIT (Calabria Registry of Dialysis and Transplantation) Working Group. Abdominal obesity and all-cause and cardiovascular mortality in end-stage renal disease. J Am Coll Cardiol. 2009, 14:1265-1272. 10.1016/j.jacc.2008.12.040

67. Hill AJ, Basourakos SP, Lewicki P, et al.: Incidence of kidney stones in the United States: the continuous national health and nutrition examination survey. J Urol. 2022, 207:851-856. 10.1097/JU.0000000000002331

68. Chen W, Man S, Hong Y, et al.: Association between metabolically healthy obesity and kidney stones: Results from the 2011-2018 National Health and Nutrition Examination Survey. Front Public Health. 2023, 25:1103393. 10.3389/fpubh. 2023.1103393

69. Maimaitiyiming M, Yang H, Zhou L, et al.: Associations between an obesity-related dietary pattern and incidence of overall and site-specific cancers: a prospective cohort study. BMC Med. 2023, 10:251-254. 10.1186/s12916-023-02955-y

70. Arnold M, Pandeya N, Byrnes G, et al.: Global burden of cancer attributable to high body-mass index in 2012: a population-based study. The lancet oncology. Lancet Oncol. 2015, 16:36-46. 10.1016/S1470-2045(14)71123-4

71. Herrington WG, Smith M, Bankhead C, et al.: Body-mass index and risk of advanced chronic kidney disease: Prospective analyses from a primary care cohort of 1.4 million adults in England. PloS one. 2017, 8:0173515. 10.1371/jour nal.pone.0173515

72. Yim HE, Yoo KH: Obesity and chronic kidney disease: prevalence, mechanism, and management. Clin Exp Pediatr. 2021, 64:511-518. 10.3345/cep.2021.00108

73. Kovesdy CP, Furth S, Zoccali C, et al.: Obesity and kidney disease: hidden consequences of the epidemic. J Nephrol. 2017, 104:1-4. 10.1007/s40 620-017-0377-y

74. Wang AY, Kovesdy CP: Nutrition and obesity impacts on kidney health. Contrib Nephrol. 2021, 199:24-42. 10.1159/000517669

75. Stasi A, Cosola C, Caggiano G, et al.: Obesity-related chronic kidney disease: principal mechanisms and new approaches in nutritional management. Front Nutr. 2022, 24:925619. 10.33 89/fnut.2022.925619

76. Danilovic A, Marchini GS, Pucci ND, et al.: Effect of a low-calorie diet on 24-hour urinary parameters of obese adults with idiopathic calcium oxalate kidney stones. Int Braz J Urol. 2021, 47:1136-1147. 10.1590/S1677-5538.IBJU.2021.0140

77. Abufaraj M, Siyam A, Xu T, et al.: Association between body fat mass and kidney stones in US adults: analysis of the national health and nutrition examination survey 2011-2018. Eur Urol Focus. 2022, 8:580-587. 10.1016/j.euf.2021.03.010

78. Klisic J, Hu MC, Nief V, et al.: Insulin activates Na+/H+ exchanger 3: biphasic response and glucocorticoid dependence. Am J Physiol Renal Physiol. 2002, 283:532-539. 10.1152/ajprenal.003 65.2001

79. Imenez Silva PH, Mohebbi N: Kidney metabolism and acid-base control: back to the basics. Pflugers Arch. 2022, 474:919-934. 10.10 07/s00424-022-02696-6

80. Wang D, Tan J, Geng E, et al.: Impact of body mass index on size and composition of urinary stones: a systematic review and meta-analysis. Int Braz J Urol. 2023, 5:281-298. 10.1590/S1677-553 8.IBJU.2022.0587

81. Sinha MK, Collazo-Clavell ML, Rule A, et al.: Hyperoxaluric nephrolithiasis is a complication of Roux-en-Y gastric bypass surgery. Kidney Int. 2007, 1:100-107. 10.1038/sj.ki.5002194

82. Calle EE, Kaaks R: Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer. 2004, 1:579-591. 10.1038/nrc1408

83. Dalamaga M, Diakopoulos KN, Mantzoros CS: The role of adiponectin in cancer: a review of current evidence. Endocr Rev. 2012, 1:547-594. 10.1210/er.2011-1015

84. Lamas O, Marti A, Martinez JA: Obesity and immunocompetence . Eur J Clin Nutr. 2002, 56:42-45. 10.1038/sj.ejcn.1601484

85. Lim C, Savan R: The role of the IL-22/IL-22R1 axis in cancer. Cytokine Growth Factor Rev. 2014, 1:257-271. 10.1016/j.cytogfr.2014.04.005

86. Grivennikov SI, Greten FR, Karin M: Immunity, inflammation, and cancer. Cell J. 2010, 140:883-899. 10.1016/j.cell.2010.01.025

87. Zierle-Ghosh A, Jan A. Physiology, Body Mass Index. [Updated 2023 Nov 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535456/