Obesity-related indices are associated with albuminuria and advanced kidney disease in type 2 diabetes mellitus

Figures & data

Table 1. Comparison of baseline characteristics between patients with and without albuminuria.

Characteristics	Without albuminuria (n = 1,223)	With albuminuria (n = 649)	p
Age (year)	63.6 ± 11.3	64.7 ± 11.2	0.023
Male gender (%)	45.1	39.4	0.018
Coronary artery disease (%)	15.2	20.3	0.005
Cerebrovascular disease (%)	4.1	7.1	0.005
Systolic blood pressure (mmHg)	132.6 ± 17.5	139.3 ± 20.4	<0.001
Diastolic blood pressure (mmHg)	77.0 ± 10.7	79.5 ± 12.0	<0.001
Body height (cm)	159.2 ± 8.2	158.6 ± 8.6	0.111
Body weight (kg)	64.9 ± 10.6	66.8 ± 11.4	0.001
Waist circumference (cm)	88.6 ± 9.2	91.6 ± 9.9	<0.001
Hip circumference (cm)	97.9 ± 7.1	99.7 ± 8.5	<0.001
BMI category (%)			<0.001
Underweight (BMI <18.5 kg/m^2)	0.7	0.8
Normal (18.5 ≤ BMI <24 kg/m^2)	33.4	24.7
Overweight (24 ≤ BMI <27 kg/m^2)	36.0	31.9
Mild obesity (27 ≤ BMI <30 kg/m^2)	19.3	25.7
Moderate obesity (30 ≤ BMI <35 kg/m^2)	9.5	51.1
Severe obesity (BMI ≥35 kg/m^2)	1.1	1.8
Laboratory parameters
Fasting glucose (mg/dL)	144.6 ± 50.3	156.1 ± 54.3	<0.001
HbA1c (%)	7.5 ± 1.6	8.0 ± 1.8	<0.001
Triglyceride (mg/dL)	117 (86-165)	141 (101.5-204)	<0.001
Total cholesterol (mg/dL)	183.1 ± 35.3	190.4 ± 43.2	0.002
HDL-cholesterol (mg/dL)	50.5 ± 13.2	48.2 ± 12.7	<0.001
LDL-cholesterol (mg/dL)	103.4 ± 26.9	106.2 ± 30.6	0.145
eGFR (mL/min/1.73 m^2)	69.9 ± 19.0	65.1 ± 22.6	<0.001
Medications
Oral anti-diabetic drugs (%)	90.5	89.3	0.433
Insulin (%)	35.7	48.5	<0.001
ACEI and/or ARB (%)	67.3	85.2	<0.001
Statins use (%)	58.3	62.0	0.123
Fibrate use (%)	14.0	20.9	<0.001
Obesity related indices
BMI (kg/m^2)	25.5 ± 3.4	26.5 ± 3.7	<0.001
WHR	0.91 ± 0.06	0.92 ± 0.07	<0.001
WHtR	0.56 ± 0.06	0.58 ± 0.06	<0.001
LAP	44.1 ± 32.3	62.6 ± 56.7	<0.001
BRI	4.6 ± 1.3	5.0 ± 1.4	<0.001
CI	1.28 ± 0.08	1.30 ± 0.09	<0.001
VAI	2.3 ± 2.4	3.1 ± 3.4	<0.001
BAI	31.0 ± 4.9	32.1 ± 5.5	<0.001
AVI	16.0 ± 3.3	17.0 ± 3.7	<0.001
ABSI	0.081 ± 0.005	0.082 ± 0.006	<0.001
TyG index	9.0 ± 0.6	9.3 ± 0.7	<0.001

BMI: body mass index; HbA_1c: glycated hemoglobin; HDL: high-density lipoprotein; LDL: low-density lipoprotein; eGFR: estimated glomerular filtration rate; ACEI: angiotensin converting enzyme inhibitor; ARB: angiotensin II receptor blocker; WHR: waist–hip ratio; WHtR: waist-to-height ratio; LAP: lipid accumulation product; BRI: body roundness index; CI: conicity index; VAI: visceral adiposity index; BAI: body adiposity index; AVI: abdominal volume index; ABSI: a body shape index; TyG index: triglyceride glucose index.

Table 2. Association of obesity related indices with albuminuria using multivariable logistic regression analysis.

Obesity-related indices	Multivariable
	OR (95% CI)	P
BMI (per 1 kg/m^2)^a	1.047 (1.016–1.078)	0.003
WHR (per 0.1)^a	1.224 (1.031–1.453)	0.021
WHtR (per 0.1)^a	1.429 (1.193–1.712)	<0.001
LAP (per 1)^b	1.008 (1.004–1.013)	<0.001
BRI (per 1)^a	1.177 (1.085–1.277)	<0.001
CI (per 0.1)^a	1.274 (1.114–1.456)	<0.001
VAI (per 1)^c	1.074 (1.020–1.130)	0.006
BAI (per 1)^a	1.034 (1.010–1.059)	0.006
AVI (per 1)^a	1.075 (1.041–1.110)	<0.001
ABSI (per 0.01)^a	1.316 (1.064–1.627)	0.011
TyG index (per 1)^d	1.307 (1.024–1.668)	0.032

Values expressed as odds ratio (OR) and 95% confidence interval (CI). Abbreviations are the same as in Table 1.

^aAdjusted for age, sex, coronary artery disease, cerebrovascular disease, systolic and diastolic blood pressures, fasting glucose, HbA_1c, log triglyceride, total cholesterol, HDL-cholesterol, LDL-cholesterol, eGFR, and medications use.

^bAdjusted for age, sex, coronary artery disease, cerebrovascular disease, systolic and diastolic blood pressures, fasting glucose, HbA_1c, total cholesterol, HDL-cholesterol, LDL-cholesterol, eGFR, and medications use.

^cAdjusted for age, sex, coronary artery disease, cerebrovascular disease, systolic and diastolic blood pressures, fasting glucose, HbA_1c, total cholesterol, LDL-cholesterol, eGFR, and medications use.

^dAdjusted for age, sex, coronary artery disease, cerebrovascular disease, systolic and diastolic blood pressures, HbA_1c, total cholesterol, HDL-cholesterol, LDL-cholesterol, eGFR, and medications use.

Table 3. Comparison of baseline characteristics between patients with and without eGFR <30 mL/min/1.73 m².

Characteristics	eGFR ≥ 30 (n = 1,815)	eGFR < 30 (n = 57)	P
Age (year)	63.8 ± 11.2	72.6 ± 10.2	<0.001
Male gender (%)	43.3	40.4	0.681
Coronary artery disease (%)	16.4	36.5	<0.001
Cerebrovascular disease (%)	5.0	11.5	0.034
Systolic blood pressure (mmHg)	134.8 ± 18.7	140.3 ± 21.1	0.031
Diastolic blood pressure (mmHg)	78.0 ± 11.2	74.6 ± 11.9	0.071
Body height (cm)	159.0 ± 8.4	157.6 ± 8.7	0.262
Body weight (Kg)	65.4 ± 11.0	69.2 ± 9.9	0.008
Waist circumference (cm)	89.4 ± 9.5	96.6 ± 8.5	<0.001
Hip circumference (cm)	98.4 ± 7.7	101.5 ± 6.8	0.001
BMI category (%)			0.001
Underweight (BMI <18.5 kg/m^2)	0.7	0
Normal (18.5 ≤ BMI <24 kg/m^2)	31.1	7.7
Overweight (24 ≤ BMI <27 kg/m^2)	34.5	36.5
Mild obesity (27 ≤ BMI <30 kg/m^2)	21.4	26.9
Moderate obesity (30 ≤ BMI <35 kg/m^2)	11.0	26.9
Severe obesity (BMI ≥ 35 kg/m^2)	1.4	1.9
Laboratory parameters
Fasting glucose (mg/dL)	149.0 ± 51.9	132.9 ± 49.8	0.006
HbA1c (%)	7.7 ± 1.7	7.2 ± 1.2	0.018
Triglyceride (mg/dL)	124 (90–175)	170 (127.25–223.5)	<0.001
Total cholesterol (mg/dL)	185.6 ± 38.2	185.1 ± 41.7	0.792
HDL-cholesterol (mg/dL)	49.8 ± 13.1	44.9 ± 12.4	0.014
LDL-cholesterol (mg/dL)	104.4 ± 28.2	103.5 ± 28.4	0.786
eGFR (mL/min/1.73 m^2)	69.5 ± 19.2	23.1 ± 5.0	<0.001
Medications
Oral anti-diabetic drugs (%)	90.3	80.8	0.023
Insulin (%)	39.2	76.9	<0.001
ACEI and/or ARB (%)	72.8	98.1	<0.001
Statins use (%)	59.1	73.1	0.043
Fibrate use (%)	16.0	28.8	0.013
Obesity related indices
BMI (kg/m^2)	25.8 ± 3.6	27.8 ± 3.1	<0.001
WHR	0.91 ± 0.07	0.95 ± 0.07	<0.001
WHtR	0.56 ± 0.06	0.61 ± 0.06	<0.001
LAP	49.6 ± 41.8	82.5 ± 74.0	<0.001
BRI	4.7 ± 1.3	5.8 ± 1.4	<0.001
CI	1.28 ± 0.08	1.34 ± 0.08	<0.001
VAI	2.5 ± 2.8	4.0 ± 3.9	<0.001
BAI	31.3 ± 5.2	33.6 ± 5.5	0.002
AVI	16.3 ± 3.4	18.8 ± 3.2	<0.001
ABSI	0.081 ± 0.005	0.084 ± 0.005	<0.001
TyG index	9.1 ± 0.7	9.3 ± 0.7	0.156

Abbreviations are the same as in Table 1.

Table 4. Association of obesity related indices with eGFR <30 mL/min/1.73 m² using multivariable logistic regression analysis.

Obesity-related indices	Multivariable
	OR (95% CI)	P
BMI (per 1 kg/m^2)^a	1.112 (1.021–1.211)	0.015
WHR (per 0.1)^a	1.887 (1.183–3.010)	0.008
WHtR (per 0.1)^a	2.091 (1.259–3.474)	0.004
LAP (per 1)^b	1.016 (1.007–1.025)	0.001
BRI (per 1)^a	1.369 (1.107–1.694)	0.004
CI (per 0.1)^a	1.501 (1.022–2.206)	0.038
VAI (per 1)^c	1.137 (1.046–1.236)	0.003
BAI (per 1)^a	1.041 (0.975–1.111)	0.226
AVI (per 1)^a	1.137 (1.042–1.242)	0.004
ABSI (per 0.01)^a	1.445 (0.783–2.666)	0.238
TyG index (per 1)^d	1.092 (0.600–1.986)	0.774

Values expressed as odds ratio (OR) and 95% confidence interval (CI). Abbreviations are the same as in Table 1.

^aAdjusted for age, sex, coronary artery disease, cerebrovascular disease, systolic and diastolic blood pressures, fasting glucose, HbA_1c, log triglyceride, total cholesterol, HDL-cholesterol, LDL-cholesterol, and medications use.

^bAdjusted for age, sex, coronary artery disease, cerebrovascular disease, systolic and diastolic blood pressures, fasting glucose, HbA_1c, total cholesterol, HDL-cholesterol, LDL-cholesterol, and medications use.

^cAdjusted for age, sex, coronary artery disease, cerebrovascular disease, systolic and diastolic blood pressures, fasting glucose, HbA_1c, total cholesterol, LDL-cholesterol, and medications use.

^dAdjusted for age, sex, coronary artery disease, cerebrovascular disease, systolic and diastolic blood pressures, HbA_1c, total cholesterol, HDL-cholesterol, LDL-cholesterol, and medications use.