Zhao Xin, Sun Jianbin, Xin Sixu, Zhang Xiaomei
Department of Endocrinology, Peking University International Hospital, Beijing, China.
Front Endocrinol (Lausanne). 2025 Mar 14;16:1549954. doi: 10.3389/fendo.2025.1549954. eCollection 2025.
This study aims to explore the correlation between visceral adiposity index (VAI) and diabetes kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM), so as to provide a clinical basis for the prevention and treatment of DKD.
This study retrospectively analyzed 1817 patients with T2DM hospitalized in the department of Endocrinology, Peking University International Hospital from January 2017 to August 2021, including 1053 males and 764 females. According the level of VAI, subjects were divided into three groups.
(1) The results showed that with the increase of VAI level, the proportion of DKD gradually increased, and there was a statistical difference (p < 0.05). With the increase of VAI levels, there is an increasing trend in males, age, WC, BMI, WHtR, WHR, VAI, LAP, ABSI, C-Index, CUN-BAE, SBP, DBP, HbA1c, FBG, PBG, UACR, TG, while HDL-C levels show a decreasing trend (p all <0.05). (2)Logistic regression showed that after adjusting age, sex, diabetic duration, smoking, drinking, BP, blood glucose and blood lipids, high level of VAI was an independent risk factor for DKD (HR=1.38, 95% CI 1.18, 1.63). (3)The model to predict the risk of DKD using anthropometric indicators, showed that the AUC of the models ranked VAI>ABSI>C-index>WHR>AVI=BRI>BMI>CUN-BAE>LAP>WHtR.(4)The predictive ability for DKD of Model 1 with VAI was higher than that of Model 2 with BMI.
The increase of VAI is an independent predictor of DKD occurrence in patients with T2DM, which provides a certain clinical basis for preventing the development of DKD in patients with T2DM.
本研究旨在探讨2型糖尿病(T2DM)患者内脏脂肪指数(VAI)与糖尿病肾病(DKD)之间的相关性,为DKD的防治提供临床依据。
本研究回顾性分析了2017年1月至2021年8月在北京大学国际医院内分泌科住院的1817例T2DM患者,其中男性1053例,女性764例。根据VAI水平,将受试者分为三组。
(1)结果显示,随着VAI水平的升高,DKD的比例逐渐增加,差异有统计学意义(p<0.05)。随着VAI水平的升高,男性、年龄、腰围(WC)、体重指数(BMI)、腰高比(WHtR)、腰臀比(WHR)、VAI、脂质蓄积产物(LAP)、脂肪量指数(ABSI)、C指数、中国成人肥胖指数(CUN-BAE)、收缩压(SBP)、舒张压(DBP)、糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后血糖(PBG)、尿白蛋白/肌酐比值(UACR)、甘油三酯(TG)均呈上升趋势,而高密度脂蛋白胆固醇(HDL-C)水平呈下降趋势(p均<0.05)。(2)Logistic回归显示,在调整年龄、性别、糖尿病病程、吸烟、饮酒、血压、血糖和血脂后,高水平VAI是DKD的独立危险因素(HR=1.38,95%CI 1.18,1.63)。(3)使用人体测量指标预测DKD风险的模型显示,模型的曲线下面积(AUC)排序为VAI>ABSI>C指数>WHR>AVI=体脂率(BRI)>BMI>CUN-BAE>LAP>WHtR。(4)VAI模型1对DKD的预测能力高于BMI模型2。
VAI升高是T2DM患者发生DKD的独立预测因素,为预防T2DM患者DKD的发生提供了一定的临床依据。