Format

Send to

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

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

Author information

1
School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
2
Department of Public Health and Environmental Medicine, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
3
Department of Nutrition and Dietetics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
4
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
5
Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
6
Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University and University Hospital, Kaohsiung, Taiwan.
7
Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University and University Hospital, Kaohsiung, Taiwan.
8
Department of Health Services Administration, China Medical University, Taichung, Taiwan.
9
Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan.

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

PMID:
27976508
DOI:
10.1111/1753-0407.12514
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center