The Association Between Hypertriglyceridemic-Waist Phenotype and Chronic Kidney Disease in Patients with Type 2 Diabetes: A Cross-Sectional METAL Study

Abstract

Background

The aim of this study was measuring the association between the hypertriglyceridemic-waist (HTGW) phenotype and chronic kidney disease in a large type 2 diabetes population.

Methods

A total of 4254 diabetic patients from the cross-sectional Environmental Pollutant Exposure and Metabolic Diseases in Shanghai (METAL) study were enrolled. The hypertriglyceridemic-waist (HTGW) phenotype was defined as the presence of an elevated waist circumference (WC) and elevated triglyceride (TG) concentration. Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m² or urinary albumin creatinine ratio (uACR) more than 30 mg/g. Linear and multiple logistic regression models were used for measuring the association between HTGW phenotype and chronic kidney disease.

Results

The prevalence of CKD was 29% and 35.8% in total participants and participants with HTGW phenotype, respectively. Subjects in the HTGW phenotype group were more likely to have CKD (OR 1.47, 95% CI: 1.11, 1.95) compared with subjects in the normal waist circumference and normal triglycerides (NTNW) group. HTGW phenotype was both associated with the increasing risk of decreased eGFR (OR 1.31, 95% CI: 1.02, 1.75) and elevated uACR (OR 1.57, 95% CI: 1.18, 2.11). Furthermore, the stratified analysis showed that the strongest positive association between HTGW phenotype and CKD presence was found in the subgroup of presence of hypertension. The associations were all fully adjusted for age, sex, BMI, current smoking, current drinking and other confounding factors.

Conclusion

Our study suggested a positive association between the HTGW phenotype and CKD in Chinese type 2 diabetes patients. Further prospective studies are needed to confirm our findings and to investigate the underlying biological mechanisms.

Keywords:

• central obesity
• type 2 diabetes mellitus
• hypertriglyceridemia waist phenotype
• chronic kidney disease

Data Sharing Statement

The raw data used in the conclusions of this manuscript will be made available by the authors, without undue reservation, to any qualified researcher. Yingli Lu could be contacted to provide that data.

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Acknowledgments

The authors thank all team members and participants in the METAL study.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors in this study declare no conflicts of interest.

Additional information

Funding

This study was supported by National Natural Science Foundation of China (91857117); Science and Technology Commission of Shanghai Municipality (18410722300, 19140902400, 20015800400, 20ZR1432500); the Major Science and Technology Innovation Program of Shanghai Municipal Education Commission (2018YFC1705103); Shanghai Municipal Human Resources and Social Security Bureau (2020074); Clinical Research Plan of SHDC (SHDC2020CR4006);Shanghai Municipal Huangpu District Commission (HLQ202004). The funders played no role in the design or conduct of the study, interpretation, analysis, collection, or management of data or in the review, preparation or approval of the article.