Abdominal Obesity Is More Closely Associated With Diabetic Kidney Disease Than General Obesity

Objective:To investigate the association of general and abdominal obesity with diabetic kidney disease(DKD)by study A and B.Research Design and Methods:Study A was a cross-sectional study,1016 patients with type 2 diabetes(T2D)with available data were recruited.Study B was a five-year prospective study,in which 279 T2D patients without DKD at baseline were followed up.Body composition was assessed using dual-energy X-ray-absorptiometry(DEXA)in study A,General obesity parameters including body mass index(BMI),total body fat percentage(TBF),fat mass index(FMI)and abdominal obesity parameters including waist circumference(WC),waist-to-height-ratio(WHtR),visceral adipose tissue(VAT)were measured.Obesity-related parameters were split into tertiles and subjects were stratified into those with low,median and high values accordingly,and then the risk of DKD were compared.Results:In study A,more obese patients were more likely to have a lower eGFR.Logistic regression analyses showed that parameters of general obesity(BMI,TBF or FMI)were associated with risk of DKD,however,the correlation disappeared when VAT was adjusted.Logistic regression analyses showed that parameters of abdominal obesity(WC,WHtR or VAT)were associated with risk of DKD,however,After controlling for confounders(including BMI),subjects with high values of abdominal obesity parameters(i.e.WC,WHtR,VAT)exhibited a higher risk of DKD compared to those with low values.In study B,41 T2D patients developed DKD after five years among 279 T2D patients.WC,WHR and WHtR were significantly associated with risk of DKD in crude,WHtR-adjusted or multivariate model.However,no relationship between BMI with risk of DKD was found in crude,WHtR-adjusted or multivariate model.Conclusions:Abdominal obesity is more closely associated with the risk of DKD than general obesity.