The Relationship Between Increased Ratio of Visceral-to-Subcutaneous Fat Area and Renal Outcome in Chinese Adults With Type 2 Diabetes and Diabetic Kidney Disease.

Abstract

OBJECTIVE:

Abdominal obesity is a risk factor of diabetes and hypertension. The aim of this study was to investigate the association between excessive abdominal fat and renal outcomes in patients with type 2 diabetes and diabetic kidney disease.

METHODS:

Thirty-five patients with type 2 diabetes and diabetic kidney disease who were followed up on for at least 1 year were enrolled. Visceral fat area and subcutaneous fat area were assessed by computed tomography to evaluate the degree of abdominal fat. Patients were divided into 2 groups. Patients in group 1 had a ratio of visceral fat area to subcutaneous fat area (V/S ratio) <0.70 (n=16), and those in group 2 had a V/S ratio ≥0.70 (n=19) according to the second quartile. Renal outcome was defined as end-stage renal disease and initiation of renal replacement therapy.

RESULTS:

At baseline, patients with a high V/S ratio had higher levels of triglycerides (p=0.060) and C-reactive protein (p=0.028), but lower high-density lipoprotein cholesterol levels (p=0.006). Strong correlations between V/S ratio and C-reactive protein (r=0.521, p=0.015) and high-density lipoprotein cholesterol (r=-0.576, p<0.001) were observed. Univariate Cox regression indicated the higher the V/S ratio, the greater the risk for a poor renal outcome (hazard ratio, 3.536; 95% confidence interval, 1.140 to 10.960; p=0.029). However, multivariate Cox analysis demonstrated that a higher V/S ratio was not an independent risk factor for progression to end-stage renal disease (hazard ratio, 2.212; 95% confidence interval, 0.543 to 9.005; p=0.268) when adjustments were made for important clinical variables.

CONCLUSION:

The V/S ratio was positively correlated with C-reactive protein and high-density lipoprotein cholesterol. The higher V/S ratio was associated with a greater risk for progression to end-stage renal disease, although it did not emerge as an independent predictor of diabetic kidney disease progression.

• Authors: Yiting Wang, Feng Chen, Jiali Wang, Tingli Wang, Junlin Zhang, Qianqian Han, Yucheng Wu, Rui Zhang, Fang Liu
• Journal: Canadian journal of diabetes (Can J Diabetes) Vol. 43 Issue 6 Pg. 415-420 (Aug 2019) ISSN: 2352-3840 [Electronic] Canada
• PMID: 30503868 (Publication Type: Journal Article)
• Copyright: Copyright © 2018 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Chemical References

• C-Reactive Protein

Topics

• Adult
• Asian People (statistics & numerical data)
• Body Mass Index
• C-Reactive Protein (analysis)
• Diabetes Mellitus, Type 2 (complications)
• Diabetic Nephropathies (etiology, metabolism, pathology)
• Female
• Follow-Up Studies
• Humans
• Intra-Abdominal Fat (physiopathology)
• Male
• Middle Aged
• Obesity (physiopathology)
• Prognosis
• Risk Factors
• Subcutaneous Fat (physiopathology)