Measurements of Obesity, Impaired Renal Function, and Albuminuria in Type 2 Diabetic Patients

Kai-Hsiang Shu ； Ju-Ying Jiang ； Yi-Fang Chuang ； Hua-Fen Chen ； Yu-Sen Peng ； Yen-Ling Chiu

《Acta Nephrologica》 33卷2期 (2019/06) Pp. 73-85

https://doi.org/10.6221/AN.201906_33(2).0003

摘要

BACKGROUND: Obesity represents the most prevalent risk factor with a strong association with multiple diseases, including chronic kidney disease. However, the differential effects or various measurements of obesity on renal function were not previously clarified in the diabetic population. METHODS: A total of 891 subjects with type 2 diabetes with different levels of albuminuria and renal function were included in the current study, along with the acquisition of demographic, anthropometric, and laboratory data. The estimated glomerular filtration rate (eGFR) was determined using the Chronic Kidney Disease Epidemiology Collaboration formula. RESULTS: In all samples, body weight (BW), body mass index (BMI), and waist circumference all showed a trend toward negative correlation with eGFR, but only waist circumference reached statistical significance. The negative relationship between BW and BMI was noted only in female patients but not in males. The negative association of waist circumference with eGFR was present in both male and female patients. BW, BMI, and waist circumference all positively correlated with albuminuria levels, in both males and females. For female patients, waist circumference more than 80 cm predicts the presence of microalbuminuria at a sensitivity of 89.9%. In contrast, the sensitivity for macroalbuminuria in males at a waist circumference of 82 cm or higher is 92.5%. CONCLUSION: Compared with BMI or BW, increased waist circumference may be a better indicator for decreased eGFR in females and exacerbated albuminuria/elevated C-reactive protein for both genders.

關鍵字

albuminuria ； diabetes mellitus ； estimated GFR ； obesity ； Waist circumference