Associations between Body Mass Index and Chronic Kidney Disease in Type 2 Diabetes Mellitus Patients: Findings from the Northeast of Thailand

Abstract

BackgroundChronic kidney disease (CKD) has emerged as a public health burden globally. Obesity and long-term hyperglycaemia can initiate the renal vascular complications in patients with type 2 diabetes mellitus (T2DM). This study aimed to investigate the association of body mass index (BMI) with the CKD in patients with T2DM.MethodsThis study has used retrospective medical records, biochemical reports, and anthropometric measurements of 3,580 T2DM patients which were collected between January to December 2015 from a district hospital in Thailand. CKD was defined according to the measurement of estimated glomerular filtration rate (<60 mL/min/1.73 m2). Multiple logistic regression analysis was used to explore the association between BMI and CKD in patients with T2DM.ResultsThe mean age of the participants was 60.86±9.67 years, 53.68% had poor glycaemic control, and 45.21% were overweight. About one-in-four (23.26%) T2DM patients had CKD. The mean BMI of non-CKD group was slightly higher (25.30 kg/m2 vs. 24.30 kg/m2) when compared with CKD patients. Multivariable analysis showed that older age, female sex, hypertension, and microalbuminuria were associated with the presence of CKD. No association was observed between CKD and poorly controlled glycosylated hemoglobin or hypercholesterolemia. Adjusted analysis further showed overweight and obesity were negatively associated with CKD (adjusted odds ratio [AOR], 0.73; 95% confidence interval [CI], 0.58 to 0.93) and (AOR, 0.53; 95% CI, 0.35 to 0.81), respectively.ConclusionThe negative association of BMI with CKD could reflect the reverse causality. Lower BMI might not lead a diabetic patient to develop CKD, but there are possibilities that CKD leads the patient to experience reduced BMI.

Obese First degree relatives of hemodialysis patients are at Higher Risk for Developing Kidney Diseases: In a Cross-sectional Study

“…In fact, the association of obesity with an increased ACR-based CKD risk was previously reported (45). In contrast our results differ from those demonstrated that, the BMI is independent factor of CKD (46).…”

Prevalence and risk factors of chronic kidney disease among Palestinian type 2 diabetic patients: a cross-sectional study

“…Diabetic patients with HTN are more likely to develop CKD than diabetic patients with normal BP. These results are consistent with the literature of different countries [ 15 , 20 , 21 ]. There is a significant overlap between HTN and CKD.…”

“…The relationship between gender and CKD among diabetic patients is inconsistent in the literature. Many studies have shown female gender as a risk factor [ 12 , 15 , 21 ], while others have reported male gender as a risk factor [ 20 ]. This may be due to the gender distribution of risk factors, such as obesity and T2DM control status.…”

“…Low blood pressure (BP) and glycemic control have been shown to cause more kidney damage and reduced renal function. Similarly, certain context variables have been shown to be positively linked to CKD, such as age, smoking, and BMI [ 13 – 15 ].…”

Effects of Variability in Blood Pressure, Glucose, and Cholesterol Concentrations, and Body Mass Index on End-Stage Renal Disease in the General Population of Korea

“…A higher risk for mortality was noted in participants who lost or gained weight compared with those with stable weight before dialysis initiation. Anorexia and weight loss accompany CKD progression [27,28]. Weight loss begins when serum Cr concentration is in the range of 1.5 to 2.0 mg/dL and earlier than may be expected [27].…”