Zhongguo quanke yixue (Jul 2022)
Relationship between Obesity and Proteinuria in Type 2 Diabetic Patients
Abstract
Background Obesity is a risk factor for the development of metabolic syndrome, type 2 diabetes mellitus (T2DM) , atherosclerosis and other diseases, but the correlation between obesity and albuminuria in diabetic patients has been insufficiently explored. Objective To investigate the correlation between obesity and albuminuria in patients with T2DM. Methods T2DM inpatients were consecutively recruited from Department of Endocrinology and Metabolism, Shanghai Jiaotong University Affiliated Sixth People's Hospital from January 2007 to June 2009. The general clinical data, physical and laboratory examination results were collected. In accordance with prevalence of obesity (defined as BMI≥25 kg/m2) , the patients were divided into obese group and non-obese group (BMI<25 kg/m2) , then the obese cases were further divided into mild (25 kg/m2≤BMI<30 kg/m2) , moderate (30 kg/m2≤ BMI<35 kg/m2) , and severe obesity subgroups (BMI≥35 kg/m2) . Albuminuria was diagnosed as 24-hour urinary albumin excretion≥30 mg/24 h. The relationship between obesity and albuminuria was analyzed by binary Logistic regression. Results In all, 3 023 T2DM cases were enrolled, including 1 609 non-obese cases, and 1 414 obese cases (1 196 cases of mild obesity, 206 cases of moderate obesity and 12 cases of severe obesity) . Compared with non-obese cases, obese cases had higher prevalence of alcohol consumption, hypertension, and history of anti-hypertensive mediation use (P<0.05) . Additionally, obese cases had higher average levels of systolic blood pressure, diastolic blood pressure, waist-to-hip ratio, fasting plasma glucose, 2-h postprandial blood glucose, serum creatinine, fasting C-peptide, 2-hour postprandial C-peptide, triglyceride, total cholesterol, low-density lipoprotein, alanine aminotransferase, and serum uric acid, and lower average levels of glycosylated hemoglobin and high-density lipoprotein (P<0.05) . Obese cases also had higher average level of 24-h urinary albumin excretion 〔13.7 (7.6, 42.6) mg/24 h〕 than did non-obese cases 〔9.7 (6.0, 22.3) mg/24 h〕 (P<0.05) . The prevalence of albuminuria (30.0%, 424/1 414) in obese cases was significantly higher than that of non-obese cases (20.2%, 325/1 609) (P<0.05) . Binary Logistic regression analysis showed that obesity was closely associated with albuminuria in T2DM〔OR=1.266, 95%CI (1.013, 1.582) , P<0.05〕 after adjusting for confounding variables. Conclusion Obesity may be an independent risk factor of albuminuria in T2DM. So controlling obesity is very important in decreasing the risk of albuminuria in T2DM patients.
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