engleski

Waist to height ratio is independently associated with chronic kidney disease in overweight type 2 diabetic patients

Chronic kidney disease (CKD) i.e. diabetic nephropathy is one of the most serious complications of central obesity-induced type 2 diabetes mellitus (T2DM). Body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) are traditional tools to detect obesity and higher risk of micro- and macrovascular complications in T2DM. Waist-to-height ratio (WhtR) was also recently reported to be associated with CKD in non diabetic patients. The aim of our study to investigate the predictive power of BMI, WC, WHR and WHtR for CKD prevalence in overweight T2DM patients. Study included 125 overweight (BMI≥35 kg/m2) T2DM patients. Basic anthropometric measurements were performed on all study subjects by the same physician. Among the 125 T2DM patients 65 (52%) were male and 60 (48%) female, with median age of 58 years and 36 (29%) with CKD. The results from ROC analysis of the four anthropometric indices for CKD shows that AUCs for WHtR was significantly higher than AUC for WC with respect to nephropathy, while the AUCs for other anthropometric parameters suggest that those predictors are not to be considered as validated tests. In the logistic regression models of the nephropathy in case of an increase of one SD of the respective anthropometric parameter, only WHtR yielded the significant and great OR of 1.69 (CI 1.12-1.89, P<0.05) in association to nephropathy after adjustment for age, gender, disease duration, HbA1c, dyslipidaemia, arterial hypertension and smoking status. Central obesity measured with BMI, WC, WHR and WHtR is associated with CKD in diabetic and nondiabetic population. Our study results indicate that WHtR might be of a greater importance as a risk factor in CKD development than other anthropometric parameters that indicate obesity in overweight T2DM patients. High sensitivity but low specificity of WHtR in predicting CKD is clearly important because it might give a possibility to identify the disease and could be used as a good screening test.

type 2 diabetes; chronic kidney disease; waist to height ratio

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