| Objective To investigate the relationship between abdominal fat distribution and chronic kidney disease in hospitalized patients with type 2 diabetes mellitusMethods The patients with type 2 diabetes who were hospitalized in the hospital from January 2020 to October 2020 were selected as the research objects,and their clinical medical records were collected as research subjects,including age,sex,diabetes course,smoking history,drinking history,hypertension history,BMI,fasting blood glucose,postprandial blood sugar,glycosylated hemoglobin,triglyceride,total cholesterol,high-density lipoprotein,low-density lipoprotein,uric acid,urinary albumin excretion rate,estimate glomerular filtration rate,and other auxiliary materials.The insulin resistance index,islet function index,and C-peptide release index were calculated to evaluate the islet function and insulin resistance.Evaluation of chronic kidney disease based on UAER and e GFR.The subcutaneous fat area and visceral fat area measured by the bioelectrical impedance method were collected to reflect the distribution of abdominal fat.According to the triple-level of VFA,the participants were categorized into T1 group(VFA<89cm~2),T2 group(89cm~2≤VFA≤117cm~2),and T3 group(VFA>117cm~2).Visceral obesity was defined as VFA greater than 100cm~2.The participants were categorized into T1 group(SFA<173cm~2),T2 group(173cm~2≤SFA≤219cm~2)and T3 group(SFA>219cm~2)according to the triad level of SFA.Visceral obesity was defined as VFA greater than 100cm~2.The clinical characteristics of each group were described,and the differences between the groups were analyzed and the trend was analyzed.Evaluate the correlations between] abdominal fat and various clinical indicators.Logistics regression was used to analyze the correlation between abdominal fat and chronic kidney disease in patients with type 2 diabetes.Results 1.There were 731 hospitalized patients with type 2 diabetes in the study,including 485(66.35%)males and 246(33.65%)females with an average age of(57.69±10.11),the median duration of diabetes is 8.00(3.00,13.00).2.The mean BMI of the participants was 24.64±3.07kg/m2,the proportion of underweight was 1.5%,the proportion of normal weight was 42.27%,the proportion of overweight was 42.68%,and the prevalence of obesity was 13.54%.The average visceral fat area was 103.81±35.44cm~2 and the average subcutaneous fat area was 199.60 cm~2±58.00cm~2.The percentage of visceral obesity was 52.7%.Patients with visceral obesity have shorter disease duration,younger age,more male patients,more hypertension,and higher prevalence of chronic kidney disease.3.In this study,the prevalence of chronic kidney disease in hospitalized type 2 diabetic patients was 37.35%.The average visceral fat area of chronic kidney disease patients was 108.9±40.9cm~2,and the average subcutaneous fat area was 206.0±63.8cm~2,which were significantly higher than those in the non-chronic kidney disease group.4.Spearman rank correlation analysis of abdominal fat and clinical indicators showed that VFA was positively associated with UAER,e GFR,and CKD(correlation coefficients were 0.11,0.32,and 0.11),SFA was positively associated with UAER,e GFR,and CKD(correlation coefficients were 0.09,0.33 and 0.08).The VFA was more correlated than SFA with chronic kidney disease.5.Logistics regression analysis showed that after adjusting a variety of mixed factors,compared to the T1 group,and the risk of chronic kidney disease in the T3 group was increased(OR=1.67,95% CI: 1.11,2.50),and there was an interaction between gender and VFA(P <0.05).VFA increased more susceptible to chronic kidney disease in male patients.The T3 groups of SFA were compared to T1 groups,the risk of chronic kidney disease increased(OR=1.65,95% CI: 1.19,2.53),There was an interaction between age and SFA(P <0.05),SFA has a greater impact on chronic kidney disease in patients under 60 years old.To explore the relationship between visceral obesity and chronic kidney disease in normal-weight and overweight/obese patients,adjusting a variety of mixed factors,in overweight/obese patients with visceral obesity associated with increased risk of chronic kidney disease(OR=1.95,95% CI: 1.10,3.47),in patients with normal-weight,there was no significant correlation between viscera obesity and chronic kidney disease.Conclusion 1.In this study,the prevalence of chronic kidney disease in patients with type 2 diabetes was 37.35%,the prevalence of obesity was 13.54%,and the proportion of patients with visceral obesity was 52.9%.2.Abdominal fat distribution in patients with type 2 diabetes is related to chronic kidney disease.Visceral fat and subcutaneous fat will increase the risk of chronic kidney disease,and visceral fat is more closely related to chronic kidney disease. |
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