Association of Obesity Indices with Diabetic Kidney Disease and Diabetic Retinopathy in Type 2 Diabetes: A Real-World Study
Background. Diabetic microvascular complications mainly include diabetic kidney disease (DKD) and diabetic retinopathy (DR). Obesity was recognized as a risk factor for DKD, while the reported relationship between obesity and DR was inconsistent. Moreover, whether the associations can be attributed...
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2023/3819830 |
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| _version_ | 1850219606760751104 |
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| author | Shaomin Shi Lihua Ni Yuan Tian Baifang Zhang Jing Xiao Wan Xu Ling Gao Xiaoyan Wu |
| author_facet | Shaomin Shi Lihua Ni Yuan Tian Baifang Zhang Jing Xiao Wan Xu Ling Gao Xiaoyan Wu |
| author_sort | Shaomin Shi |
| collection | DOAJ |
| description | Background. Diabetic microvascular complications mainly include diabetic kidney disease (DKD) and diabetic retinopathy (DR). Obesity was recognized as a risk factor for DKD, while the reported relationship between obesity and DR was inconsistent. Moreover, whether the associations can be attributed to C-peptide levels is unknown. Methods. Data from 1142 sequential inpatients with T2DM at Xiangyang Central Hospital between June 2019 and March 2022 were extracted retrospectively from the electronic medical record system. The associations between four obesity indices (body mass index (BMI), waist-hip circumference ratio (WHR), visceral fat tissue area (VFA), and subcutaneous fat tissue area (SFA)) and DKD and DR were evaluated. Whether the associations can be attributed to C-peptide levels was also explored. Results. Obesity was a risk factor for DKD after adjusting for sex, HbA1c, TG, TC, HDL, LDL, smoking history, education, duration of diabetes, and insulin use (obesity indices: BMI (OR 1.050: 95% CI: 1.008-1.094; P=0.020); WHR (OR 10.97; 95% CI: 1.250-92.267; P=0.031); VFA (OR 1.005; 95% CI: 1.001-1.008; P=0.008)), but it became insignificant after further adjusting for fasting C-peptide. The associations between BMI, WHR, VFA, and DKD might be U-shaped. Obesity and FCP tended to protect against DR; however, they became insignificant after adjusting for multiple potential confounders. C2/C0 (the ratio of the postprandial serum C-peptide to fasting C-peptide) was a protective factor for both DKD (OR 0.894, 95% CI: 0.833-0.959, P<0.05) and DR (OR 0.851, 95% CI: 0.787-0.919; P<0.05). Conclusions. Obesity was a risk factor for DKD, and the effect may be attributable to C-peptide, which represents insulin resistance. The protective effect of obesity or C-peptide on DR was not independent and could be confounded by multiple factors. Higher C2/C0 was associated with both decreased DKD and DR. |
| format | Article |
| id | doaj-art-7a0b6cd4a1d247468bbd1745e07453d6 |
| institution | OA Journals |
| issn | 2314-6753 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-7a0b6cd4a1d247468bbd1745e07453d62025-08-20T02:07:19ZengWileyJournal of Diabetes Research2314-67532023-01-01202310.1155/2023/3819830Association of Obesity Indices with Diabetic Kidney Disease and Diabetic Retinopathy in Type 2 Diabetes: A Real-World StudyShaomin Shi0Lihua Ni1Yuan Tian2Baifang Zhang3Jing Xiao4Wan Xu5Ling Gao6Xiaoyan Wu7Department of NephrologyDepartment of NephrologyXiangyang Central HospitalDepartment of BiochemistryXiangyang Central HospitalXiangyang Central HospitalXiangyang Central HospitalDepartment of NephrologyBackground. Diabetic microvascular complications mainly include diabetic kidney disease (DKD) and diabetic retinopathy (DR). Obesity was recognized as a risk factor for DKD, while the reported relationship between obesity and DR was inconsistent. Moreover, whether the associations can be attributed to C-peptide levels is unknown. Methods. Data from 1142 sequential inpatients with T2DM at Xiangyang Central Hospital between June 2019 and March 2022 were extracted retrospectively from the electronic medical record system. The associations between four obesity indices (body mass index (BMI), waist-hip circumference ratio (WHR), visceral fat tissue area (VFA), and subcutaneous fat tissue area (SFA)) and DKD and DR were evaluated. Whether the associations can be attributed to C-peptide levels was also explored. Results. Obesity was a risk factor for DKD after adjusting for sex, HbA1c, TG, TC, HDL, LDL, smoking history, education, duration of diabetes, and insulin use (obesity indices: BMI (OR 1.050: 95% CI: 1.008-1.094; P=0.020); WHR (OR 10.97; 95% CI: 1.250-92.267; P=0.031); VFA (OR 1.005; 95% CI: 1.001-1.008; P=0.008)), but it became insignificant after further adjusting for fasting C-peptide. The associations between BMI, WHR, VFA, and DKD might be U-shaped. Obesity and FCP tended to protect against DR; however, they became insignificant after adjusting for multiple potential confounders. C2/C0 (the ratio of the postprandial serum C-peptide to fasting C-peptide) was a protective factor for both DKD (OR 0.894, 95% CI: 0.833-0.959, P<0.05) and DR (OR 0.851, 95% CI: 0.787-0.919; P<0.05). Conclusions. Obesity was a risk factor for DKD, and the effect may be attributable to C-peptide, which represents insulin resistance. The protective effect of obesity or C-peptide on DR was not independent and could be confounded by multiple factors. Higher C2/C0 was associated with both decreased DKD and DR.http://dx.doi.org/10.1155/2023/3819830 |
| spellingShingle | Shaomin Shi Lihua Ni Yuan Tian Baifang Zhang Jing Xiao Wan Xu Ling Gao Xiaoyan Wu Association of Obesity Indices with Diabetic Kidney Disease and Diabetic Retinopathy in Type 2 Diabetes: A Real-World Study Journal of Diabetes Research |
| title | Association of Obesity Indices with Diabetic Kidney Disease and Diabetic Retinopathy in Type 2 Diabetes: A Real-World Study |
| title_full | Association of Obesity Indices with Diabetic Kidney Disease and Diabetic Retinopathy in Type 2 Diabetes: A Real-World Study |
| title_fullStr | Association of Obesity Indices with Diabetic Kidney Disease and Diabetic Retinopathy in Type 2 Diabetes: A Real-World Study |
| title_full_unstemmed | Association of Obesity Indices with Diabetic Kidney Disease and Diabetic Retinopathy in Type 2 Diabetes: A Real-World Study |
| title_short | Association of Obesity Indices with Diabetic Kidney Disease and Diabetic Retinopathy in Type 2 Diabetes: A Real-World Study |
| title_sort | association of obesity indices with diabetic kidney disease and diabetic retinopathy in type 2 diabetes a real world study |
| url | http://dx.doi.org/10.1155/2023/3819830 |
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