Diabetes Metab J.  2018 Aug;42(4):330-337. 10.4093/dmj.2017.0052.

Associations between Body Mass Index and Chronic Kidney Disease in Type 2 Diabetes Mellitus Patients: Findings from the Northeast of Thailand

• Zaman SB
• Hossain N
• Rahman M

• KMID: 2418721
• DOI: http://doi.org/10.4093/dmj.2017.0052

Abstract

BACKGROUND
Chronic kidney disease (CKD) has emerged as a public health burden globally. Obesity and long-term hyperglycaemia can initiate the renal vascular complications in patients with type 2 diabetes mellitus (T2DM). This study aimed to investigate the association of body mass index (BMI) with the CKD in patients with T2DM.
METHODS
This study has used retrospective medical records, biochemical reports, and anthropometric measurements of 3,580 T2DM patients which were collected between January to December 2015 from a district hospital in Thailand. CKD was defined according to the measurement of estimated glomerular filtration rate ( < 60 mL/min/1.73 m2). Multiple logistic regression analysis was used to explore the association between BMI and CKD in patients with T2DM.
RESULTS
The mean age of the participants was 60.86±9.67 years, 53.68% had poor glycaemic control, and 45.21% were overweight. About one-in-four (23.26%) T2DM patients had CKD. The mean BMI of non-CKD group was slightly higher (25.30 kg/m2 vs. 24.30 kg/m2) when compared with CKD patients. Multivariable analysis showed that older age, female sex, hypertension, and microalbuminuria were associated with the presence of CKD. No association was observed between CKD and poorly controlled glycosylated hemoglobin or hypercholesterolemia. Adjusted analysis further showed overweight and obesity were negatively associated with CKD (adjusted odds ratio [AOR], 0.73; 95% confidence interval [CI], 0.58 to 0.93) and (AOR, 0.53; 95% CI, 0.35 to 0.81), respectively.
CONCLUSION
The negative association of BMI with CKD could reflect the reverse causality. Lower BMI might not lead a diabetic patient to develop CKD, but there are possibilities that CKD leads the patient to experience reduced BMI.

Keyword

Body mass index; Diabetes mellitus, type 2; Kidney diseases

MeSH Terms

Body Mass Index*
Diabetes Mellitus, Type 2*
Female
Glomerular Filtration Rate
Hemoglobin A, Glycosylated
Hospitals, District
Humans
Hypercholesterolemia
Hypertension
Kidney Diseases
Logistic Models
Medical Records
Obesity
Odds Ratio
Overweight
Public Health
Renal Insufficiency, Chronic*
Retrospective Studies
Thailand*

Figure

• 

  Fig. 1 Distribution of mean body mass index (BMI) values among type 2 diabetes mellitus patients by chronic kidney disease (CKD) status. CKD (−), non-CKD patient; CKD (+), CKD patient. aP<0.05.

• 

  Fig. 2 Distribution of estimated glomerular filtration rate (eGFR) categories (by chronic kidney disease [CKD]) according to body mass index (BMI) classification. T2DM, type 2 diabetes mellitus.

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