Correlation Between the Variability of Different Obesity Indices and Diabetic Kidney Disease: A Retrospective Cohort Study Based on Populations in Taiwan

Abstract

Purpose To investigate the association of five obesity indices and the variability of these indices with diabetic kidney disease (DKD) in patients with type 2 diabetes and compare the predictive validity of these markers for the risk of DKD in this large longitudinal cohort study. Patients and Methods A total of 2659 patients with type 2 diabetes who did not have DKD were enrolled between 2006 and 2019 at Lee’s United Clinic in Taiwan. Data were collected for each subject, including demographic data, personal medical history, clinical parameters and calculated Body mass index (BMI), visceral adiposity index (VAI), lipid accumulation product (LAP), body roundness index (BRI) and variability of five obesity indices. Cox regression analysis was performed to determine the relationship between different obesity indicators and DKD risk. Cox’s proportional hazards model was evaluated the predictive effect of obesity indices on DKD. Results The risk of developing DKD increased with an increase in the BRI, LAP, VAI, WC and BMI (all P trend<0.05), and the variability of VAI was significantly associated with DKD [HR=1.132, 95% CI (1.001, 1.281)] after adjusting for corresponding variables. BRI had the strongest predictive effect on DKD. BRI had the best predictive performance, with AUC of 0.807, 0.663 and 0.673 at 1, 3 and 5 years, respectively. Cox regression analysis of risk factors for DKD in patients stratified by BRI quartiles showed that patients in the Q4 group had the highest risk of developing DKD [HR=1.356, 95% CI (1.131, 1.626)]. Conclusion BMI, WC, VAI, LAP, BRI and VAI variability were associated with a significant increase in the risk of DKD events, and BRI was superior and alternative obesity index for predicting DKD.

Association between lipid accumulation product index and chronic kidney disease: A systematic review and meta-analysis

“…Abstracts of the remaining 1,172 records were searched, and full texts of 140 studies were assessed for eligibility. Finally, 17 studies were included in the review ( 8-10 , 12 , 16-28 ).…”

“…The complexity of CKD etiology is further compounded by the presence of diabetes mellitus (DM), a condition that singularly accelerates the progression of nephropathy, and is a primary cause of CKD in numerous regions ( 11 ). The close relationship between hyperglycemia, insulin resistance and lipid disorders further strengthens the need to evaluate the relationship between LAP index and CKD in diabetic subpopulations ( 12 ), and to conduct subgroup analyses based on the presence of DM. These analyses may improve risk stratification and allow for the tailoring of preventive measures in these high-risk cohorts.…”