title: High body mass index reduces glomerular filtration rate decline in type II diabetes mellitus patients with stage 3 or 4 chronic kidney disease.
abstract: Whether high body mass index (BMI) has an effect on progressive diabetic nephropathy in type II diabetes mellitus (DM) patients with chronic kidney disease (CKD) stage 3 or 4 remains unclear. This prospective study aimed to investigate the relationship between BMI and progression of renal function deterioration in type II DM patients with CKD stage 3 or 4.A total of 105 type II DM patients with CKD stage 3 or 4 participated in this 24-month prospective observational study. Patients were divided into 3 groups according to BMI as follows: normal group, BMI of 18.5-22.9 kg/m; overweight group, BMI of 23-24.9 kg/m; and obese group, BMI of ≥25 kg/m. The primary end point was a 2-fold elevation in serum creatinine levels (measured twice with a 1-month interval) from baseline values, need for long-term dialysis, or death during the 24-month observation period.In the linear regression analysis with the stepwise method, each 1 kg/m increase in BMI led to an increase of 0.32 mL min × 1.73 m in the estimated glomerular filtration rate (95% confidence interval, CI, 0.01-0.62; P = 0.04) during the 24-month study period. Moreover, multivariate Cox regression analysis showed that compared with the obese group, the normal BMI group (hazard ratio = 2.76, 95% CI : 1.27-6; P = 0.01) achieved the primary outcome after adjusting for other factors.In this 24-month prospective observational study, we showed that BMI of ≥25 kg/m was a protective factor for renal function deterioration in type II DM patients with CKD stage 3 or 4.
authors.affiliation: Department of Nephrology and Division of Clinical Toxicology, Chang Gung Memorial Hospital, Linkou Medical Center (WHH, CYC, JLL, DTLT, CWH, THY); and Chang Gung University and School of Medicine (WHH, CYC, JLL, DTLT, CWH, THY), Taoyuan, Taiwan, Republic of China (ROC).
authors.forename: Wen-Hung
authors.initials: WH
authors.lastname: Huang
authors.forename: Chao-Yu
authors.initials: CY
authors.lastname: Chen
authors.forename: Ja-Liang
authors.initials: JL
authors.lastname: Lin
authors.forename: Dan-Tzu
authors.initials: DT
authors.lastname: Lin-Tan
authors.forename: Ching-Wei
authors.initials: CW
authors.lastname: Hsu
authors.forename: Tzung-Hai
authors.initials: TH
authors.lastname: Yen
mesh_terms: D000368:Aged; D015992:Body Mass Index; D003404:Creatinine / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology; D011446:Prospective Studies; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000503:physiopathology* / Q000628:therapy
chemical_list: D003404:Creatinine
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