This study aimed to determine whether proteinuria is associated with the subsequent development of chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN). We conducted a population-based retrospective cohort study using the Korean National Health Insurance Service database. Individuals aged ≥ 20 years who underwent national health screening in 2009 (N = 3,937,902) were followed until December 2020. Participants with a prior history of CIDP/MMN or diagnosis within one year of screening were excluded. Proteinuria was assessed via urine dipstick (positive ≥ 1+). The primary outcome was incident CIDP/MMN, defined by the concurrent presence of ICD-10 code G61.8 and Rare and Intractable Disease program code V126. Cox proportional hazards models examined the association, adjusting for potential confounders. At baseline, 2.5% of individuals had proteinuria. During follow-up, 210 individuals developed CIDP/MMN. The incidence rate was significantly higher in those with proteinuria (1.44 per 100,000 person-years) than in those without (0.50 per 100,000 person-years). After adjustment for demographics, lifestyle, and comorbidities, proteinuria remained significantly associated with increased CIDP/MMN risk (adjusted hazard ratio 2.32; 95% confidence interval 1.35-4.03). This association was consistent across subgroups defined by sex, age, and chronic kidney disease. Proteinuria is associated with a modest risk of developing CIDP/MMN. These findings suggest possible shared immunopathologic mechanisms involving antigens or immune pathways common to both the kidney and peripheral nerves. Neurologic monitoring may be warranted in individuals with proteinuria.

Yebin Park, Kyungdo Han. Korean J Fam Pract 2024;14:105-13. https://doi.org/10.21215/kjfp.2024.14.2.105

Background/Objective: Maternal obesity is an established risk factor for adverse obstetric outcomes. However, its association with oligohydramnios remains unclear and has been examined using body mass index (BMI) alone. We assessed pre-pregnancy general and abdominal obesity in relation to oligohydramnios. Methods: We analyzed 762,104 women who delivered between 2010 and 2018 and had undergone a national health examination within two years before conception. Women were classified into four phenotypes by BMI (general obesity: ≥25 kg/m²) and waist circumference (abdominal obesity: ≥85 cm). Odds ratios were estimated by logistic regression adjusted for pre-pregnancy characteristics, and interaction was tested on the additive and multiplicative scales. Results: Oligohydramnios occurred in 13,860 women (1.82%). Relative to women with neither phenotype, adjusted odds were increased for abdominal obesity alone (1.163; 95% CI 1.013–1.336), general obesity alone (1.125; 95% CI 1.051–1.204), and both (1.336; 95% CI 1.241–1.438). Absolute risk was 2.19% among women with both phenotypes and 1.79% among those with neither, with no interaction on either scale (p = 0.811). Conclusions: General and abdominal obesity were each associated with oligohydramnios. Because nearly one in four women with abdominal obesity had a BMI below the obesity threshold, assessment by BMI alone leaves part of this risk unrecognized.