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

被引:47
作者
Chung, Hsin-Fang [1 ]
Al Mamun, Abdullah [1 ]
Huang, Meng-Chuan [2 ,3 ]
Long, Kurt Z. [1 ]
Huang, Ya-Fang [7 ]
Shin, Shyi-Jang [4 ]
Hwang, Shang-Jyh [5 ,6 ]
Hsu, Chih-Cheng [7 ,8 ,9 ,10 ]
机构
[1] Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia
[2] Kaohsiung Med Univ, Grad Inst Med, Dept Publ Hlth & Environm Med, Coll Med, Kaohsiung, Taiwan
[3] Kaohsiung Med Univ Hosp, Dept Nutr & Dietet, Kaohsiung, Taiwan
[4] Kaohsiung Med Univ, Dept Internal Med, Div Endocrinol & Metab, Kaohsiung, Taiwan
[5] Kaohsiung Med Univ, Dept Internal Med, Div Nephrol, Kaohsiung, Taiwan
[6] Univ Hosp, Kaohsiung, Taiwan
[7] Natl Hlth Res Inst, Inst Populat Hlth Sci, 35 Keyan Rd, Zhunan 35053, Miaoli County, Taiwan
[8] China Med Univ, Dept Hlth Serv Adm, Taichung, Taiwan
[9] Natl Yang Ming Univ, Inst Clin Med, Taipei, Taiwan
[10] Swiss Trop & Publ Hlth Inst, Dept Epidemiol & Publ Hlth, Basel, Switzerland
关键词
Asian; chronic kidney disease; obesity; type; 2; diabetes; weight change; STAGE RENAL-DISEASE; BODY-MASS INDEX; METABOLIC SYNDROME; LOSS INTERVENTION; ASSOCIATION; OVERWEIGHT; HYPERTENSION; NEPHROPATHY; ADULTS; RISK;
D O I
10.1111/1753-0407.12514
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BackgroundThe 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. MethodsAt 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 m(2); body mass index (BMI) was categorised as normal (18.5-22.9 kg/m(2)), overweight (23-27.4 kg/m(2)), or obese (27.5 kg/m(2)); 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). ResultsOver 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). ConclusionsDiabetic 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.
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收藏
页码:983 / 993
页数:11
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