Ou Yu-Lun, Lee Mei-Yueh, Lin I-Ting, Wen Wei-Lun, Hsu Wei-Hao, Chen Szu-Chia
Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Ren Fail. 2021 Dec;43(1):1250-1258. doi: 10.1080/0886022X.2021.1969247.
Obesity is an important risk factor for the development of diseases including diabetes, hypertension, and cardiovascular disease. However, few reports have investigated the relationships between these obesity-related indices and diabetic nephropathy. The aim of this study was to evaluate associations between obesity-related markers with albuminuria and advanced kidney disease in patients with type 2 diabetes mellitus (DM). Obesity-related indices including body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body roundness index (BRI), conicity index (CI), lipid accumulation product (LAP), visceral adiposity index (VAI), body adiposity index (BAI), abdominal volume index (AVI), body shape index (BSI), and triglyceride glucose (TyG) index were measured. Albuminuria was defined as a urine albumin/creatinine ratio of ≥30 mg/g. Advanced kidney disease was defined as an estimated glomerular filtration rate (eGFR) <30 ml/min/1.73 m. A total of 1872 patients with type 2 DM (mean age 64.0 ± 11.3 years, 809 males and 1063 females) were enrolled. In multivariable analysis, 11 high obesity-related indices (BMI, WHR, WHtR, LAP, BRI, CI, VAI, BAI, AVI, ABSI, and TyG index) were significantly associated with albuminuria. In addition, high BMI, WHR, WHtR, LAP, BRI, CI, VAI, and AVI were significantly associated with eGFR <30 ml/min/1.73 m. The results of this study showed that various obesity-related indices were significantly associated with albuminuria and advanced kidney disease in patients with type 2 DM. Screening may be considered in public health programs to recognize and take appropriate steps to prevent subsequent complications.
肥胖是包括糖尿病、高血压和心血管疾病在内的多种疾病发生发展的重要危险因素。然而,很少有报告研究这些与肥胖相关的指标与糖尿病肾病之间的关系。本研究的目的是评估2型糖尿病(DM)患者中与肥胖相关的标志物与蛋白尿和晚期肾病之间的关联。测量了包括体重指数(BMI)、腰臀比(WHR)、腰高比(WHtR)、体圆度指数(BRI)、锥度指数(CI)、脂质蓄积产物(LAP)、内脏脂肪指数(VAI)、身体脂肪指数(BAI)、腹部容积指数(AVI)、身体形状指数(BSI)和甘油三酯葡萄糖(TyG)指数在内的与肥胖相关的指标。蛋白尿定义为尿白蛋白/肌酐比值≥30mg/g。晚期肾病定义为估计肾小球滤过率(eGFR)<30ml/min/1.73m²。共纳入1872例2型糖尿病患者(平均年龄64.0±11.3岁,男性809例,女性1063例)。在多变量分析中,11个高肥胖相关指标(BMI、WHR、WHtR、LAP、BRI、CI、VAI、BAI、AVI、ABSI和TyG指数)与蛋白尿显著相关。此外,高BMI、WHR、WHtR、LAP、BRI、CI、VAI和AVI与eGFR<30ml/min/1.73m²显著相关。本研究结果表明,多种与肥胖相关的指标与2型糖尿病患者的蛋白尿和晚期肾病显著相关。在公共卫生项目中可考虑进行筛查,以识别并采取适当措施预防后续并发症。