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

Chung, Hsin-Fang, Al Mamun, Abdullah, Huang, Meng-Chuan, Long, Kurt Z., Huang, Ya-Fang, Shin, Shyi-Jang, Hwang, Shang-Jyh and Hsu, Chih-Cheng (2017) Obesity, weight change, and chronic kidney disease in patients with type 2 diabetes mellitus: a longitudinal study in Taiwan. Journal of Diabetes, 9 11: 983-993. doi:10.1111/1753-0407.12514


Author Chung, Hsin-Fang
Al Mamun, Abdullah
Huang, Meng-Chuan
Long, Kurt Z.
Huang, Ya-Fang
Shin, Shyi-Jang
Hwang, Shang-Jyh
Hsu, Chih-Cheng
Title Obesity, weight change, and chronic kidney disease in patients with type 2 diabetes mellitus: a longitudinal study in Taiwan
Journal name Journal of Diabetes   Check publisher's open access policy
ISSN 1753-0407
1753-0393
Publication date 2017-02-05
Year available 2017
Sub-type Article (original research)
DOI 10.1111/1753-0407.12514
Open Access Status Not yet assessed
Volume 9
Issue 11
Start page 983
End page 993
Total pages 11
Place of publication Weinheim, Germany
Publisher Wiley - VCH
Language eng
Abstract 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.
Formatted 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.
Keyword Asian
Chronic kidney disease
Obesity
Type 2 diabetes
Weight change
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID NCT00288678
NSC-102-2628-B-037-008-MY3
KMU-TP103A22
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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