title: Which anthropometric parameter is best related with urinary albumin excretion and creatinine clearance in type 2 diabetes: body mass index, waist circumference, waist-to-hip ratio, or conicity index?
abstract: OBJECTIVE
  We analyzed the relationships between body mass index (BMI), waist circumference (WC), waist-to-hip ratio, and conicity index and 24-hour urinary albumin excretion rate (UAER) and creatinine clearance.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Patients presenting to a state hospital.
  
  
  METHODS
  Study involved patients with type 2 diabetes.
  
  
  METHODS
  Study participants underwent medical history examination, measurement of office blood pressure (BP), measurement of anthropometric factors and calculations (including BMI, WC, waist-to-hip ratio, and conicity index), physical examination, biochemical analysis, and 24-hour urine specimen collection to determine creatinine clearance and UAER.
  
  
  RESULTS
  In all, 202 patients with type 2 diabetes (male/female: 91/111, aged: 58.4 ± 10.1 years) were included. It was found that 24-hour UAER correlated with WC (rho: +0.176, P = .012), serum albumin (rho: -0.324, P < .0001), and systolic BP (rho: +0.153, P = .029), whereas creatinine clearance correlated with age (rho: -0.152, P = .031), BMI (rho: +0.191, P = .007), albumin level (rho: +0.365, P < .0001), and uric acid level (rho: -0.369, P < .0001). The stepwise linear regression analysis revealed that WC (P = .012), glycosylated hemoglobin (P = .018), and systolic BP (P = .043) were found to be independently related to logarithmically converted 24-hour UAER, whereas creatinine clearance was found to be related to duration of diabetes (P = .001), BMI (P = .008), presence of peripheral arterial disease (P = .021), fasting serum glucose level (P = .003), and uric acid level (P < .0001). However, after correction for body surface area, BMI was no longer associated with creatinine clearance.
  
  
  CONCLUSIONS
  Among the anthropometric parameters, only an increase in WC was found to be independently related to 24-hour UAER. Although BMI was associated with creatinine clearance, this association was lost after creatinine clearance was corrected for body surface area.
authors: Department of Nephrology, Zonguldak Atatürk State Hospital, Turkey. afsarbrs@yahoo.com
authors: Baris
authors: B
authors: Afsar
authors: Rengin
authors: R
authors: Elsurer
authors: Ertugrul
authors: E
authors: Güner
authors: Alper
authors: A
authors: Kirkpantur
mesh_terms: D000368:Aged; D000418:Albumins / Q000032:analysis*; D001794:Blood Pressure; D015992:Body Mass Index; D003404:Creatinine / Q000097:blood / Q000652:urine; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000652:urine*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000652:urine; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood; D059349:Urine Specimen Collection; D055105:Waist Circumference; D049629:Waist-Hip Ratio
chemical_list: D000418:Albumins; D003404:Creatinine; D006442:Glycated Hemoglobin; D014527:Uric Acid