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2型糖尿病患者中体重调整后腰围指数与糖尿病肾病的关联

Association of weight-adjusted waist index and diabetic kidney disease in type 2 diabetes mellitus.

作者信息

Ding Yunyi, Lv Siyao, Xie Ruijie, Ye Wei, Luo Yichen, Li Yayu

机构信息

Department of Nephrology, Hangzhou TCM Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

Department of Gastroenterology, Hangzhou TCM Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

出版信息

Endocr Connect. 2024 Mar 4;13(4). doi: 10.1530/EC-23-0491. Print 2024 Apr 1.

Abstract

OBJECTIVE

The aim of this study was to investigate the relationship between weight-adjusted-waist index (WWI) and diabetic kidney disease in individuals afflicted with type 2 diabetes.

METHODS

Comprehensive data were ascertained from the National Health and Nutrition Examination Survey in 2013-March 2020. Weighted univariate, multivariate logistic regression models, subgroup analyses and tests for interaction were performed. Additionally, we employed smooth curve fitting to assess linear correlations and the threshold effects were calculated by applying a binary linear regression model. Breakpoints are identified by a model with maximum likelihood ratio and a two-step recursive approach. Receiver operating characteristic curve (ROC) along with the area under the curve (AUC) value predict the capability of WWI and body mass index for diabetic kidney disease.

RESULTS

A total of 10,661 individuals diagnosed with type 2 diabetes were included, and the overall prevalence of diabetic kidney disease was 20.74%. WWI exhibited a positive correlation with the likelihood of diabetic kidney disease in type 2 diabetes patients (OR: 1.17, 95% CI: 1.03-1.33). The results of subgroup analysis showed significant interaction for gender (P < 0.05). Among female patients, U-shaped correlations were observed with a breakpoint at 11.48. Additionally, weight-adjusted waist index (AUC = 0.664) proved to be a more effective predictor of diabetic kidney disease compared to body mass index (AUC = 0.555).

CONCLUSION

In patients with type 2 diabetes, increased weight-adjusted-waist index is implicated with an increased risk of diabetic kidney disease. WWI can be used as a new anthropometric index to predict diabetic kidney disease, and its predictive ability is stronger than body mass index.

摘要

目的

本研究旨在探讨体重调整腰围指数(WWI)与2型糖尿病患者糖尿病肾病之间的关系。

方法

综合数据来自2013年至2020年3月的美国国家健康与营养检查调查。进行了加权单变量、多变量逻辑回归模型、亚组分析和交互作用检验。此外,我们采用平滑曲线拟合来评估线性相关性,并应用二元线性回归模型计算阈值效应。通过具有最大似然比的模型和两步递归方法确定断点。采用受试者工作特征曲线(ROC)及其曲线下面积(AUC)值来预测WWI和体重指数对糖尿病肾病的预测能力。

结果

共纳入10661例诊断为2型糖尿病的患者,糖尿病肾病的总体患病率为20.74%。WWI与2型糖尿病患者患糖尿病肾病的可能性呈正相关(OR:1.17,95%CI:1.03-1.33)。亚组分析结果显示性别存在显著交互作用(P<0.05)。在女性患者中,观察到U型相关性,断点为11.48。此外,与体重指数(AUC=0.555)相比,体重调整腰围指数(AUC=0.664)被证明是糖尿病肾病更有效的预测指标。

结论

在2型糖尿病患者中,体重调整腰围指数升高与糖尿病肾病风险增加有关。WWI可作为预测糖尿病肾病的新人体测量指标,其预测能力强于体重指数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0936/10959041/1d8facca55e4/EC-23-0491fig1.jpg

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