Obesity, weight change, and chronic kidney disease in patients with type 2 diabetes mellitus: A longitudinal study in Taiwan

J Diabetes. 2017 Nov;9(11):983-993. doi: 10.1111/1753-0407.12514. Epub 2017 Feb 5.

Abstract

Background: The aim of the present study was to investigate relationships between the risk of chronic kidney disease (CKD) and obesity and weight changes in Asian patients with type 2 diabetes.

Methods: At baseline (2003-05), 1187 diabetic patients aged 30-70 years were recruited to the study, with follow-up surveys completed in 2008, 2009, and 2010. Chronic kidney disease was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min per 1.73 m2 ; body mass index (BMI) was categorised as normal (18.5-22.9 kg/m2 ), overweight (23-27.4 kg/m2 ), or obese (≥27.5 kg/m2 ); waist circumference (WC) ≥80 cm for women and ≥90 cm for men was taken to indicate abdominal obesity. Changes in weight and WC were calculated from baseline to each follow-up survey. Relative risk (RR) and 95% confidence intervals (CIs) of CKD were estimated. To estimate the risk for incident CKD, associations were examined in patients without CKD at baseline (n = 881).

Results: Over 7 years of follow-up, obesity (RR 1.48; 95% CI 1.08-2.04; P = 0.015) and high WC (RR 1.23; 95% CI 1.00-1.52; P = 0.049) were associated with CKD after adjusting for covariates. Among participants without CKD at baseline, those who gained >10% weight (RR 1.43; 95% CI 1.07-1.90; P = 0.015) and in whom WC increased >15% (RR 1.37; 95% CI 1.01-1.85; P = 0.045) had a higher risk of incident CKD than those who remained stable (±5% changes in weight or WC).

Conclusions: Diabetic patients who are obese and those with excessive central fat were more likely to have CKD. Large weight gain (>10%) and increases in WC (>15%) independently predicted incident CKD.

Keywords: 2型糖尿病; Asian; chronic kidney disease; obesity; type 2 diabetes; weight change; 亚洲人; 体重改变; 慢性肾病; 肥胖.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Asian Continental Ancestry Group
  • Body Mass Index
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / ethnology
  • Female
  • Glomerular Filtration Rate
  • Health Surveys / methods
  • Health Surveys / statistics & numerical data
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Obesity / complications*
  • Obesity / ethnology
  • Overweight / complications*
  • Overweight / ethnology
  • Renal Insufficiency, Chronic / complications*
  • Renal Insufficiency, Chronic / ethnology
  • Risk Factors
  • Taiwan
  • Waist Circumference