The Association Between Insulin Resistance, Leptin, and Resistin and Diabetic Nephropathy in Type 2 Diabetes Mellitus Patients with Different Body Mass Indexes

Figures & data

Table 1 Clinical and Metabolic Parameters of T2DM Patients

Characteristics	Normal	Overweight	Obese	P value
N (%)	144(46.6%)	113(36.6%)	52(16.8%)
Male-sex (%)	85(59.0%)	82(72.6%)	32(61.5%)	0.071
Age	53.7±13.7	53.7±13.4	47.9±15.0	0.024
BMI	21.4±1.9	25.8±1.1	31.2±3.0	<0.001
HbA1c, %	9.0±2.5	9.3±2.4	9.1±2.4	0.777
HOMA-B, %	171.7±152.1	183.2±155.2	194.8±145.9	0.618
HOMA-IR	5.8±5.0	7.4±6.0	8.6±6.2	0.005
ALT, U/L	26.6±41.0	29.4±38.7	34.5±29.6	0.448
AST, U/L	23.7±23.1	24.1±18.7	28.2±23.9	0.429
TC, mmol/L	4.0±1.2	4.2±1.1	4.3±1.5	0.339
TG, mmol/L	1.8±1.4	2.3±2.0	3.4±4.5	<0.001
HDL	1.1±0.3	1.0±0.3	1.0±0.2	0.004
LDL	2.4±0.9	2.6±0.9	2.4±0.9	0.145
BUN, mmol/L	6.6±3.0	6.3±2.8	5.4±1.9	0.044
Scr, umol/L	82.7±43.5	86.3±53.5	73.7±24.7	0.263
eGFR, mL/min/1.7 m^2	89.6±30.0	90.5±26.0	97.0±23.4	0.255
Smoking (Yes %)	47(32.6%)	42(37.2%)	12(23.1%)	0.200
Drinking (Yes %)	20(14.0%)	22(19.5%)	9(17.3%)	0.497
Leptin, ng/mL	4.3±3.4	7.4±6.1	10.1±8.2	<0.001
Resistin, ng/mL	12.1±10.5	9.3±8.0	12.2±10.4	0.051
DN (Yes %)	57(39.6%)	41(36.3%)	20(38.5%)	0.863

Abbreviations: ALT, aminotransferase activity; AST, aspartate transaminase; TC, total cholesterol; TG, triglyceride; HDL, high-density lipoprotein; LDL, low density lipoprotein; BUN, blood urea nitrogen; Scr, serum creatinine; eGFR, estimated glomerular filtration rate; DN, diabetic nephropathy.

Figure 1 The association between clinical indexes and diabetic nephropathy in the total population. The median of some variables (HbA1c, HOMA-B, HOMA-IR, leptin and resistin) were used as cut-off points when creating groups. The values less than median were as the reference.

Table 2 Logistic Regression Analysis of Risk Factors for Diabetic Nephropathy in the Normal Weight Group

		OR^a	P value^a	OR^b	P value^b
HOMA-IR	<Median	Ref		Ref
	≥Median	3.975(1.928,8.194)	<0.001	4.210(1.776,9.936)	0.001
Leptin	<Median	Ref		Ref
	≥Median	3.100(1.389,6.920)	0.006	2.474(1.084,5.650)	0.031
Resistin	<Median	Ref		Ref
	≥Median	7.489(3.427,16.366)	<0.001	8.299(3.611,19.072)	<0.001

Figure 2 Receiver operating characteristic (ROC) curves analysis of insulin resistance, leptin, and resistin for diabetic nephropathy in normal-weight, overweight and obese patients with T2DM. ROC curves and corresponding areas under the curve (AUC) for diabetic nephropathy were performed in normal-weight (A), overweight (B) and obese patients (C) with T2DM.

Table 3 Logistic Regression Analysis of Risk Factors for Diabetic Nephropathy in the Overweight Group

		OR^a	P value^a	OR^b	P value^b
HOMA-IR	<Median	Ref		Ref
	≥Median	1.437(0.658,3.140)	0.363	1.903(0.748,4.841)	0.177
Leptin	<Median	Ref		Ref
	≥Median	1.879(0.781,4.521)	0.159	2.371(0.898,6.262)	0.081
Resistin	<Median	Ref		Ref
	≥Median	1.251(0.570,2.748)	0.577	1.199(0.526,2.732)	0.666

Table 4 Logistic Regression Analysis of Risk Factors for Diabetic Nephropathy in the Obesity Group

		OR^a	P value^a	OR^b	P value^b
HOMA-IR	<Median	Ref		Ref
	≥Median	0.816(0.251,2.655)	0.816	3.073(0.552,17.118)	0.200
Leptin	<Median	Ref		Ref
	≥Median	0.642(0.190,2.168)	0.476	0.708(0.183,2.742)	0.617
Resistin	<Median	Ref		Ref
	≥Median	1.918(0.601,6.124)	0.272	2.333(0.617,8.827)	0.212

Notes: ^aAdjustment for sex and age. ^bAdjustment for sex, age, HbA1c, HOMA-B, smoking and drinking status.