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内脏脂肪组织与白蛋白尿的关系及内脏肥胖与糖尿病对白蛋白尿的交互作用。

Association of visceral adipose tissue with albuminuria and interaction between visceral adiposity and diabetes on albuminuria.

机构信息

Department of Endocrinology, Peking University International Hospital, Beijing, 102206, People's Republic of China.

出版信息

Acta Diabetol. 2024 Jul;61(7):909-916. doi: 10.1007/s00592-024-02271-8. Epub 2024 Apr 1.

Abstract

AIMS

To explore the correlation between visceral adipose tissue and albuminuria, and whether there is interaction between visceral adipose tissue and diabetes on albuminuria.

METHODS

The study subjects were adult subjects (age ≥ 18 years) from the National Health and Nutrition Examination Surveys (NHANES) database of the USA in 2017-2018. Visceral fat area (VFA) was measured by dual-energy X-ray absorptiometry (DXA). Subjects were divided into three groups according to VFA: low (VFA 0-60cm), medium (VFA 60-120 cm) and high (VFA ≥ 120 cm). Albuminuria was defined as urinary albumin-to-creatinine ratio (UACR) ≥ 30 mg/g. The statistical analysis software used is STATA 17.0.

RESULTS

Data pertaining to 2965 participants (2706 without albuminuria) were included in the analysis. High VFA is an independent risk factor for albuminuria (OR 1.367, 95% CI 1.023-1.827). In the low-VFA group, there is no significant association between diabetes and albuminuria (OR 1.415, 95% CI 0.145-13.849). In the medium-VFA group, diabetes is an independent risk factor for albuminuria (OR 2.217, 95% CI 1.095-4.488). In the high-VFA group, diabetes is also an independent risk factor for albuminuria (OR 5.150, 95% CI 3.150-8.421). There is an additive interaction between high VFA (VFA ≥ 120 cm) and diabetes on the effect of albuminuria (RERI 3.757, 95% CI 0.927-6.587, p = 0.009), while no multiplication interaction (OR 1.881, 95% CI 0.997-1.023, p = 0.141).

CONCLUSIONS

High VFA may represent an independent risk factor for albuminuria. The amount of visceral fat may affect the effect of diabetes on albuminuria. The higher the visceral fat, the stronger the correlation between diabetes and albuminuria should be present. We suppose an additive interaction between VFA and diabetes on the effect of albuminuria.

摘要

目的

探讨内脏脂肪组织与白蛋白尿的相关性,以及内脏脂肪组织与糖尿病对白蛋白尿的相互作用。

方法

本研究对象为 2017-2018 年美国国家健康与营养调查(NHANES)数据库中的成年受试者(年龄≥18 岁)。通过双能 X 射线吸收法(DXA)测量内脏脂肪面积(VFA)。根据 VFA 将受试者分为三组:低(VFA 0-60cm)、中(VFA 60-120cm)和高(VFA≥120cm)。白蛋白尿定义为尿白蛋白/肌酐比值(UACR)≥30mg/g。使用的统计分析软件是 STATA 17.0。

结果

共纳入 2965 名参与者(2706 名无白蛋白尿)的数据进行分析。高 VFA 是白蛋白尿的独立危险因素(OR 1.367,95%CI 1.023-1.827)。在低 VFA 组中,糖尿病与白蛋白尿之间无显著关联(OR 1.415,95%CI 0.145-13.849)。在中 VFA 组中,糖尿病是白蛋白尿的独立危险因素(OR 2.217,95%CI 1.095-4.488)。在高 VFA 组中,糖尿病也是白蛋白尿的独立危险因素(OR 5.150,95%CI 3.150-8.421)。高 VFA(VFA≥120cm)与糖尿病对白蛋白尿的影响之间存在附加交互作用(RERI 3.757,95%CI 0.927-6.587,p=0.009),而无乘法交互作用(OR 1.881,95%CI 0.997-1.023,p=0.141)。

结论

高 VFA 可能是白蛋白尿的独立危险因素。内脏脂肪量可能会影响糖尿病对白蛋白尿的影响。内脏脂肪越高,糖尿病与白蛋白尿之间的相关性就越强。我们假设 VFA 和糖尿病对白蛋白尿的影响之间存在附加交互作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dbd/11182824/4ee5d09008a0/592_2024_2271_Fig1_HTML.jpg

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