PMID- 38462354
OWN - NLM
STAT- MEDLINE
DCOM- 20240312
LR  - 20240312
IS  - 0376-2491 (Print)
IS  - 0376-2491 (Linking)
VI  - 104
IP  - 10
DP  - 2024 Mar 12
TI  - [Correlation between weight variability and the risk of diabetic nephropathy in 
      patients with type 2 diabetes mellitus].
PG  - 742-750
LID - 10.3760/cma.j.cn112137-20230724-00081 [doi]
AB  - Objective: To evaluate the relationship between different indexes of weight 
      variability and the risk of diabetic kidney disease (DKD) in patients with type 2 
      diabetes mellitus (T2DM). Methods: A retrospective cohort study. The clinical 
      data of 2 180 T2DM patients without DKD who underwent case management at Lee's 
      United Clinic in Taiwan, China from 2002 to 2018 were retrospectively analyzed, 
      including 1 103 females and 1 077 males, with an average age of (64.8+/-12.4) 
      years. Regular follow-up was conducted for patients for at least 2 years, and 
      their metabolic indexes were monitored annually. BMI variability independent of 
      the mean (BMI-VIM), average yearly mean square successive difference (BMI-ASV), 
      coefficient of variation (BMI-CV) and standard deviation (BMI-SD) were 
      calculated,based on the body mass index (BMI) recorded annually by the patients. 
      Patients were divided into four groups (Q(1)-Q(4)) based on the quartiles of the 
      four weight variability indexes. DKD group and non-DKN group(NDKD group) were 
      defined based on the occurrence of DKD at the end of the follow-up. Cox 
      proportional hazards regression models were used to analyze the relationship 
      between the four weight variability indicators and the incidence of DKD. Subgroup 
      analysis was performed by categorizing patients into non-obesity (BMI<28 kg/m(2)) 
      and obesity groups (BMI>/=28 kg/m(2)) to investigate the impact of the four weight 
      variability indicators on the risk of DKD. Results: After a follow-up of 
      (4.55+/-2.13) years, 904 patients developed DKD. Compared with the NDKD group, 
      patients in the DKD group had a higher proportion of females, older age, longer 
      duration of diabetes, more insulin users, higher waist-to-hip ratio, higher 
      levels of BMI-VIM, BMI-ASV, BMI-CV, BMI-SD, systolic blood pressure, diastolic 
      blood pressure, and urine albumin(-)creatinine ratio, a lower proportion of 
      hypoglycemic drugs, estimated glomerular filtration rate, and high-density 
      lipoprotein cholesterol level, with statistically significant differences between 
      the two groups(all P<0.05). Cox proportional hazards regression analysis results 
      revealed that the risk of DKD in T2DM patients increased with the increase in 
      BMI-SD, BMI-CV, BMI-VIM, and BMI-ASV after correcting a series of influencing 
      factors. In the BMI-VIM subgroup, compared with the Q(1) group, the risk of DKD 
      in the Q(4) group increased by 22.4% [HR=1.224 (95%CI:1.008-1.487), P=0.041]. In 
      the BMI-ASV group, compared with the Q(1) group, the risk of DKD in the Q(4) 
      group increased by 51.1% [HR=1.511 (95%CI:1.240-1.841), P<0.01]. In the BMI-CV 
      group, compared with the Q(1) group, the risk of DKD in the Q(4) group increased 
      by 22.2% [HR=1.222 (95%CI:1.006-1.485), P=0.044]. In the BMI-SD subgroup, 
      compared with the Q(1) group, the risk of DKD in the Q(4) group increased by 
      22.2% [HR=1.222 (95%CI:1.002-1.490), P=0.048]. Sub-group analysis showed that 
      when the non-obesity group was grouped by BMI-ASV, after correcting a series of 
      influencing factors, compared with the Q(1) group, the highest risk of DKD 
      occurred in the Q(4) group [HR=1.551 (95%CI:1.228-1.958), P<0.001];when the 
      obesity group was grouped by BMI-ASV, after correcting a series of influencing 
      factors, compared with the Q(1) group, the highest risk of DKD occurred in the 
      Q(4) group [HR=1.703 (95%CI:1.168-2.485), P=0.006]. Conclusion: Increases in 
      BMI-VIM, BMI-ASV, BMI-CV, and BMI-SD are associated with an increased risk of DKD 
      in T2DM patients.
FAU - Fang, Y Q
AU  - Fang YQ
AD  - International School of Nursing, Hainan Medical University, Haikou 571199, China.
FAU - Wang, W W
AU  - Wang WW
AD  - the First Affiliated Hospital of Hainan Medical University, Clinical Research 
      Center for Metabolic Disease, Haikou 570102, China.
FAU - Liu, H H
AU  - Liu HH
AD  - Department of Endocrinology, Hainan General Hospital, Haikou 570311, China.
FAU - Tang, F L
AU  - Tang FL
AD  - International School of Nursing, Hainan Medical University, Haikou 571199, China.
FAU - Yau-Jiunn, T J
AU  - Yau-Jiunn TJ
AD  - Department of Endocrinology, Lee's United Clinic, Pingtung 900,China.
FAU - Lou, Q Q
AU  - Lou QQ
AD  - the First Affiliated Hospital of Hainan Medical University, Clinical Research 
      Center for Metabolic Disease, Haikou 570102, China.
LA  - chi
GR  - 2021YFE0204800/National Key R & D Program of China/
GR  - ZDYF2021SHFZ236/Key Research and Development Program of Hainan Province/
PT  - English Abstract
PT  - Journal Article
PL  - China
TA  - Zhonghua Yi Xue Za Zhi
JT  - Zhonghua yi xue za zhi
JID - 7511141
SB  - IM
MH  - Male
MH  - Female
MH  - Humans
MH  - Middle Aged
MH  - Aged
MH  - *Diabetes Mellitus, Type 2/complications
MH  - *Diabetic Nephropathies/epidemiology/complications
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Obesity/complications/epidemiology
EDAT- 2024/03/11 00:42
MHDA- 2024/03/12 06:42
CRDT- 2024/03/10 22:18
PHST- 2024/03/12 06:42 [medline]
PHST- 2024/03/11 00:42 [pubmed]
PHST- 2024/03/10 22:18 [entrez]
AID - 10.3760/cma.j.cn112137-20230724-00081 [doi]
PST - ppublish
SO  - Zhonghua Yi Xue Za Zhi. 2024 Mar 12;104(10):742-750. doi: 
      10.3760/cma.j.cn112137-20230724-00081.